1
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Agyei FK, Scharf B, Duodu S. Vibrio cholerae Bacteremia: An Enigma in Cholera-Endemic African Countries. Trop Med Infect Dis 2024; 9:103. [PMID: 38787036 PMCID: PMC11125774 DOI: 10.3390/tropicalmed9050103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Revised: 03/06/2024] [Accepted: 03/08/2024] [Indexed: 05/25/2024] Open
Abstract
Cholera is highly endemic in many sub-Saharan African countries. The bacterium Vibrio cholerae is responsible for this severe dehydrating diarrheal disease that accounts for over 100,000 deaths each year globally. In recent years, the pathogen has been found to invade intestinal layers and translocate into the bloodstream of humans. The non-toxigenic strains of V. cholerae (non-O1/O139), also known as NOVC, which do not cause epidemic or pandemic cases of cholera, are the major culprits of V. cholerae bacteremia. In non-cholera-endemic regions, clinical reports on NOVC infection have been noted over the past few decades, particularly in Europe and America. Although low-middle-income countries are most susceptible to cholera infections because of challenges with access to clean water and inappropriate sanitation issues, just a few cases of V. cholerae bloodstream infections have been reported. The lack of evidence-based research and surveillance of V. cholerae bacteremia in Africa may have significant clinical implications. This commentary summarizes the existing knowledge on the host risk factors, pathogenesis, and diagnostics of NOVC bacteremia.
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Affiliation(s)
- Foster K. Agyei
- West African Centre for Cell Biology of Infectious Pathogens, University of Ghana, Accra LG54, Ghana;
- Department of Biological Sciences, Virginia Polytechnic Institute and State University, Blacksburg, VA 24061, USA;
| | - Birgit Scharf
- Department of Biological Sciences, Virginia Polytechnic Institute and State University, Blacksburg, VA 24061, USA;
| | - Samuel Duodu
- West African Centre for Cell Biology of Infectious Pathogens, University of Ghana, Accra LG54, Ghana;
- Department of Biochemistry, Cell and Molecular Biology, University of Ghana, Accra LG54, Ghana
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2
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Davidson N, Edwards F, Harris PNA, Laupland KB. Vibrio species bloodstream infections in Queensland, Australia. Intern Med J 2024; 54:157-163. [PMID: 37497569 DOI: 10.1111/imj.16187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 06/28/2023] [Indexed: 07/28/2023]
Abstract
BACKGROUND Vibrio species bloodstream infections have been associated with significant mortality and morbidity. Limited information is available regarding the epidemiology of bloodstream infections because of Vibrio species in the Australian context. AIMS The objective of this study was to define the incidence and risk factors for developing Vibrio species bloodstream infections and compare differences between different species. METHODS All patients with Vibrio spp. isolated from positive blood cultures between 1 January 2000 and 31 December 2019 were identified by the state-wide Pathology Queensland laboratory. Demographics, clinical foci of infections and comorbid conditions were collected in addition to antimicrobial susceptibility results. RESULTS About 100 cases were identified between 2000 and 2019 with an incidence of 1.2 cases/1 million person-years. Seasonal and geographical variation occurred with the highest incidence in the summer months and in the tropical north. Increasing age, male sex and multiple comorbidities were identified as risk factors. Vibrio vulnificus was isolated most frequently and associated with the most severe disease. Overall case fatality was 19%. CONCLUSIONS There is potential for increasing cases of Vibrio species infections globally with ageing populations and climate change. Ongoing clinical awareness is required to ensure optimal patient outcomes.
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Affiliation(s)
- Natalie Davidson
- Department of Microbiology, Pathology Queensland, Brisbane, Queensland, Australia
| | - Felicity Edwards
- Faculty of Health, Queensland University of technology (QUT), Brisbane, Queensland, Australia
| | - Patrick N A Harris
- Department of Microbiology, Pathology Queensland, Brisbane, Queensland, Australia
- Faculty of Medicine, UQ Center for Clinical Research, University of Queensland, Brisbane, Queensland, Australia
| | - Kevin B Laupland
- Faculty of Health, Queensland University of technology (QUT), Brisbane, Queensland, Australia
- Department of Intensive Care Services, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
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3
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Vezzulli L, Baker-Austin C, Kirschner A, Pruzzo C, Martinez-Urtaza J. Global emergence of environmental non-O1/O139 Vibrio cholerae infections linked with climate change: a neglected research field? Environ Microbiol 2020; 22:4342-4355. [PMID: 32337781 DOI: 10.1111/1462-2920.15040] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Accepted: 04/22/2020] [Indexed: 12/20/2022]
Abstract
The bacterium Vibrio cholerae is a natural inhabitant of aquatic ecosystems across the planet. V. cholerae serogroups O1 and O139 are responsible for cholera outbreaks in developing countries accounting for 3-5 million infections worldwide and 28.800-130.000 deaths per year according to the World Health Organization. In contrast, V. cholerae serogroups other than O1 and O139, also designated as V. cholerae non-O1/O139 (NOVC), are not associated with epidemic cholera but can cause other illnesses that may range in severity from mild (e.g. gastroenteritis, otitis, etc.) to life-threatening (e.g. necrotizing fasciitis). Although generally neglected, NOVC-related infections are on the rise and represent one of the most striking examples of emerging human diseases linked to climate change. NOVC strains are also believed to potentially contribute to the emergence of new pathogenic strains including strains with epidemic potential as a direct consequence of genetic exchange mechanisms such as horizontal gene transfer and genetic recombination. Besides general features concerning the biology and ecology of NOVC strains and their associated diseases, this review aims to highlight the most relevant aspects related to the emergence and potential threat posed by NOVC strains under a rapidly changing environmental and climatic scenario.
