The genetic diversity of Vibrio vulnificus isolates from clinical and environmental sources originating from the Baltic Sea region was evaluated by multilocus sequence typing (MLST), and possible relationships between MLST clusters, potential genotypic and phenotypic traits associated with pathogenicity, and source of isolation were investigated. The studied traits included genotyping of polymorphic loci (16S rRNA, vcg, and pilF), presence/absence of potential virulence genes, including nanA, nab, and genes of pathogenicity regions, metabolic features, hemolytic activity, resistance to human serum, and cytotoxicity to human intestinal cells. MLST generated 35 (27 new) sequence types and divided the 53 isolates (including four reference strains) into two main clusters, with cluster I containing biotype 1 and 2 isolates of mainly environmental origin and cluster II containing biotype 1 isolates of mainly clinical origin. Cluster II isolates were further subdivided into two branches. Branch IIB included isolates from recent cases of wound infections that were acquired at the German Baltic Sea coastline between 2010 and 2011 and isolates from seawater samples of the same regions isolated between 1994 and 2010. Comparing the MLST data with the results of genotyping and phenotyping showed that strains of MLST cluster II possess a number of additional pathogenicity-associated traits compared to cluster I strains. Rapid microbiological methods such as matrix-assisted laser desorption ionization-time of flight (MALDI-TOF) mass spectrometry combined with typing of selected virulence-associated traits (e.g., serum resistance, mannitol fermentation, nanA, and pathogenicity region XII) could be used for risk assessment purposes regarding V. vulnificus strains isolated from the Baltic Sea region.
Vibrio vulnificus is a potent bacterial pathogen present in coastal waters worldwide and is found preferentially in waters with moderate salinity. It can cause serious wound infections with lethal outcome and is also responsible for cases of death caused by consumption of contaminated seafood. In the United States, particularly oysters contaminated with V. vulnificus have been reported to be responsible for deadly infections (1-3). The severity of disease is strongly influenced by the health condition of exposed individuals. Immunocompromised people and persons with underlying diseases resulting in elevated serum iron levels are especially at high risk. In the case of primary septicemia, mortality rates greater than 50% have been reported, and for wound infections, approximately rates of 25% have been reported (4). Environmental factors, such as warm water and moderate salinity, are known to favor the multiplication of the pathogen. Therefore, the effect of global warming on seawater temperatures has aroused concerns that infections caused by V. vulnificus will increase in numbers (5-8). However, despite the frequent occurrence of the pathogen, the number of cases reported is relatively low, indicating that not all strains of V. vuln...