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Clinical manifestations and molecular epidemiology ofVibrio vulnificus infections in Denmark

  • A. Dalsgaard
  • N. Frimodt-Møller
  • B. Bruun
  • L. Høi
  • J. L. Larsen
Article

Abstract

The clinical manifestations of and epidemiological data from 11 patients infected withVibrio vulnificus admitted to Danish hospitals during the unusually warm summer of 1994 are reported. All patients contracted the disease after exposure to seawater; however, none had consumed seafood. Four patients developed bacteremia, one of whom subsequently died; nine patients, including the four with bacteremia, exhibited skin manifestations. Four patients contracted the disease while fishing; in at least one case the patient had handled eels. AllVibrio vulnificus strains were highly susceptible to 11 antimicrobial agents tested. Plasmid analysis revealed that 8 of 11 strains carried plasmids. Ribotyping using the enzymeHindIII on the 11 strains showed five different types, two of which comprised four strains each. The present study provides the first clinical and epidemiological data about a series of humanVibrio vulnificus infections from a temperate zone.

Keywords

Internal Medicine Clinical Manifestation Antimicrobial Agent Epidemiological Data Temperate Zone 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Kaysner CA, Abeyta CJ, Wekell MM, De Paola AJ, Stott RF, Leitch JM: Virulent strains ofVibrio vulnificus isolated from estuaries of the United States West Coast. Applied and Environmental Microbiology 1987, 53: 1349–1351.Google Scholar
  2. 2.
    Oliver JD, Warner RA, Cleland DR: Distribution ofV. vulnificus and other lactose fermenting vibrios in the marine environment. Applied and Environmental Microbiology 1983, 45: 985–998.Google Scholar
  3. 3.
    Tamplin M, Rodrick GE, Blake NJ, Cuba T: Isolation and characterization ofVibrio vulnificus from two Florida estuaries. Applied and Environmental Microbiology 1982, 44: 1466–1470.Google Scholar
  4. 4.
    O'Neill KR, Jones SH, Grimes DJ: Seasonal incidence ofVibrio vulnificus in the Great Bay estuary of New Hampshire and Maine. Applied and Environmental Microbiology 1992, 58: 3257–3262.Google Scholar
  5. 5.
    Veenstra J, Rietra PJ, Coster JM, Slaats E, Dirks-Go S: Seasonal variations in the occurrence ofVibrio vulnificus along the Dutch coast. Epidemiology and Infection 1994, 112: 285–290.Google Scholar
  6. 6.
    Tison DL, Nishibuchi M, Greenwood JD, Seidler RJ:Vibrio vulnificus biogroup 2: new biogroup pathogenic for eels. Applied and Environmental Microbiology 1982, 44: 640–646.Google Scholar
  7. 7.
    Biosca EG, Amaro C, Esteve C, Fouz B, Toranzo AE: First record ofVibrio vulnificus biotype 2 from diseased European eels (Anguilla anguilla). Journal of Fish Diseases 1991, 14: 103–109.Google Scholar
  8. 8.
    Levine WC, Griffin PM:Vibrio infections on the Gulf Coast: results of first year of regional surveillance. Journal of Infectious Diseases 1993, 167: 479–483.Google Scholar
  9. 9.
    Chuang YC, Yuan CY, Liu CY, Lan CK, Huang AH:Vibrio vulnificus infection in Taiwan: report of 28 cases and review of clinical manifestations and treatment. Clinical Infectious Diseases 1992, 15: 271–276.Google Scholar
  10. 10.
    Bock T, Christensen N, Eriksen NHR, Winter S, Rygaard H, Jørgensen F: The first fatal case ofVibrio vulnificus in Denmark. Acta Pathologica Microbiologica Immunologica Scandinavica 1994, 102: 874–876.Google Scholar
  11. 11.
    Hansen LN, Sørensen J, Bisgaard AT: Alvorlig systemisk infektion medVibrio vulnificus. Ugeskrift for Laeger 1995, 157: 3202–3204.Google Scholar
  12. 12.
    Kelly MT, Hickman-Brenner FW, Farmer JJ III: Vibrio. In: Balows A, Hausler WJ, Herrmann KL, Isenberg HD, Shadomy HJ (ed): Manual of clinical microbiology. American Society of Microbiology, Washington DC, 1991, p. 384–395.Google Scholar
  13. 13.
    Wright AC, Miceli GA, Landry WL, Christy JB, Watkins WD, Morris JG Jr.: Rapid identification ofVibrio vulnificus on nonselective media with an alkaline phosphataselabeled oligonucleotide probe. Applied and Environmental Microbiology 1993, 59: 541–546.Google Scholar
  14. 14.
    Kado CI, Liu ST: Rapid procedure for detection and isolation of large and small plasmids. Journal of Bacteriology 1981, 145: 1365–1373.Google Scholar
