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Zaghi I, Tebano G, Vanino E, Vandi G, Cricca M, Sambri V, Fantini M, Di Antonio F, Terzitta M, Russo E, Cristini F, Bassi P, Biagetti C, Tatarelli P. Non-cholera Vibrio spp. invasive infections in the summer following May 2023 flood disaster in Romagna, Italy: a case series. Eur J Clin Microbiol Infect Dis 2024:10.1007/s10096-024-04842-7. [PMID: 38735888 DOI: 10.1007/s10096-024-04842-7] [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: 02/03/2024] [Accepted: 05/02/2024] [Indexed: 05/14/2024]
Abstract
Non-cholera Vibrio spp. includes ubiquitous organisms living in aquatic environments. Their occurrence is associated with global warming and meteorological disasters. In May 2023 the Romagna region, Italy, was affected by severe floods. In the following 15 weeks we observed 5 patients with invasive infections caused by V. vulnificus (3/5) and V. harveyi (2/5). All patients (median age 77 years) had medical comorbidities and shared exposure to seawater. Two patients needed surgery; 2 died. In conclusion, we observed an increased burden of Vibrio spp. invasive infections after May 2023 floods, affecting old patients with predisposing medical conditions.
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Affiliation(s)
- I Zaghi
- Infectious Diseases Unit, Ravenna Hospital, Ravenna, Italy.
- Unit of Microbiology, The Greater Romagna Area Hub Laboratory, 47522, Cesena, Italy.
| | - G Tebano
- Infectious Diseases Unit, Ravenna Hospital, Ravenna, Italy
| | - E Vanino
- Infectious Diseases Unit, Ravenna Hospital, Ravenna, Italy
| | - G Vandi
- Infectious Diseases Unit, Rimini Hospital, Rimini, Italy
| | - M Cricca
- Unit of Microbiology, The Greater Romagna Area Hub Laboratory, 47522, Cesena, Italy
- Department of Medical and Surgical Sciences (DIMEC)-Alma Mater Studiorum, University of Bologna, 40138, Bologna, Italy
| | - V Sambri
- Unit of Microbiology, The Greater Romagna Area Hub Laboratory, 47522, Cesena, Italy
- Department of Medical and Surgical Sciences (DIMEC)-Alma Mater Studiorum, University of Bologna, 40138, Bologna, Italy
| | - M Fantini
- Clinical and Organizational Research Unit, Romagna AUSL, Ravenna, Italy
| | - F Di Antonio
- Anesthesia and Intensive Care Unit, Ravenna Hospital, Ravenna, Italy
| | - M Terzitta
- Anesthesia and Intensive Care Unit, Ravenna Hospital, Ravenna, Italy
| | - E Russo
- Department of Surgery and Trauma, Anesthesia and Intensive Care Unit, Maurizio Bufalini Hospital, Cesena, AUSL Della Romagna, Italy
| | - F Cristini
- Infectious Diseases Unit, Forlì and Cesena Hospitals, Forlì and Cesena, Italy
| | - P Bassi
- Infectious Diseases Unit, Ravenna Hospital, Ravenna, Italy
| | - C Biagetti
- Infectious Diseases Unit, Rimini Hospital, Rimini, Italy
| | - P Tatarelli
- Infectious Diseases Unit, Ravenna Hospital, Ravenna, Italy
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Hsieh CM, Hu SY, Hsieh MS, Huang SC, Shen CH, Tsai YC. Better Performance of Modified Scoring Systems to Predict the Clinical Outcomes of Vibrio Bacteremia in the Emergency Department: An Observational Study. J Pers Med 2024; 14:385. [PMID: 38673012 PMCID: PMC11051138 DOI: 10.3390/jpm14040385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Revised: 03/25/2024] [Accepted: 03/27/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Vibrio is a genus of Gram-negative bacteria found in various aquatic environments, including saltwater and freshwater. Vibrio bacteremia can lead to sepsis, a potentially life-threatening condition in which the immune system enters overdrive in response to the disease, causing widespread inflammation and damage to tissues and organs. V. vulnificus had the highest case fatality rate (39%) of