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Affiliation(s)
- Luigi Vezzulli
- Department of Earth, Environmental and Life Sciences (DISTAV), University of Genoa, Genoa, Italy
| | - Craig Baker-Austin
- Centre for Environment, Fisheries and Aquaculture Science, CEFAS, Weymouth, UK
| | - Alexander Kirschner
- Institute for Hygiene and Applied Immunology - Water Microbiology, Medical University of Vienna, Vienna, Austria.,Division Water Quality and Health, Karl Landsteiner University of Health Sciences, Krems, Austria
| | - Carla Pruzzo
- Department of Earth, Environmental and Life Sciences (DISTAV), University of Genoa, Genoa, Italy
| | - Jaime Martinez-Urtaza
- Centre for Environment, Fisheries and Aquaculture Science, CEFAS, Weymouth, UK.,Department of Genetics and Microbiology, Facultat de Biociéncies, Universitat Autònoma de Barcelona (UAB), 08193 Bellaterra, Barcelona, Spain
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4
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Engel MF, Muijsken MA, Mooi-Kokenberg E, Kuijper EJ, van Westerloo DJ. Vibrio cholerae non-O1 bacteraemia: description of three cases in the Netherlands and a literature review. ACTA ACUST UNITED AC 2017; 21:30197. [PMID: 27104237 DOI: 10.2807/1560-7917.es.2016.21.15.30197] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Accepted: 01/22/2016] [Indexed: 11/20/2022]
Abstract
Vibrio cholerae non-O1 serogroup (VCNO) bacteraemia is a severe condition with a high case-fatality rate. We report three cases diagnosed in the Netherlands, identified during a national microbiological congress, and provide a literature review on VCNO bacteraemia. A search strategy including synonyms for 'VCNO' and 'bacteraemia' was applied to PubMed, Medline, Web of Science and Embase databases. The three cases were reported in elderly male patients after fish consumption and/or surface water contact. The literature search yielded 82 case reports on 90 cases and six case series. Thirty case reports were from Asia (30/90; 33%), concerned males (67/90; 74%), and around one third (38/90; 42%) involved a history of alcohol abuse and/or liver cirrhosis The presenting symptom often was gastroenteritis (47/90; 52%) which occurred after seafood consumption in 32% of the cases (15/47).Aside from the most frequent symptom being fever, results of case series concurred with these findings. Published cases also included rare presentations e.g. endophthalmitis and neonatal meningitis. Based on the limited data available, cephalosporins seemed the most effective treatment. Although mainly reported in Asia, VCNO bacteraemia occurs worldwide. While some risk factors for VCNO were identified in this study, the source of infection remains often unclear. Clinical presentation may vary greatly and therefore a quick microbiological diagnosis is indispensable.
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Affiliation(s)
- Madelon F Engel
- Medical Microbiology Department, Leiden University Medical Centre, Leiden, the Netherlands
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5
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Ali MK, Kim RY, Karim R, Mayall JR, Martin KL, Shahandeh A, Abbasian F, Starkey MR, Loustaud-Ratti V, Johnstone D, Milward EA, Hansbro PM, Horvat JC. Role of iron in the pathogenesis of respiratory disease. Int J Biochem Cell Biol 2017; 88:181-195. [PMID: 28495571 DOI: 10.1016/j.biocel.2017.05.003] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Revised: 05/01/2017] [Accepted: 05/03/2017] [Indexed: 12/13/2022]
Abstract
Iron is essential for many biological processes, however, too much or too little iron can result in a wide variety of pathological consequences, depending on the organ system, tissue or cell type affected. In order to reduce pathogenesis, iron levels are tightly controlled in throughout the body by regulatory systems that control iron absorption, systemic transport and cellular uptake and storage. Altered iron levels and/or dysregulated homeostasis have been associated with several lung diseases, including chronic obstructive pulmonary disease, lung cancer, cystic fibrosis, idiopathic pulmonary fibrosis and asthma. However, the mechanisms that underpin these associations and whether iron plays a key role in the pathogenesis of lung disease are yet to be fully elucidated. Furthermore, in order to survive and replicate, pathogenic micro-organisms have evolved strategies to source host iron, including freeing iron from cells and proteins that store and transport iron. To counter these microbial strategies, mammals have evolved immune-mediated defence mechanisms that reduce iron availability to pathogens. This interplay between iron, infection and immunity has important ramifications for the pathogenesis and management of human respiratory infections and diseases. An increased understanding of the role that iron plays in the pathogenesis of lung disease and respiratory infections may help inform novel therapeutic strategies. Here we review the clinical and experimental evidence that highlights the potential importance of iron in respiratory diseases and infections.
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Affiliation(s)
- Md Khadem Ali
- School of Biomedical Sciences and Pharmacy, Faculty of Health and Medicine, The University of Newcastle, Callaghan NSW 2308, Australia
| | - Richard Y Kim
- School of Biomedical Sciences and Pharmacy, Faculty of Health and Medicine, The University of Newcastle, Callaghan NSW 2308, Australia
| | - Rafia Karim
- School of Biomedical Sciences and Pharmacy, Faculty of Health and Medicine, The University of Newcastle, Callaghan NSW 2308, Australia
| | - Jemma R Mayall
- School of Biomedical Sciences and Pharmacy, Faculty of Health and Medicine, The University of Newcastle, Callaghan NSW 2308, Australia
| | - Kristy L Martin
- School of Biomedical Sciences and Pharmacy, Faculty of Health and Medicine, The University of Newcastle, Callaghan NSW 2308, Australia
| | - Ali Shahandeh
- School of Biomedical Sciences and Pharmacy, Faculty of Health and Medicine, The University of Newcastle, Callaghan NSW 2308, Australia
| | - Firouz Abbasian
- Global Centre for Environmental Remediation, Faculty of Science, the University of Newcastle, Callaghan, NSW 2308, Australia
| | - Malcolm R Starkey
- School of Biomedical Sciences and Pharmacy, Faculty of Health and Medicine, The University of Newcastle, Callaghan NSW 2308, Australia
| | | | - Daniel Johnstone
- Bosch Institute and Discipline of Physiology, The University of Sydney, Sydney NSW 2000, Australia
| | - Elizabeth A Milward
- School of Biomedical Sciences and Pharmacy, Faculty of Health and Medicine, The University of Newcastle, Callaghan NSW 2308, Australia
| | - Philip M Hansbro
- School of Biomedical Sciences and Pharmacy, Faculty of Health and Medicine, The University of Newcastle, Callaghan NSW 2308, Australia
| | - Jay C Horvat
- School of Biomedical Sciences and Pharmacy, Faculty of Health and Medicine, The University of Newcastle, Callaghan NSW 2308, Australia.