  15. 15.
    Dalsgaard A, Serichantalergs O, Pitarangsi C, Echeverria P: Molecular characterization and antibiotic susceptibility patterns ofVibrio cholerae non-O1. Epidemiology and Infection 1995, 114: 51–63.Google Scholar
  16. 16.
    Rochelle PA, Fry JC, Day MJ, Bale MJ: An accurate method for estimating sizes of small and large plasmids and DNA fragments by gel electrophoresis. Journal of General Applied Microbiology 1985, 132: 53–59.Google Scholar
  17. 17.
    Threlfall EJ, Rowe B, Ferguson JL, Ward LR: Characterization of plasmids conferring resistance to gentamycin and apramycin in strains ofSalmonella typhimurium phage type 204c isolated in Britain. Journal of Hygiene 1986, 97: 419–426.Google Scholar
  18. 18.
    Pedersen K, Larsen JL: rRNA gene restriction patterns ofVibrio anguillarum serogroup O1. Diseases of Aquatic Organisms 1993, 16: 121–126.Google Scholar
  19. 19.
    Dalsgaard A, Echeverria P, Larsen JL, Siebeling R, Serichantalergs O, Huss HH: Application of ribotyping for differentiatingVibrio cholera non-O1 isolates from shrimp farms in Thailand. Applied and Environmental Microbiology 1995, 61: 245–251.Google Scholar
  20. 20.
    National Committee for Clinical Laboratory Standards: Methods for dilution antimicrobial susceptibility tests for bacteria that grow aerobically. Approved standard M7A2. NCCLS, Villanova, PA, 1993.Google Scholar
  21. 21.
    Klontz KC, Lieb S, Schreiber M, Janowski HT, Baldy LM, Gunn RA: Syndromes ofVibrio vulnificus infections. Clinical and epidemiologic features in Florida cases, 1981–1987. Annals of Internal Medicine 1988, 109: 318–323.Google Scholar
  22. 22.
    Hoge CW, Watsky D, Peeler RN, Libonati JP, Israel E, Morris JG: Epidemiology and spectrum ofVibrio infections in a Chesapeake Bay community. Journal of Infectious Diseases 1989, 160: 985–993.Google Scholar
  23. 23.
    Andersen HK:Vibrio vulnificus. Ugeskrift for Laeger 1991, 153: 2361–2362.Google Scholar
  24. 24.
    Veenstra J, Rietra PJ, Stoutenbeek CP, Coster JM, de Gier HH, Dirks-Go S: Infection by an indole-negative variant ofVibrio vulnificus transmitted by eels. Journal of Infectious Diseases 1992, 166: 209–210.Google Scholar
  25. 25.
    Amaro C, Biosca EG, Fouz B, Toranzo AE, Garay E: Role of iron, capsule, and toxins in the pathogenicity ofVibrio vulnificus biotype 2 for mice. Infection and Immunity 1994, 62: 759–763.Google Scholar
  26. 26.
    Stelma GNJ, Reyes AL, Peeler JT, Johnson CH, Spaulding PL: Virulence characteristics of clinical and environmental isolates ofVibrio vulnificus. Applied and Environmental Microbiology 1992, 58: 2776–2782.Google Scholar
  27. 27.
    Tison DL, Kelly MT: Virulence ofVibrio vulnificus strains from marine environments. Applied and Environmental Microbiology 1986, 51: 1004–1006.Google Scholar
  28. 28.
    DePaola A, Capers GM, Alexander D: Densities ofVibrio vulnificus in the intestines of fish from the U.S. Gulf Coast. Applied and Environmental Microbiology 1994, 60: 984–988.Google Scholar
  29. 29.
    Kelly MT: Effect of temperature and salinity onVibrio (Beneckea) vulnificus occurrence in a Gulf Coast environment. Applied and Environmental Microbiology 1982, 44: 820–824.Google Scholar
  30. 30.
    Biosca EG, Llorens H, Garay E, Amaro C: Presence of a capsule inVibrio vulnificus biotype 2 and its relationship to virulence for eels. Infection and Immunity 1993, 61: 1611–1618.Google Scholar
  31. 31.
    Davidson LS, Oliver JD: Plasmid carriage inVibrio vulnificus and other lactose-fermenting marine vibrios. Applied and Environmental Microbiology 1986, 52: 211–213.Google Scholar
  32. 32.
    Fang FC: Use of tetracycline for treatment ofVibrio vulnificus infections. Clinical Infectious Diseases 1992, 15: 1071–1072.Google Scholar

Copyright information

© Springer-Verlag 1996

Authors and Affiliations

  • A. Dalsgaard
    • 1
  • N. Frimodt-Møller
    • 3
  • B. Bruun
    • 3
  • L. Høi
    • 1
  • J. L. Larsen
    • 2
  1. 1.Department of Veterinary MicrobiologyThe Royal Veterinary and Agricultural UniversityFrederiksberg CDenmark
  2. 2.Laboratory of Fish DiseasesThe Royal Veterinary and Agricultural UniversityFrederiksberg CDenmark
  3. 3.Department of Clinical MicrobiologyStatens SeruminstitutCopenhagenDenmark

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