<i>Notes from the Field:</i> Fatal <i>Vibrio anguillarum</i> Infection in an Immunocompromised Patient — Maine, 2017

Sinatra, Jennifer; Colby, Kate

doi:10.15585/mmwr.mm6734a5

Cited by 16 publications

(12 citation statements)

References 3 publications

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“…On the other hand, species harboring virulence genes but not known to cause human disease, like V. antiquarius (Dahanayake, De Silva, Hossain, Shin, & Heo, 2018; Nur et al., 2015) and V. fujianensis (Fang et al., 2018), were isolated from water only. V. anguillarum , a well‐known fish pathogen (Ina‐Salwany et al., 2019) rarely associated with serious human infection (Sinatra & Colby, 2018), was only isolated from bivalves.…”

Section: Resultsmentioning

confidence: 99%

Vibrios from the Norwegian marine environment: Characterization of associated antibiotic resistance and virulence genes

et al. 2020

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A total of 116 Vibrio isolates comprising V. alginolyticus (n = 53), V. metschnikovii (n = 38), V. anguillarum (n = 21), V. antiquarius (n = 2), and V. fujianensis (n = 2) were obtained from seawater, fish, or bivalve molluscs from temperate Oceanic and Polar Oceanic area around Norway. Antibiotic sensitivity testing revealed resistance or reduced susceptibility to ampicillin (74%), oxolinic acid (33%), imipenem (21%), aztreonam (19%), and tobramycin (17%). Whole‐genome sequence analysis of eighteen drug‐resistant isolates revealed the presence of genes like β‐lactamases, chloramphenicol‐acetyltransferases, and genes conferring tetracycline and quinolone resistance. The strains also carried virulence genes like hlyA, tlh, rtxA to D and aceA, E and F. The genes for cholerae toxin (ctx), thermostable direct hemolysin (tdh), or zonula occludens toxin (zot) were not detected in any of the isolates. The present study shows low prevalence of multidrug resistance and absence of virulence genes of high global concern among environmental vibrios in Norway. However, in the light of climate change, and projected rising sea surface temperatures, even in the cold temperate areas, there is a need for frequent monitoring of resistance and virulence in vibrios to be prepared for future public health challenges.

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Section: Resultsmentioning

confidence: 99%

Vibrios from the Norwegian marine environment: Characterization of associated antibiotic resistance and virulence genes

et al. 2020

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“…The increasing sea surface temperature will lead to increase Vibrio spp. abundance in coastal waters [129], with potential severe consequences on human health: as a case in point, V. anguillarum resulted already associated with human illness [130]. Overall, the incidence of Vibrio-associated illnesses is increasing worldwide and especially in European countries, where recreational activities (swimming/bathing) are common in coastal areas [131][132][133].…”

Section: Discussionmentioning

confidence: 99%

The Microbial Community Associated with Rhizostoma pulmo: Ecological Significance and Potential Consequences for Marine Organisms and Human Health

et al. 2020

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Jellyfish blooms are frequent and widespread in coastal areas worldwide, often associated with significant ecological and socio-economic consequences. Recent studies have also suggested cnidarian jellyfish may act as vectors of bacterial pathogens. The scyphomedusa Rhizostoma pulmo is an outbreak-forming jellyfish widely occurring across the Mediterranean basin. Using combination of culture-based approaches and a high-throughput amplicon sequencing (HTS), and based on available knowledge on a warm-affinity jellyfish-associated microbiome, we compared the microbial community associated with R. pulmo adult jellyfish in the Gulf of Taranto (Ionian Sea) between summer (July 2016) and winter (February 2017) sampling periods. The jellyfish-associated microbiota was investigated in three distinct compartments, namely umbrella, oral arms, and the mucus secretion. Actinobacteria, Bacteroidetes, Chlamydiae, Cyanobacteria, Deinococcus-Thermus, Firmicutes, Fusobacteria, Planctomycetes, Proteobacteria, Rhodothermaeota, Spirochaetes, Tenericutes, and Thaumarchaeota were the phyla isolated from all the three R. pulmo compartments in the sampling times. In particular, the main genera Mycoplasma and Spiroplasma, belonging to the class Mollicutes (phylum Tenericutes), have been identified in all the three jellyfish compartments. The taxonomic microbial data were coupled with metabolic profiles resulting from the utilization of 31 different carbon sources by the BIOLOG Eco-Plate system. Microorganisms associated with mucus are characterized by great diversity. The counts of culturable heterotrophic bacteria and potential metabolic activities are also remarkable. Results are discussed in terms of R. pulmo ecology, the potential health hazard for marine and human life as well as the potential biotechnological applications related to the associated microbiome.

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“…Virulent isolates of V. anguillarum can replicate inside the insect but antibiotics to which the bacterium is susceptible can be administered to save the host from a lethal inoculum of bacteria [38]. Notably, V. anguillarum was recently reported to be responsible for a lethal human infection [39]. Therefore, this hostpathogen system was selected for application in the present study as a model of systemic Vibrio infection.…”

Section: Introductionmentioning

confidence: 99%

“…Notably, V . anguillarum was recently reported to be responsible for a lethal human infection [ 39 ]. Therefore, this host‒pathogen system was selected for application in the present study as a model of systemic Vibrio infection.…”

Section: Introductionmentioning

confidence: 99%

Optimising efficacy of antibiotics against systemic infection by varying dosage quantities and times

et al. 2020

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Mass production and use of antibiotics has led to the rise of resistant bacteria, a problem possibly exacerbated by inappropriate and non-optimal application. Antibiotic treatment often follows fixed-dose regimens, with a standard dose of antibiotic administered equally spaced in time. But are such fixed-dose regimens optimal or can alternative regimens be designed to increase efficacy? Yet, few mathematical models have aimed to identify optimal treatments based on biological data of infections inside a living host. In addition, assumptions to make the mathematical models analytically tractable limit the search space of possible treatment regimens (e.g. to fixed-dose treatments). Here, we aimed to address these limitations by using experiments in a Galleria mellonella (insect) model of bacterial infection to create a fully parametrised mathematical model of a systemic Vibrio infection. We successfully validated this model with biological experiments, including treatments unseen by the mathematical model. Then, by applying artificial intelligence, this model was used to determine optimal antibiotic dosage regimens to treat the host to maximise survival while minimising total antibiotic used. As expected, host survival increased as total quantity of antibiotic applied during the course of treatment increased. However, many of the optimal regimens tended to follow a large initial 'loading' dose followed by doses of incremental reductions in antibiotic quantity (dose 'tapering'). Moreover, application of the entire antibiotic in a single dose at the start of treatment was never optimal, except when the total quantity of antibiotic was very low. Importantly, the range of optimal regimens identified was broad enough to allow the antibiotic prescriber to choose a regimen based on additional criteria or preferences. Our findings demonstrate the utility of an insect host to model antibiotic therapies in vivo and the approach lays a foundation for future regimen optimisation for patient and societal benefits.

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Notes from the Field: Fatal Vibrio anguillarum Infection in an Immunocompromised Patient — Maine, 2017

Cited by 16 publications

References 3 publications

Vibrios from the Norwegian marine environment: Characterization of associated antibiotic resistance and virulence genes

Vibrios from the Norwegian marine environment: Characterization of associated antibiotic resistance and virulence genes

The Microbial Community Associated with Rhizostoma pulmo: Ecological Significance and Potential Consequences for Marine Organisms and Human Health

Optimising efficacy of antibiotics against systemic infection by varying dosage quantities and times

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