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Bastos P, Trindade F, da Costa J, Ferreira R, Vitorino R. Human Antimicrobial Peptides in Bodily Fluids: Current Knowledge and Therapeutic Perspectives in the Postantibiotic Era. Med Res Rev 2017; 38:101-146. [PMID: 28094448 PMCID: PMC7168463 DOI: 10.1002/med.21435] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Revised: 11/04/2016] [Accepted: 11/14/2016] [Indexed: 12/12/2022]
Abstract
Antimicrobial peptides (AMPs) are an integral part of the innate immune defense mechanism of many organisms. Due to the alarming increase of resistance to antimicrobial therapeutics, a growing interest in alternative antimicrobial agents has led to the exploitation of AMPs, both synthetic and isolated from natural sources. Thus, many peptide-based drugs have been the focus of increasing attention by many researchers not only in identifying novel AMPs, but in defining mechanisms of antimicrobial peptide activity as well. Herein, we review the available strategies for the identification of AMPs in human body fluids and their mechanism(s) of action. In addition, an overview of the distribution of AMPs across different human body fluids is provided, as well as its relation with microorganisms and infectious conditions.
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Affiliation(s)
- Paulo Bastos
- Department of Medical Sciences, iBiMED-Institute for Research in Biomedicine, University of Aveiro, Aveiro, Portugal
| | - Fábio Trindade
- Department of Medical Sciences, iBiMED-Institute for Research in Biomedicine, University of Aveiro, Aveiro, Portugal.,Unidade de Investigação Cardiovascular, Departamento de Cirurgia e Fisiologia, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
| | - João da Costa
- Department of Chemistry, CESAM, University of Aveiro, Aveiro, Portugal
| | - Rita Ferreira
- Department of Chemistry, QOPNA, Mass Spectrometry Center, University of Aveiro, Aveiro, Portugal
| | - Rui Vitorino
- Department of Medical Sciences, iBiMED-Institute for Research in Biomedicine, University of Aveiro, Aveiro, Portugal.,Unidade de Investigação Cardiovascular, Departamento de Cirurgia e Fisiologia, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
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7
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Payne SM, Mey AR, Wyckoff EE. Vibrio Iron Transport: Evolutionary Adaptation to Life in Multiple Environments. Microbiol Mol Biol Rev 2016; 80:69-90. [PMID: 26658001 PMCID: PMC4711184 DOI: 10.1128/mmbr.00046-15] [Citation(s) in RCA: 76] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Iron is an essential element for Vibrio spp., but the acquisition of iron is complicated by its tendency to form insoluble ferric complexes in nature and its association with high-affinity iron-binding proteins in the host. Vibrios occupy a variety of different niches, and each of these niches presents particular challenges for acquiring sufficient iron. Vibrio species have evolved a wide array of iron transport systems that allow the bacteria to compete for this essential element in each of its habitats. These systems include the secretion and uptake of high-affinity iron-binding compounds (siderophores) as well as transport systems for iron bound to host complexes. Transporters for ferric and ferrous iron not complexed to siderophores are also common to Vibrio species. Some of the genes encoding these systems show evidence of horizontal transmission, and the ability to acquire and incorporate additional iron transport systems may have allowed Vibrio species to more rapidly adapt to new environmental niches. While too little iron prevents growth of the bacteria, too much can be lethal. The appropriate balance is maintained in vibrios through complex regulatory networks involving transcriptional repressors and activators and small RNAs (sRNAs) that act posttranscriptionally. Examination of the number and variety of iron transport systems found in Vibrio spp. offers insights into how this group of bacteria has adapted to such a wide range of habitats.
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Affiliation(s)
- Shelley M Payne
- Department of Molecular Biosciences, University of Texas at Austin, Austin, Texas, USA
| | - Alexandra R Mey
- Department of Molecular Biosciences, University of Texas at Austin, Austin, Texas, USA
| | - Elizabeth E Wyckoff
- Department of Molecular Biosciences, University of Texas at Austin, Austin, Texas, USA
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8
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Maraki S, Christidou A, Anastasaki M, Scoulica E. Non-O1, non-O139 Vibrio cholerae bacteremic skin and soft tissue infections. Infect Dis (Lond) 2015; 48:171-6. [PMID: 26503346 DOI: 10.3109/23744235.2015.1104720] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Non-O1, non-O139 Vibrio cholerae can cause sporadic cases of gastroenteritis and extra-intestinal invasive infections, following exposure to contaminated seawater or freshwater or after consumption of raw seafood. Bacteremic infections with skin and soft tissue manifestations are uncommon and in most cases are associated with liver cirrhosis, haematologic malignancies, diabetes mellitus and other immunosuppressed conditions. METHODS The medical literature was reviewed and we found 47 published cases of non-O1, non-O139 Vibrio cholerae bacteremic skin and soft tissue infections. A fatal case of bacteremia with bullous cellulitis in a 43-year-old patient with liver cirrhosis is described, which is the first reported in Greece. RESULTS From January 1974 to May 2015, a total of 48 patients with non-O1, non-O139 Vibrio cholerae bacteremia with skin and soft tissue infections were reported. Males predominated. Liver cirrhosis, chronic liver disease and alcohol abuse were common comorbidities. The soft tissue lesions most commonly described were localised cellulitis, with or without bullous and haemorrhagic lesions (66.7%), while necrotising fasciitis was more rare (29.2%). Of the 48 patients with non-O1, non-O139 V. cholerae bacteremic skin and soft tissue infections, 20 (41.7%) died despite treatment. CONCLUSION Although rarely encountered, non-O1, non-O139 Vibrio cholerae should be included in the differential diagnosis of bacteremic skin and soft tissue infections in patients with underlying illnesses and epidemiologic risk factors. Timely and appropriate antibiotic and surgical treatments are important in the management of the infection.