all reported foodborne infections in the United States and a high mortality rate in Asia, including Taiwan. Numerous scoring systems have been created to estimate the mortality risk in the emergency department (ED). However, there are no specific scoring systems to predict the mortality risk of Vibrio bacteremia. Therefore, this study modified the existing scoring systems to better predict the mortality risk of Vibrio bacteremia. METHODS Cases of Vibrio bacteremia were diagnosed based on the results from at least one blood culture in the ED. Patient data were extracted from the electronic clinical database, covering January 2012 to December 2021. The primary outcome was in-hospital mortality.This study used univariate and multivariate analyses to evaluate the mortality risk. RESULTS This study enrolled 36 patients diagnosed with Vibrio bacteremia, including 23 males (63.9%) and 13 females (36.1%), with a mean age of 65.1 ± 15.7 years. The in-hospital mortality rate amounted to 25% (9/36), with 31.5% in V. vulnificus (6/19) and 17.6% in V. non-vulnificus (3/17). The non-survivors demonstrated higher MEDS (10.3 ± 2.4) than the survivors (6.2 ± 4.1) (p = 0.002). Concerning the qSOFA, the survivors scored 0.3 ± 0.5, and the non-survivors displayed a score of 0.6 ± 0.7 (p = 0.387). The AUC of the ROC for the MEDS and qSOFA was 0.833 and 0.599, respectively. This study modified the scoring systems with other predictive factors, including BUN and pH. The AUC of the ROC for the modified MEDS and qSOFA reached up to 0.852 and 0.802, respectively. CONCLUSION The MEDS could serve as reliable indicators for forecasting the mortality rate of patients grappling with Vibrio bacteremia. This study modified the MEDS and qSOFA to strengthen the predictive performance of mortality risk for Vibrio bacteremia. We advocate the prompt initiation of targeted therapeutic interventions and judicious antibiotic treatments to curb fatality rates.
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Affiliation(s)
- Chia-Ming Hsieh
- Department of Emergency Medicine, Taichung Veterans General Hospital, Taichung 40705, Taiwan; (C.-M.H.); (C.-H.S.); (Y.-C.T.)
- Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung 402202, Taiwan
- Institute of Medicine, School of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan
- School of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan;
| | - Sung-Yuan Hu
- Department of Emergency Medicine, Taichung Veterans General Hospital, Taichung 40705, Taiwan; (C.-M.H.); (C.-H.S.); (Y.-C.T.)
- Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung 402202, Taiwan
- Institute of Medicine, School of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan
- School of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan;
- School of Medicine, National Yang Ming Chiao Tung University, Taipei 11217, Taiwan;
| | - Ming-Shun Hsieh
- School of Medicine, National Yang Ming Chiao Tung University, Taipei 11217, Taiwan;
- Department of Emergency Medicine, Taipei Veterans General Hospital, Taoyuan Branch, Taoyuan 330, Taiwan
- Department of Emergency Medicine, Taipei Veterans General Hospital, Taipei 11217, Taiwan
| | - Shih-Che Huang
- School of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan;
- Department of Emergency Medicine, Chung Shan Medical University Hospital, Taichung 40201, Taiwan
- Lung Cancer Research Center, Chung Shan Medical University Hospital, Taichung 40201, Taiwan
| | - Chia-Hui Shen
- Department of Emergency Medicine, Taichung Veterans General Hospital, Taichung 40705, Taiwan; (C.-M.H.); (C.-H.S.); (Y.-C.T.)
| | - Yi-Chun Tsai
- Department of Emergency Medicine, Taichung Veterans General Hospital, Taichung 40705, Taiwan; (C.-M.H.); (C.-H.S.); (Y.-C.T.)
