Vibrio vulnificus is a serious gram-negative pathogen that can lead to wound and intestinal infections and has high rates of mortality.
Vibrio vulnificus is a serious gram-negative pathogen that can lead to wound infections and intestinal infections. The pathogen can be found in brackish, high salinity waters and is endemic to the southeastern US coast. However, in the summer months of 2017 and 2018, 5 cases were detected in connection to the Delaware Bay, and 1 patient died.
A case report on the detection of the pathogen in the previously non-endemic area was published in Annals of Internal Medicine.
V vulnificus wound infections occur through breaks in the skin, and intestinal infections can occur following consumption of seafood. Either source of infection can then lead to bloodstream infections.
“People who have liver disease tend to carry a higher risk of developing an infection due to the mechanism by which the bacteria replicate,” the authors of the report told Contagion®. “People who are immunosuppressed or have diabetes are also at an increased risk of developing a V vulnificus infection if exposed.”
The investigators, led by Katherine Doktor, MD, of Cooper University Hospital, note that mortality of both wound and skin infections is high.
“Signs of necrotizing fasciitis (severe skin infection) would include a rapidly worsening, painful, red area near where any type of abrasion occurred, as well as fever and chills,” the authors continued.
The team of investigators, which also included Contagion® Editorial Advisory Board member Madeline King, PharmD, explained that the symptoms could begin up to a few days after exposure, with gastrointestinal infection symptoms likely to present earlier.
A summary of each of the 5 cases is included below:
According to the authors, rising sea temperatures may lead to more cases of infection in non-endemic areas. “The biggest takeaway is that as sea temperatures are warming, non-endemic areas may start to see an increase in V vulnificus related infections,” the authors told Contagion®. “It is important for clinicians to keep this in mind when treating patients who may have been exposed to waters where V vulnificus lives.”
As infections can occur from being in the water or eating or handling infected seafood, the investigators offer some preventive measures. “One suggestion would be to keep areas that may be exposed to sea water (or other brackish, warm waters) covered. This would help limit abrasions that may occur, which would allow the bacteria to enter the skin. Eating cleaned and cooked seafood is a measure to reduce the risk of developing a gastrointestinal infection.”