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Affiliation(s)
- Sofia Maraki
- a Department of Clinical Microbiology , Parasitology, Zoonoses and Geographical Medicine
| | - Athanasia Christidou
- a Department of Clinical Microbiology , Parasitology, Zoonoses and Geographical Medicine
| | - Maria Anastasaki
- b Intensive Care Medicine Department , University Hospital of Heraklion , Crete , Greece
| | - Efstathia Scoulica
- c Laboratory of Clinical Bacteriology and Molecular Microbiology , School of Medicine, University of Crete , Heraklion , Crete , Greece
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9
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Deshayes S, Daurel C, Cattoir V, Parienti JJ, Quilici ML, de La Blanchardière A. Non-O1, non-O139 Vibrio cholerae bacteraemia: case report and literature review. SPRINGERPLUS 2015; 4:575. [PMID: 26543710 PMCID: PMC4627963 DOI: 10.1186/s40064-015-1346-3] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/10/2015] [Accepted: 09/16/2015] [Indexed: 01/12/2023]
Abstract
Non-O1, non-O139 Vibrio cholerae (NOVC) are increasingly frequently observed ubiquitous microorganisms occasionally responsible for intestinal and extra-intestinal infections. Most cases involve self-limiting gastroenteritis or ear and wound infections in immunocompetent patients. Bacteraemia, which have been described in patients with predisposing factors, are rare and poorly known, both on the clinical and therapeutic aspects. We describe a case of NOVC bacteraemia and a systematic literature review in PubMed conducted up to November 2014 using a combination of the following search terms: “Vibrio cholerae non-O1” and “bacter(a)emia”. The case was a 70 year-old healthy male subject returning from Senegal and suffering from NOVC bacteraemia associated with liver abscesses. Disease evolution was favourable after 2 months’ therapy (ceftriaxone then ciprofloxacin). Three hundred and fifty cases of NOVC bacteraemia have been identified in the literature. The majority of patients were male (77 %), with a median age of 56 years and presenting with predisposing conditions (96 %), such as cirrhosis (55 %) or malignant disease (20 %). Diarrhoea was inconstant (42 %). Mortality was 33 %. The source of infection, identified in only 25 % of cases, was seafood consumption (54 %) or contaminated water (30 %). Practitioners should be aware of these infections, in order to warn patients with predisposing conditions, on the risk of ingesting raw or undercooked seafood or bathing in potentially infected waters.
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Affiliation(s)
- S Deshayes
- Service des Maladies Infectieuses et Tropicales, CHU Côte de Nacre, avenue Côte de Nacre, 14033 Caen Cedex 9, France
| | - C Daurel
- Service de Microbiologie, CHU Côte de Nacre, avenue Côte de Nacre, 14033 Caen Cedex 9, France
| | - V Cattoir
- Service de Microbiologie, CHU Côte de Nacre, avenue Côte de Nacre, 14033 Caen Cedex 9, France
| | - J-J Parienti
- Service des Maladies Infectieuses et Tropicales, CHU Côte de Nacre, avenue Côte de Nacre, 14033 Caen Cedex 9, France ; Unité de Biostatistiques, CHU Côte de Nacre, avenue Côte de Nacre, 14033 Caen Cedex 9, France
| | - M-L Quilici
- Centre National de Référence des Vibrions et du Choléra, Institut Pasteur, 28 rue du Docteur Roux, 75724 Paris Cedex 15, France
| | - A de La Blanchardière
- Service des Maladies Infectieuses et Tropicales, CHU Côte de Nacre, avenue Côte de Nacre, 14033 Caen Cedex 9, France
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Rare Strain of Vibrio cholerae Septicemia in a Patient with Multiple Myeloma. Case Rep Crit Care 2015; 2015:596906. [PMID: 26257967 PMCID: PMC4518176 DOI: 10.1155/2015/596906] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2015] [Revised: 06/18/2015] [Accepted: 06/25/2015] [Indexed: 10/24/2022] Open
Abstract
Introduction. Non-O1/non-O139 is a rare strain of Vibrio cholera that has been documented to cause significant morbidity and mortality in the immunosuppressed population. Case Presentation. A patient with multiple myeloma develops non-O1/non-O139 Vibrio cholera septicemia, leading to multiorgan failure and ultimately death. Discussion. An exceedingly rare strain of Vibrio cholera, non-O1/non-O139, may be an important factor of morbidity and mortality in certain immunosuppressed populations, such as patients with multiple myeloma and malignancies. Conclusion. Bacteremia involving generally noninvasive microbes, such as non-O1/non-O139 Vibrio cholerae, can have significant deleterious effects in the immunosuppressed patients as shown by this case report. Physicians need to be more diligent when treating these patients.