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Li X, Wang C, Guo Z, Xiao T, Ji Y, Ma Y, Li M, Xia J, Liu X. Enhancing Vibrio vulnificus infection diagnosis for negative culture patients with metagenomic next-generation sequencing. Front Cell Infect Microbiol 2023; 13:1210919. [PMID: 38035326 PMCID: PMC10687401 DOI: 10.3389/fcimb.2023.1210919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Accepted: 10/20/2023] [Indexed: 12/02/2023] Open
Abstract
Objective To evaluate the diagnostic value of metagenomic next-generation sequencing (mNGS) in Vibrio vulnificus (V. vulnificus) infection. Methods A retrospective analysis of patients with V. vulnificus infection at the Fifth Affiliated Hospital of Sun Yat-Sen University from January 1, 2020 to April 23, 2023 was conducted. 14 enrolled patients were diagnosed by culture or mNGS. The corresponding medical records were reviewed, and the clinical data analyzed included demographics, epidemiology laboratory findings, physical examination, symptoms at presentation, antibiotic and surgical treatment, and outcome. Results In this study, 78.6% (11/14) patients had a history of marine trauma (including fish stab, shrimp stab, crab splints and fish hook wounds), 7.1% (1/14) had eaten seafood, and the remaining 14.3% (2/14) had no definite cause. Isolation of V. vulnificus from clinical samples including blood, tissue, fester and secreta. 9 cases were positive for culture, 5 cases were detected synchronously by mNGS and got positive for V. vulnificus. 85.7% (12/14) cases accepted surgical treatment, with 1 patient suffering finger amputated. 14 enrolled patients received appropriate antibiotic therapy, and all of them had recovered and discharged. 9 strains V. vulnificus isolated in this study were sensitive to most beta-lactam antibiotics, aminoglycosides, quinolones, etc. Conclusion Vibrio vulnificus infection is a common water-exposed disease in Zhuhai, which requires identification of a number of pathogens. Of severe infections with unknown pathogen, mNGS can be used simultaneously, and the potential to detect multiple pathogens is of great help in guiding treatment.
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Affiliation(s)
- Xinghua Li
- Department of Infectious Diseases, The Fifth Affiliated Hospital of Sun Yet-sun University, Zhuhai, China
| | - Chengzhuo Wang
- Department of Infectious Diseases, The Fifth Affiliated Hospital of Sun Yet-sun University, Zhuhai, China
| | - Zhaowang Guo
- Clinical Laboratory, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
| | - Tongyang Xiao
- Clinical Laboratory, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
| | - Yuxin Ji
- Department of Infectious Diseases, The Fifth Affiliated Hospital of Sun Yet-sun University, Zhuhai, China
| | - Yongguang Ma
- Department of Orthopaedics, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
| | - Meiyi Li
- Department of Infectious Diseases, The Fifth Affiliated Hospital of Sun Yet-sun University, Zhuhai, China
| | - Jinyu Xia
- Department of Infectious Diseases, The Fifth Affiliated Hospital of Sun Yet-sun University, Zhuhai, China
| | - Xi Liu
- Department of Infectious Diseases, The Fifth Affiliated Hospital of Sun Yet-sun University, Zhuhai, China
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Sathiyamoorthi E, Lee JH, Tan Y, Lee J. Antimicrobial and antibiofilm activities of formylchromones against Vibrio parahaemolyticus and Vibrio harveyi. Front Cell Infect Microbiol 2023; 13:1234668. [PMID: 37662002 PMCID: PMC10471482 DOI: 10.3389/fcimb.2023.1234668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 07/28/2023] [Indexed: 09/05/2023] Open
Abstract
Gram-negative Vibrio species are major foodborne pathogens often associated with seafood intake that causes gastroenteritis. On food surfaces, biofilm formation by Vibrio species enhances the resistance of bacteria to disinfectants and antimicrobial agents. Hence, an efficient antibacterial and antibiofilm approach is urgently required. This study examined the antibacterial and antivirulence effects of chromones and their 26 derivatives against V. parahaemolyticus and V. harveyi. 6-Bromo-3-formylchromone (6B3FC) and 6-chloro-3-formylchromone (6C3FC) were active antibacterial and antibiofilm compounds. Both 6B3FC and 6C3FC exhibited minimum inhibitory concentrations (MICs) of 20 µg/mL for planktonic cell growth and dose-dependently inhibited biofilm formation. Additionally, they decreased swimming motility, protease activity, fimbrial agglutination, hydrophobicity, and indole production at 20 µg/mL which impaired the growth of the bacteria. Furthermore, the active compounds could completely inhibit the slimy substances and microbial cells on the surface of the squid and shrimp. The most active compound 6B3FC inhibited the gene expression associated in quorum sensing and biofilm formation (luxS, opaR), pathogenicity (tdh), and membrane integrity (vmrA) in V. parahaemolyticus. However, toxicity profiling using seed germination and Caenorhabditis elegans models suggests that 6C3FC may have moderate effect at 50 µg/mL while 6B3FC was toxic to the nematodes 20-100 µg/mL. These findings suggest chromone analogs, particularly two halogenated formylchromones (6B3FC and 6C3FC), were effective antimicrobial and antibiofilm agents against V. parahaemolyticus in the food and pharmaceutical sectors.
