Non-O1, non-O139 Vibrio cholerae bacteremia in an urban academic medical center in the United States

Abstract

Non-O1, non-O139 Vibrio cholerae (NOVC) are genetically diverse strains that are generally non-pathogenic in healthy hosts. In immunocompromised patients or those with liver disease, NOVC have been shown to cause gastroenteritis, wound infections or sepsis and are often associated with high mortality rates. We report a case of a patient with liver cirrhosis and chronic venous insufficiency who was found to have NOVC bacteremia. The patient had recently visited Florida, USA but had no seafood consumption or exposure to aquatic environments. The patient was managed with antimicrobials, with a favorable outcome.

<p>Non-O1, Non-O139 <em>Vibrio cholerae</em> (NOVC) Bacteremia: Case Report and Literature Review, 2015–2019</p>

“…5 NOVC causes gastroenteritis 6 and is related to extraintestinal infections, including skin and wound infections, otitis, bacteremia, biliary tract and urinary tract infections, pneumonia, peritonitis and meningitis. 4,7,8 Statistical analysis of 83 NOVC-infected patients in Taiwan from 2009-2014 showed that gastroenteritis was the most common illness due to NOVC (accounting for 54.2%), followed by biliary tract infection (14.5%) and primary bacteremia (13.3%). 9 Gastroenteritis can be mild to severe for both sporadic and break cases, but the prognosis of all cases is favorable.…”

“…Our review included 23 cases of NOVC bacteremia described in 18 reports from 2015-2019 (Table 2). [1][2][3][4][5]7,[10][11][12][13][14][15][16][17][18][19][20][21] The male-to-female ratio was 3.6:1, and the median age was 56 years. The youngest patient developed this disease at only 3 days of age, and the oldest patient was 83 years old.…”

“…Shanley et al hypothesized that NOVC caused bacteremia by spreading from the small intestine or skin wounds into the blood and lymphatic system. 4 Patients with liver cirrhosis are susceptible to NOVC bacteremia because of increased intestinal permeability, altered iron metabolism, and impaired phagocytosis and complement. 1 Previous studies revealed that several virulence factors were involved in the NOVC pathogenicity and invasiveness.…”

“…Currently, no definitive guidelines exist for treating NOVC bacteremia. 4 Therefore, clinicians should increase their knowledge of NOVC bacteremia to promptly diagnose and treat patients.…”

Cell Death Signaling Pathway Induced by Cholix Toxin, a Cytotoxin and eEF2 ADP-Ribosyltransferase Produced by Vibrio cholerae

“…Vezzuli et al noted an increasing number of case reports showing bacteremia and fatalities involving sepsis and necrotizing fasciitis apart from the diarrhea associated with NOVC strains [ 7 , 12 ]. Patients with liver cirrhosis were found to be susceptible to NOVC bacteremia [ 13 , 14 ].…”