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11
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Kell D, Potgieter M, Pretorius E. Individuality, phenotypic differentiation, dormancy and 'persistence' in culturable bacterial systems: commonalities shared by environmental, laboratory, and clinical microbiology. F1000Res 2015; 4:179. [PMID: 26629334 PMCID: PMC4642849 DOI: 10.12688/f1000research.6709.2] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/04/2015] [Indexed: 01/28/2023] Open
Abstract
For bacteria, replication mainly involves growth by binary fission. However, in a very great many natural environments there are examples of phenotypically dormant, non-growing cells that do not replicate immediately and that are phenotypically 'nonculturable' on media that normally admit their growth. They thereby evade detection by conventional culture-based methods. Such dormant cells may also be observed in laboratory cultures and in clinical microbiology. They are usually more tolerant to stresses such as antibiotics, and in clinical microbiology they are typically referred to as 'persisters'. Bacterial cultures necessarily share a great deal of relatedness, and inclusive fitness theory implies that there are conceptual evolutionary advantages in trading a variation in growth rate against its mean, equivalent to hedging one's bets. There is much evidence that bacteria exploit this strategy widely. We here bring together data that show the commonality of these phenomena across environmental, laboratory and clinical microbiology. Considerable evidence, using methods similar to those common in environmental microbiology, now suggests that many supposedly non-communicable, chronic and inflammatory diseases are exacerbated (if not indeed largely caused) by the presence of dormant or persistent bacteria (the ability of whose components to cause inflammation is well known). This dormancy (and resuscitation therefrom) often reflects the extent of the availability of free iron. Together, these phenomena can provide a ready explanation for the continuing inflammation common to such chronic diseases and its correlation with iron dysregulation. This implies that measures designed to assess and to inhibit or remove such organisms (or their access to iron) might be of much therapeutic benefit.
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Affiliation(s)
- Douglas Kell
- School of Chemistry and The Manchester Institute of Biotechnology, The University of Manchester, Manchester, Lancashire, M1 7DN, UK
| | - Marnie Potgieter
- Department of Physiology, Faculty of Health Sciences, University of Pretoria, Arcadia, 0007, South Africa
| | - Etheresia Pretorius
- Department of Physiology, Faculty of Health Sciences, University of Pretoria, Arcadia, 0007, South Africa
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12
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Kell D, Potgieter M, Pretorius E. Individuality, phenotypic differentiation, dormancy and 'persistence' in culturable bacterial systems: commonalities shared by environmental, laboratory, and clinical microbiology. F1000Res 2015; 4:179. [PMID: 26629334 DOI: 10.12688/f1000research.6709.1] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/29/2015] [Indexed: 01/28/2023] Open
Abstract
For bacteria, replication mainly involves growth by binary fission. However, in a very great many natural environments there are examples of phenotypically dormant, non-growing cells that do not replicate immediately and that are phenotypically 'nonculturable' on media that normally admit their growth. They thereby evade detection by conventional culture-based methods. Such dormant cells may also be observed in laboratory cultures and in clinical microbiology. They are usually more tolerant to stresses such as antibiotics, and in clinical microbiology they are typically referred to as 'persisters'. Bacterial cultures necessarily share a great deal of relatedness, and inclusive fitness theory implies that there are conceptual evolutionary advantages in trading a variation in growth rate against its mean, equivalent to hedging one's bets. There is much evidence that bacteria exploit this strategy widely. We here bring together data that show the commonality of these phenomena across environmental, laboratory and clinical microbiology. Considerable evidence, using methods similar to those common in environmental microbiology, now suggests that many supposedly non-communicable, chronic and inflammatory diseases are exacerbated (if not indeed largely caused) by the presence of dormant or persistent bacteria (the ability of whose components to cause inflammation is well known). This dormancy (and resuscitation therefrom) often reflects the extent of the availability of free iron. Together, these phenomena can provide a ready explanation for the continuing inflammation common to such chronic diseases and its correlation with iron dysregulation. This implies that measures designed to assess and to inhibit or remove such organisms (or their access to iron) might be of much therapeutic benefit.
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Affiliation(s)
- Douglas Kell
- School of Chemistry and The Manchester Institute of Biotechnology, The University of Manchester, Manchester, Lancashire, M1 7DN, UK
| | - Marnie Potgieter
- Department of Physiology, Faculty of Health Sciences, University of Pretoria, Arcadia, 0007, South Africa
| | - Etheresia Pretorius
- Department of Physiology, Faculty of Health Sciences, University of Pretoria, Arcadia, 0007, South Africa
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13
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Trubiano JA, Lee JYH, Valcanis M, Gregory J, Sutton BA, Holmes NE. Non-O1, non-O139 Vibrio cholerae bacteraemia in an Australian population. Intern Med J 2015; 44:508-11. [PMID: 24816311 DOI: 10.1111/imj.12409] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2013] [Accepted: 12/16/2013] [Indexed: 11/27/2022]
Abstract
This retrospective case series identifies the largest cohort of non-O1, non-O139 Vibrio cholerae bacteraemia in an Australian population from 2000 to 2013. We examine the risk factors, epidemiology, clinical presentations and mortality of non-O1, non-O139 V. cholerae bacteraemia in Victoria and compare them with published cases in the literature. This case series highlights the pathogenic potential of non-O1, non-O139 V. cholerae and identifies possible associations with host (underlying chronic liver disease and malignancy) and environmental factors (contaminated water supply and raw seafood). Clinicians should be aware of the morbidity and mortality associated with invasive non-O1, non-O139 V. cholerae infections, particularly in immunocompromised patients.