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Affiliation(s)
| | - Jin-Hyung Lee
- School of Chemical Engineering, Yeungnam University, Gyeongsan, Republic of Korea
| | - Yulong Tan
- Special Food Research Institute, Qingdao Agricultural University, Qingdao, China
| | - Jintae Lee
- School of Chemical Engineering, Yeungnam University, Gyeongsan, Republic of Korea
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Chang CY, Wu KH, Wu PH, Hung SK, Hsiao CT, Wu SR, Chang CP. In-hospital mortality associated with necrotizing soft tissue infection due to Vibrio vulnificus: a matched-pair cohort study. World J Emerg Surg 2022; 17:28. [PMID: 35624468 PMCID: PMC9145496 DOI: 10.1186/s13017-022-00433-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Accepted: 05/21/2022] [Indexed: 11/15/2022] Open
Abstract
Background It remains unclear whether Vibrio vulnificus necrotizing soft tissue infection (NSTI) is associated with higher mortality compared with non-Vibrio NSTI. This study’s objective was to compare outcomes including in-hospital mortality and prognosis between patients with V. vulnificus NSTI and those with non-Vibrio NSTI. Method A retrospective 1:2 matched-pair cohort study of hospitalized patients with NSTI diagnosed by surgical finding was conducted in two tertiary hospitals in southern Taiwan between January 2015 and January 2020. In-hospital outcomes (mortality, length of stay) were compared between patients with and without V. vulnificus infection. We performed multiple imputation using chained equations followed by multivariable regression analyses fitted with generalized estimating equations to account for clustering within matched pairs. All-cause in-hospital mortality and length of stay during hospitalization were compared for NSTI patients with and without V. vulnificus. Result A total of 135 patients were included, 45 in V. vulnificus NSTI group and 90 in non-Vibrio group. The V. vulnificus NSTI patients had higher mortality and longer hospital stays. Multivariable logistic regression analysis revealed that V. vulnificus NSTI was significantly associated with higher in-hospital mortality compared with non-Vibrio NSTI (adjusted odds ratio = 1.52; 95% confidence interval 1.36–1.70; p < 0.01). Conclusion Vibrio vulnificus NSTI was associated with higher in-hospital mortality and longer hospital stay which may increase health care costs, suggesting that preventing V. vulnificus infection is essential.
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Affiliation(s)
- Chih-Yao Chang
- Department of Emergency Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Kai-Hsiang Wu
- Department of Emergency Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Po-Han Wu
- Department of Emergency Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Shang-Kai Hung
- Department of Emergency Medicine, Chang Gung Memorial Hospital, Taoyüan, Taiwan
| | - Cheng-Ting Hsiao
- Department of Emergency Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan.,Department of Medicine, Chang Gung University, Taoyüan, Taiwan
| | - Shu-Ruei Wu
- Department of Pediatric, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Chia-Peng Chang
- Department of Emergency Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan.
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