Clinical Characteristics and Molecular Subtyping of<i>Vibrio vulnificus</i>Illnesses, Israel

Zaidenstein, Ronit; Sadik, Chantal; Lerner, Larisa; Valinsky, Lea; Kopelowitz, June; Yishai, Ruth; Agmon, Vered; Parsons, Michele B.; Bopp, Cheryl A.; Weinberger, Miriam

doi:10.3201/eid1412.080499

Cited by 48 publications

(44 citation statements)

References 32 publications

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“…6A). However, BT3 infections are not strongly correlated with underlying infection or high iron content, as 45% of patients have no predisposing conditions (15). In mice not treated with iron dextran, mice also succumbed to infection with BAA87rif in a dose-dependent manner (Fig.…”

Section: Resultsmentioning

confidence: 97%

“…From 1996 to 1999, changes in marketing practices to allow vendors to sell live fish in Israel led to an outbreak of a new lineage of V. vulnificus, resulting in a large number of wound infections associated with the handling and preparation of tilapia and carp (14). These BT3 strains continue to be present in fish ponds and the Sea of Galilee and have caused nearly 200 infections with 10% mortality from 1996 to 2008 (15).…”

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confidence: 99%

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Vibrio vulnificus Biotype 3 Multifunctional Autoprocessing RTX Toxin Is an Adenylate Cyclase Toxin Essential for Virulence in Mice

et al. 2014

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Vibrio vulnificus is an environmental organism that causes both food-borne and wound infections with high morbidity and mortality in humans. The annual incidence and global distribution of infections associated with this pathogen are increasing with climate change. In the late 1990s, an outbreak of tilapia-associated wound infections in Israel was linked to a previously unrecognized variant of V. vulnificus designated biotype 3. The sudden emergence and clonality of the outbreak suggest that this strain may be a true newly emergent pathogen with novel virulence properties compared to those of other V. vulnificus strains. In a subcutaneous infection model to mimic wound infection, the multifunctional autoprocessing RTX (MARTX) toxin of biotype 3 strains was shown to be an essential virulence factor contributing to highly inflammatory skin wounds with severe damage affecting every tissue layer. We conducted a sequencing-based analysis of the MARTX toxin and found that biotype 3 MARTX toxin has an effector domain structure distinct from that of either biotype 1 or biotype 2. Of the two new domains identified, a domain similar to Pseudomonas aeruginosa ExoY was shown to confer adenylate cyclase activity on the MARTX toxin. This is the first demonstration that the biotype 3 MARTX toxin is essential for virulence and that the ExoY-like MARTX effector domain is a catalytically active adenylate cyclase.

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Section: Resultsmentioning

confidence: 97%

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confidence: 99%

Vibrio vulnificus Biotype 3 Multifunctional Autoprocessing RTX Toxin Is an Adenylate Cyclase Toxin Essential for Virulence in Mice

et al. 2014

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“…Despite the abundance of diverse environmental populations of V. vulnificus in Israel (Broza et al, 2009(Broza et al, , 2012, nearly all microbiologically confirmed infections in Israel were caused by the same biotype 3 (sequence type 8 by MLST) (Bisharat et al, 1999(Bisharat et al, , 2005Broza et al, 2009;Zaidenstein et al, 2008). These observations emphasized the virulent potential of biotype 3.…”

Section: Introductionmentioning

confidence: 90%

Transcriptome profiling analysis of Vibrio vulnificus during human infection

et al. 2013

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Vibrio vulnificus is a waterborne pathogen that was responsible for an outbreak of severe softtissue infections among fish farmers and fish consumers in Israel. Several factors have been shown to be associated with virulence. However, the transcriptome profile of the pathogen during human infection has not been determined yet. We compared the transcriptome profile, using RNA sequencing, of a human-pathogenic strain harvested directly from tissue of a patient suffering from severe soft-tissue infection with necrotizing fasciitis, with the same strain and three other environmental strains grown in vitro. The five sequenced libraries were aligned to the reference genomes of V. vulnificus strains CMCP6 and YJ016. Approximately 47.8 to 62.3 million pairedend raw reads were generated from the five runs. Nearly 84 % of the genome was covered by reads from at least one of the five runs, suggesting that nearly 16 % of the genome is not transcribed or is transcribed at low levels. We identified 123 genes that were differentially expressed during the acute phase of infection. Sixty-three genes were mapped to the large chromosome, 47 genes mapped to the small chromosome and 13 genes mapped to the YJ016 plasmid. The 123 genes fell into a variety of functional categories including transcription, signal transduction, cell motility, carbohydrate metabolism, intracellular trafficking and cell envelope biogenesis. Among the genes differentially expressed during human infection we identified genes encoding bacterial toxin (RtxA1) and genes involved in flagellar components, Flp-coding region, GGDEF family protein, iron acquisition system and sialic acid metabolism.

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“…One hundred twelve patients required a single drug (47 with ampicillin-clavulanate, 27 doxycycline, six ceftriaxone). The rest required combined treatment [1].…”

Section: Discussionmentioning

confidence: 99%

“…This is more prevalent in patients with chronic liver disease as well as other immune-compromising states, and is mainly induced by direct injury from the fish backbone while purchasing, cleaning or handling live fish [1].…”

Section: Introductionmentioning

confidence: 99%

Necrotizing Fasciitis Secondary to Vibrio vulnificus

Akhondi

Lopez

2014

J Med Cases

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Clinical Characteristics and Molecular Subtyping ofVibrio vulnificusIllnesses, Israel

Abstract: The genetically distinct biotype 3 has penetrated Israeli freshwaters and is causing severe illness in persons who handle tilapia or carp.

Cited by 48 publications

References 32 publications

Vibrio vulnificus Biotype 3 Multifunctional Autoprocessing RTX Toxin Is an Adenylate Cyclase Toxin Essential for Virulence in Mice

Vibrio vulnificus Biotype 3 Multifunctional Autoprocessing RTX Toxin Is an Adenylate Cyclase Toxin Essential for Virulence in Mice

Transcriptome profiling analysis of Vibrio vulnificus during human infection

Necrotizing Fasciitis Secondary to Vibrio vulnificus

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