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Affiliation(s)
- J A Trubiano
- Department of Infectious Diseases, Austin Health, Melbourne, Victoria, Australia; Communicable Disease Prevention and Control Section, Health Protection Branch, Victorian Government Department of Health, Melbourne, Victoria, Australia
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Akoachere JFTK, Mbuntcha CKP. Water sources as reservoirs of Vibrio cholerae O1 and non-O1 strains in Bepanda, Douala (Cameroon): relationship between isolation and physico-chemical factors. BMC Infect Dis 2014; 14:421. [PMID: 25073409 PMCID: PMC4131033 DOI: 10.1186/1471-2334-14-421] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2013] [Accepted: 07/11/2014] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Cholera has been endemic in Douala since 1971. Most outbreaks start from Bepanda, an overcrowded neighbourhood with poor hygiene and sanitary conditions. We investigated water sources in Bepanda as reservoirs of Vibrio cholerae, the causative agent of cholera, determined its antibiotic susceptibility and some physico-chemical characteristics that could maintain the endemicity of this organism in Bepanda. METHODS Three hundred and eighteen water samples collected from 45 wells, 8 taps and 1 stream from February to July 2009 were analyzed for V. cholerae using standard methods. Isolates were characterized morphologically, biochemically and serologically. The disc diffusion technique was employed to investigate antibiotic susceptibility. Differences in prevalence of organism between seasons were analysed. Correlation strength and direction of association between physico-chemical parameters and occurrence of V. cholerae was analyzed using the Kendall tau_b non-parametric correlation. This was further confirmed with the forward-stepwise binary logistic regression. RESULTS Eighty-seven (27.4%) samples were positive for V. cholerae. Isolation was highest from wells. The organism was isolated in the rainy season and dry season but the frequency of isolation was significantly higher (χ2 = 7.009, df = 1, P = 0.008) in the rainy season. Of the 96 confirmed V. cholerae isolates, 32 (33.3%) belonged to serogroup O1 and 64 (66.6%) were serogroup non-O1/non-O139. Isolates from tap (municipal water) were non-O1/non-O139 strains. Salinity had a significant positive correlation with isolation in the dry season (+0.267, P = 0.015) and rainy season (+0.223, P = 0.028). The forward-stepwise method of binary logistic regression indicated that as pH (Wald = 11.753, df = 1), P = 0.001) increased, odds of isolation of V. cholerae also increased (B = 1.297, S.E = 0.378, Exp(B) = 3.657). All isolates were sensitive to ciprofloxacin and ofloxacin. Multi-drug resistance was predominant among the non-O1/non-O139 isolates. CONCLUSION V. cholerae was found in wells and stream in both seasons. Cholera will continue to be a health threat in Bepanda if intervention measures to prevent outbreak are not implemented. Continuous monitoring of water sources in this and other cholera high-risk areas in Cameroon is necessary, for a better preparedness and control of cholera.
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Affiliation(s)
- Jane-Francis Tatah Kihla Akoachere
- />Department of Microbiology and Parasitology, Faculty of Science, University of Buea, Buea, Cameroon
- />Laboratory for Emerging Infectious Diseases, Faculty of Science, University of Buea, Buea, Cameroon
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15
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Abstract
The proliferative capability of many invasive pathogens is limited by the bioavailability of iron. Pathogens have thus developed strategies to obtain iron from their host organisms. In turn, host defense strategies have evolved to sequester iron from invasive pathogens. This review explores the mechanisms employed by bacterial pathogens to gain access to host iron sources, the role of iron in bacterial virulence, and iron-related genes required for the establishment or maintenance of infection. Host defenses to limit iron availability for bacterial growth during the acute-phase response and the consequences of iron overload conditions on susceptibility to bacterial infection are also examined. The evidence summarized herein demonstrates the importance of iron bioavailability in influencing the risk of infection and the ability of the host to clear the pathogen.
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Khan S, Kumar A, Meparambu D, Thomas S, Harichandran D, Karim S. Fatal non-O1, non-O139 Vibrio cholerae septicaemia in a patient with chronic liver disease. J Med Microbiol 2013; 62:917-921. [DOI: 10.1099/jmm.0.049296-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
A 49-year-old male with underlying liver disease presented with fever and signs of sepsis. Non-O1/non-O139 Vibrio cholerae was isolated from his blood culture, which was positive for the hlyA and toxR genes. We report this fatal case of non-O1/non-O139 V. cholera sepsis and review the literature on non-O1/non-O139 V. cholerae sepsis in patients with chronic liver disease.
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Affiliation(s)
- Sadia Khan
- Department of Microbiology, Amrita Institute of Medical Sciences, Ponekara, Kochi-682041, Kerala, India
| | - Anil Kumar
- Department of Microbiology, Amrita Institute of Medical Sciences, Ponekara, Kochi-682041, Kerala, India
| | - Divya Meparambu
- Cholera and Environmental Biology Laboratory, Dept of Molecular Microbiology Rajiv Gandhi Center for Biotechnology Trivandrum, Kerala, India
| | - Sabu Thomas
- Cholera and Environmental Biology Laboratory, Dept of Molecular Microbiology Rajiv Gandhi Center for Biotechnology Trivandrum, Kerala, India
| | - Deepa Harichandran
- Department of Microbiology, Amrita Institute of Medical Sciences, Ponekara, Kochi-682041, Kerala, India
| | - Shamsul Karim
- Department of Microbiology, Amrita Institute of Medical Sciences, Ponekara, Kochi-682041, Kerala, India
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17
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Lim TS, Ji AY, Lee JH, Chang S, Kim IS, Kim YJ, Kim BK, Kim SU, Park JY, Ahn SH, Han KH, Kim DY. Non-O1, Non-O139Vibrio choleraeSepticemia after Acupuncture. EWHA MEDICAL JOURNAL 2013. [DOI: 10.12771/emj.2013.36.s.s22] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Tae Seop Lim
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Ah-Young Ji
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Jung-Hee Lee
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Sooyun Chang
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - In-Soo Kim
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Young Ju Kim
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Beom Kyung Kim
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Seung Up Kim
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Jun Yong Park
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Sang Hoon Ahn
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Kwang-Hyub Han
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Do Young Kim
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
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Lower limb cellulitis and its mimics. J Am Acad Dermatol 2012; 67:163.e1-12; quiz 175-6. [DOI: 10.1016/j.jaad.2012.03.024] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2011] [Revised: 03/28/2012] [Accepted: 03/29/2012] [Indexed: 12/17/2022]
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Aguinaga A, Portillo ME, Yuste JR, del Pozo JL, García-Tutor E, Pérez-Gracia JL, Leiva J. Non-O1 Vibrio cholerae inguinal skin and soft tissue infection with bullous skin lesions in a patient with a penis squamous cell carcinoma. Ann Clin Microbiol Antimicrob 2009; 8:17. [PMID: 19454006 PMCID: PMC2691727 DOI: 10.1186/1476-0711-8-17] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2009] [Accepted: 05/19/2009] [Indexed: 01/22/2023] Open
Abstract
Vibrio spp. is a pathogen rarely isolated in cancer patients, and in most cases it is associated with haematological diseases. Cutaneous manifestations of this organism are even rarer. We report a case of Non-O1 Vibrio cholerae inguinal skin and soft tissue infection presenting bullous skin lesions in a young type II diabetic patient with a penis squamous cell carcinoma having a seawater exposure history.
