Fatal Sepsis from Vibrio vulnificus in a Hemodialyzed Patient

Stabellini, N; Camerani, A.; Lambertini, D; Rossi, Maria Rita; Bettoli, Vincenzo; Gilli, P

doi:10.1159/000044916

Cited by 12 publications

(11 citation statements)

References 25 publications

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“…Currently, there is no specific guideline that describes a minimum level of V. vulnificus in gulf water that could potentially be hazardous to humans. However, a number of studies have suggested that V. vulnificus can cause wound infections and septicemia, often with fatal consequences, during recreational activities in coastal waters (13,20,36,41,43,45,47,49). Therefore, we felt that it was necessary to demonstrate that the real-time PCR detection method described in this study could potentially be used for detection of this pathogen in gulf water.…”

Section: Discussionmentioning

confidence: 96%

Rapid Detection ofVibrio vulnificusin Shellfish and Gulf of Mexico Water by Real-Time PCR

Panicker

Myers

Bej

2004

Appl Environ Microbiol

163

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In this paper we describe optimization of SYBR Green I-based real-time PCR parameters and testing of a large number of microbial species with vvh-specific oligonucleotide primers to establish a rapid, specific, and sensitive method for detection of Vibrio vulnificus in oyster tissue homogenate and Gulf of Mexico water (gulf water Vibrio vulnificus is a gram-negative halophilic bacterium commonly found in warm coastal waters throughout the world (37, 44). In the United States, this microorganism is indigenous to Gulf of Mexico water (gulf water) and thrives during the warmer months. V. vulnificus is known to cause gastroenteritis and, in some cases, septicemia when it is ingested in raw or poorly cooked oysters (25,26). Infection by V. vulnificus often results in fatal consequences, and the mortality rate is up to 60%, primarily in individuals who are immunocompromised (10,11,17,18,28,31).)Since infection by V. vulnificus is one of the leading causes of seafood-related illnesses in the United States, the Interstate Shellfish Sanitation Conference (ISSC) has proposed that illnesses caused by V. vulnificus due to consumption of shellfish must be reduced by at least 60% by the year 2007 (21). In order to achieve this goal, the ISSC suggests that consumable oysters should not contain more than 3 CFU of V. vulnificus per g of oyster meat (21). Therefore, to meet this objective, a rapid, reliable, and sensitive method for detection of this pathogen is as important as the methods of treatment for reducing the numbers of V. vulnificus in oysters to an acceptable level. Detection of V. vulnificus by conventional biochemical and microbiological culture methods, such as the most-probablenumber method or the use of selective agar media, are timeconsuming and require several days to obtain confirmatory results (42). A genetically based colorimetric colony hybridization method targeting the V. vulnificus-specific hemolysin gene, vvh, has been described previously and has been recommended as an alternative method for detection of this microorganism in shellfish (24,33,52). Although the DNA-DNA colony hybridization method in which the vvh gene segment is used as a probe is reliable and specific for detection of this pathogen, it takes at least 3 days to complete. A conventional PCR method for detection of V. vulnificus and other microbial pathogens in shellfish has also been shown to be effective (8,22). However, this PCR approach requires analysis of the amplified DNA in an agarose gel or by DNA-DNA hybridization to confirm the results, which again is time-consuming and laborious.Recently, introduction of a real-time PCR amplification method in which SYBR Green I fluorescent dye is used has made detection of microbial pathogens such as Legionella (46), Escherichia coli (23), Vibrio parahaemolyticus (7), and Campylobacter (29) rapid and cost-effective and the analysis of results simple. The SYBR Green I fluorescent dye binds to the minor grooves of the amplified DNA during the primer annealing and extension steps of each PCR cyc...

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Section: Discussionmentioning

confidence: 96%

Rapid Detection ofVibrio vulnificusin Shellfish and Gulf of Mexico Water by Real-Time PCR

Panicker

Myers

Bej

2004

Appl Environ Microbiol

163

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“…This is consistent with reports of V. vulnificus infections in other persons in Alabama who had renal disease. Furthermore, there are reports of 2 other patients with chronic renal disease who had V. vulnificus infection [4,9]. One also had transfusion iron overload [9], and the other had hypogammaglobulinemia due to nephrotic syndrome [4].…”

Section: Discussionmentioning

confidence: 99%

“…Persons with chronic renal disease may also have increased susceptibility to Vibrio infection [6,7], but there are few descriptions of such cases [4,8,9]. Here, we describe the occurrence of V. vulnificus infection in a man treated with long-term hemodialysis who also received periodic intravenous infusions of iron sucrose and erythropoietin for management of anemia.…”

mentioning

confidence: 99%

Vibrio vulnificus Infection in a Hemodialysis Patient Receiving Intravenous Iron Therapy

Barton

Coghlan

Reymann

et al. 2003

Clinical Infectious Diseases

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A 73-year-old man treated with long-term hemodialysis, erythropoietin, and intravenous iron sucrose infusions developed Vibrio vulnificus infection after eating raw oysters harvested from the Alabama coast. Five of the 31 persons with cases of V. vulnificus infection reported to the Alabama Department of Public Health (Montgomery) during 1996-2002 (including the patient described here) also had renal disease. Persons with renal disease, especially those treated with long-term hemodialysis and intravenous iron infusions, may have an increased risk of infection with V. vulnificus.

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“…Skin infections, however, can progress to necrotizing fasciitis and require surgical intervention. 7 In immunocompromised hosts, exposure to V vulniJicus is associated with life-threatening primary septicemia, either through the gastrointestinal tract or through wounds. Onset of severe illness with fulminant septicemia is rapid.…”

Section: Discussionmentioning

confidence: 99%

A Case of Fatal Food-borne Septicemia: Can Family Physicians Provide Prevention?

Martin

Wright

Banakarim

2000

The Journal of the American Board of Family Medicine

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Fatal Sepsis from Vibrio vulnificus in a Hemodialyzed Patient

Cited by 12 publications

References 25 publications

Rapid Detection ofVibrio vulnificusin Shellfish and Gulf of Mexico Water by Real-Time PCR

Rapid Detection ofVibrio vulnificusin Shellfish and Gulf of Mexico Water by Real-Time PCR

Vibrio vulnificus Infection in a Hemodialysis Patient Receiving Intravenous Iron Therapy

A Case of Fatal Food-borne Septicemia: Can Family Physicians Provide Prevention?

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