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Affiliation(s)
- Aitziber Aguinaga
- Department of Clinical Microbiology, University Hospital of Navarra, Pamplona, Spain.
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20
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Necrotizing soft-tissue infections and primary sepsis caused by Vibrio vulnificus and Vibrio cholerae non-O1. ACTA ACUST UNITED AC 2009; 66:899-905. [PMID: 19276771 DOI: 10.1097/ta.0b013e31816a9ed3] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Vibrio species are a rare cause of necrotizing soft-tissue infections and primary septicemia, which are likely to occur in patients with hepatic disease, diabetes, adrenal insufficiency, and immunocompromised conditions. These organisms thrive in warm seawater and are often present in raw oysters, shellfish, and other seafood. This study examined fulminating clinical characteristics of Vibrio vulnificus and Vibrio cholerae non-O1 soft-tissue infections and identified outcome predictors. MATERIALS Thirty patients with necrotizing fasciitis and sepsis caused by Vibrio species were retrospectively reviewed. Twenty-eight patients had a history of contact with seawater or raw seafood. Eight patients had hepatic disease such as hepatitis or liver cirrhosis, and seven patients had diabetes mellitus. Nine patients had hepatic dysfunction combined with diabetes mellitus. Microbiology laboratory culture studies confirmed V. vulnificus in 23 patients and V. cholerae non-O1 in seven patients. RESULTS Surgical debridement or immediate limb amputation was initially performed in all patients with necrotizing soft-tissue infections. Eleven patients (37%) died within several days of admission and 19 survived. The mortality of V. cholerae non-O1 group (57%) is higher than that of the V. vulnificus group (30%). A significantly higher mortality rate was noted in patients with initial presentations of a systolic blood pressure of < or =90 mm Hg, leukopenia, decreased platelet counts, and a combination of hepatic dysfunction and diabetes mellitus. CONCLUSIONS Vibrio necrotizing soft-tissue infections should be suspected in patients with appropriate clinical findings and history of contact with seawater or seafood. V. cholerae non-O1 may cause bacteremia more often than V. vulnificus in patients with liver cirrhosis. Early fasciotomy and culture-directed antimicrobial therapy are aggressively recommended in patients with hypotensive shock, leukopenia, high band forms of white blood cells, decreased platelet counts, severe hypoalbuminemia, and underlying chronic illness, such as hepatic dysfunction and diabetes mellitus.
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Phetsouvanh R, Nakatsu M, Arakawa E, Davong V, Vongsouvath M, Lattana O, Moore CE, Nakamura S, Newton PN. Fatal bacteremia due to immotile Vibrio cholerae serogroup O21 in Vientiane, Laos - a case report. Ann Clin Microbiol Antimicrob 2008; 7:10. [PMID: 18439249 PMCID: PMC2373308 DOI: 10.1186/1476-0711-7-10] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2007] [Accepted: 04/25/2008] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Human infections with non-O1, non-O139 V. cholerae have been described from Laos. Elsewhere, non cholera-toxin producing, non-O1, non-O139 V. cholerae have been described from blood cultures and ascitic fluid, although they are exceedingly rare isolates. CASE PRESENTATION We describe a farmer who died with Vibrio cholerae O21 bacteremia and peritonitis in Vientiane, Laos, after eating partially cooked apple snails (Pomacea canaliculata) and mussels (Ligumia species). The cultured V. cholerae were non-motile. PCR detected ompW and toxR gene regions but not the ctxA, ompU, omp K and TCP gene regions. Although the organisms lacked flagellae on scanning electron microscopy, they possessed the Vibrio flagellin flaA gene. CONCLUSION Severe bacteremic non-O1, non-O139 V. cholerae is reported from Laos. The organisms were unusual in being non-motile. They possessed the Vibrio flagellin flaA gene. Further research to determine the reasons for the non-motility and virulence is required.
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Affiliation(s)
- Rattanaphone Phetsouvanh
- Wellcome Trust-Mahosot Hospital-Oxford Tropical Medicine Research Collaboration, Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao PD.
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22
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Khan FA, Fisher MA, Khakoo RA. Association of hemochromatosis with infectious diseases: expanding spectrum. Int J Infect Dis 2007; 11:482-7. [PMID: 17600748 DOI: 10.1016/j.ijid.2007.04.007] [Citation(s) in RCA: 142] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2006] [Revised: 02/26/2007] [Accepted: 04/05/2007] [Indexed: 02/06/2023] Open
Abstract
Withholding iron from potential pathogens is a host defense strategy. There is evidence that iron overload per se compromises the ability of phagocytes to kill microorganisms. Several hypotheses exist to explain the association of hemochromatosis with infection. A combination of mechanisms likely contributes to the increase in susceptibility to infection in these patients. A review of the current literature delineating various pathogens to which patients with hemochromatosis are potentially susceptible, and recent advances in the understanding of the association of hemochromatosis with infection, are discussed.
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Affiliation(s)
- Fida A Khan
- Department of Medicine, Section of Infectious Diseases, Ohio Valley Medical Center, 2000 Eoff Street, Wheeling, WV 26003, USA.
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23
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Chang-Chien CH, Ding HT, Liu C, Yang CS. Vibrio infection associated with finning injury of the hand. Injury 2007; 38:614-8. [PMID: 16945371 DOI: 10.1016/j.injury.2006.04.134] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2006] [Revised: 04/25/2006] [Accepted: 04/26/2006] [Indexed: 02/02/2023]
Abstract
BACKGROUND Penetrating injury by fish fins is common and often overlooked. Vibrio spp. are known worldwide for their virulence, quickly causing soft-tissue infection and lethal septicaemia. Vibrio infection following finning injury is rare, but can result in devastating complications in susceptible individuals. AIM To elucidate the clinical significance of such injury. METHOD Between July 2003 and September 2005, nine cases of Vibrio infection caused by finning injury to the hand were retrospectively reviewed. Clinical data, including skin presentations, treatment course and outcomes, were collected and reviewed. RESULTS In our group of nine patients, seven had concurrent hepatoma, diabetes mellitus, cirrhosis, chronic renal insufficiency or the effects of long-term steroid use; three had wound infections manifested by cellulitis or tenosynovitis and six had life-threatening necrotising soft-tissue infections. Vibrio spp. were identified from the wound (n=4), blood (n=1), and both (n=4). Symptoms appeared within a few hours to 3 days after injury, with 50% of patients developing symptoms within 24h; three patients were hypotensive upon admission; one patient received antibiotic therapy only and eight required emergency fasciotomy. All patients survived and none required amputation. The mean hospital stay was 23.2 days. CONCLUSIONS Vibrio infections after finning injury can produce bacteraemic necrotising soft tissue-infections, especially in individuals with a systemic illness. Health education should include a recommendation to wear protective gloves while handling fish. Early antibiotic and surgical treatment can avoid potentially life-threatening complications.
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Affiliation(s)
- Chih-Hsuan Chang-Chien
- Department of Plastic and Reconstructive Surgery, Chia-Yi Christian Hospital, Chiayi, Taiwan.
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24
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Chang-Chien CH. Bacteraemic necrotizing fasciitis with compartment syndrome caused by non-O1 Vibrio cholerae. J Plast Reconstr Aesthet Surg 2006; 59:1381-4. [PMID: 17113524 DOI: 10.1016/j.bjps.2006.06.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2005] [Revised: 06/01/2006] [Accepted: 06/04/2006] [Indexed: 11/27/2022]
Abstract
Non-O1 Vibrio cholerae are gram-negative rods that can cause sporadic gastroenteritis, bacteraemia, and extraintestinal infections, primarily following the consumption of raw seafood or exposure of damaged skin to contaminated saltwater during the summer months. Bacteraemic necrotizing fasciitis caused by non-O1 V. cholerae has rarely been reported. Liver cirrhosis, haemochromatosis, and immunosuppression are important factors contributing to the severity of the infections and outcome. This report describes a case of liver cirrhosis in which right lower leg compartment syndrome and acute renal failure presented as the initial symptoms of bacteraemic necrotizing fasciitis. The organisms growing in the wound and blood cultures were identified as non-O1 V. cholerae. After antibiotic therapy, fasciotomy, right above-knee amputation, repeat debridement of the left lower leg and split-thickness skin grafts, the patient was eventually discharged in a stable condition.
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Affiliation(s)
- Chih-Hsuan Chang-Chien
- Department of Plastic and Reconstructive Surgery, Chia-Yi Christian Hospital, No. 539 Zhongxiao Road, Chiayi City 600, Taiwan.
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Sánchez-Olmedo JI, Fajardo López-Cuervo J, García-Díaz F, Villanueva-Serrano S. Sepsis grave y celulitis por Vibrio cholerae no 01 en un paciente inmunocompetente. Med Clin (Barc) 2005; 125:717. [PMID: 16324488 DOI: 10.1016/s0025-7753(05)72164-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Anderson AML, Varkey JB, Petti CA, Liddle RA, Frothingham R, Woods CW. Non-o1 Vibrio cholerae septicemia: Case report, discussion of literature, and relevance to bioterrorism. Diagn Microbiol Infect Dis 2004; 49:295-7. [PMID: 15313536 DOI: 10.1016/j.diagmicrobio.2004.04.016] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2004] [Accepted: 04/20/2004] [Indexed: 11/28/2022]
Abstract
Non-O1 Vibrio cholerae (NOVC) is a rare cause of septicemia in the United States. We report a case of NOVC septicemia and discuss the literature pertaining to this organism. NOVC takes on new significance given that it can be confused with toxigenic V. cholerae, a Centers for Disease Control and Prevention category B bioterrorism agent.
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Affiliation(s)
- Albert M L Anderson
- Department of Medicine, Durham Veterans Affairs Medical Center, Durham, NC, USA.
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Choi SM, Lee DG, Kim MS, Park YH, Kim YJ, Lee S, Kim HJ, Choi JH, Yoo JH, Kim DW, Min WS, Shin WS, Kim CC. Bacteremic cellulitis caused by non-O1, non-O139 Vibrio cholerae in a patient following hematopoietic stem cell transplantation. Bone Marrow Transplant 2003; 31:1181-2. [PMID: 12796802 DOI: 10.1038/sj.bmt.1704044] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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28
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Norton R, Vucak M, Stalewski H. Vibrio cholerae non-O1 facial cellulitis in a North Queensland, Australian child. Pediatr Infect Dis J 2001; 20:550-1. [PMID: 11368121 DOI: 10.1097/00006454-200105000-00020] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Vibrio cholerae is an uncommon cause of cellulitis in Australia. Most reported cases worldwide have involved marine or brackish water contact. A recognized risk factor for acquiring this infection is chronic liver disease secondary to hepatitis B. We describe a case of extensive facial cellulitis caused by Vibrio cholerae non-O1, non-0139, in an 11-year-old indigenous girl from North Queensland, Australia, who was hepatitis B surface antigen-negative. Treatment consisted of extensive debridement, antibiotics, hyperbaric oxygen and facial reconstructive surgery. Early microbiologic diagnosis and a combined therapeutic approach are important in the management of this condition.
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Affiliation(s)
- R Norton
- Department of Clinical Microbiology, Townsville General Hospital, Queensland, Australia
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