Vibrio parahaemolyticus
| Vibrio parahaemolyticus | ||||||||||||||
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| SEM image of V. parahaemolyticus SEM image of V. parahaemolyticus
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| Scientific classification | ||||||||||||||
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| Binomial name | ||||||||||||||
| Vibrio parahaemolyticus (Fujino et al. 1951) Sakazaki et al. 1963 |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Vibrio parahaemolyticus is a curved, rod-shaped, Gram-negative bacterium found in saltwater. V. parahaemolyticus is oxidase positive, facultatively aerobic, and does not form spores. Like other members of the genus Vibrio, this species is motile, with a single, polar flagellum.[1]
Pathogenesis
While infection can occur via the fecal-oral route, ingestion of bacteria in raw or undercooked seafood, usually oysters, is the predominant cause the acute gastroenteritis caused by V. parahaemolyticus.[2] Wound infections also occur, but are less common than seafood-borne disease. The disease mechanism of V. parahaemolyticus infections has not been fully elucidated.[3] However, most clinical disease results from strains that carry either the thermostable direct hemolysin gene (tdh) or the tdh-related hemolysin gene (trh) or both genes.
Epidemiology
Outbreaks tend to be concentrated along coastal regions during the summer and early fall when higher water temperatures favor higher levels of bacteria. Seafood most often implicated includes squid, mackerel, tuna, sardines, crab, shrimp, and bivalves like oysters and clams.[4] The incubation period of ~24 hours is followed by explosive, watery diarrhea accompanied by nausea, vomiting, abdominal cramps, and sometimes fever. Vibrio parahaemolyticus symptoms typically resolve with-in 72 hours, but can persist for up to 10 days in immunocompromised individuals. As the vast majority of cases of V. parahaemolyticus food infection are self-limiting, treatment is not typically necessary. In severe cases, fluid and electrolyte replacement is indicated.[1]
Additionally, swimming or working in affected areas can lead to infections of the eyes or ears [5] and open cuts and wounds. Following Hurricane Katrina, there were 22 vibrio wound infections 3 of which were caused by V. parahaemolyticus and 2 of these lead to death.
Treatment
Antimicrobial regimen
- 1. Sepsis or Soft Tissue Infection Antibiotic Management [6]
- Preferred regimen: Doxycycline 100 mg IV q12h AND Ceftazidime 2 g IV q8h OR Fluoroquinolone
- Alternative regimen (1): Cefotaxime 2 g IV q6h IV AND Ciprofloxacin 400 mg IV q12h (synergistic in vitro) OR Moxifloxacin 400 mg IV OD OR Levofloxacin 750 mg IV OD
- Alternative regimen (2): Cefotaxime AND Minocycline (synergistic in vitro)
- 2. Gastroenteritis
- Most cases self-limiting
- Maintain hydration: oral or parenteral routes
- Role of Doxycycline or Fluoroquinolones unclear, does not appear to shorten duration of non-cholera gastroenteritis
References
- ↑ 1.0 1.1 Ryan KJ; Ray CG (editors) (2004). Sherris Medical Microbiology (4th ed. ed.). McGraw Hill. ISBN 0-8385-8529-9.
- ↑ Finkelstein RA (1996). Cholera, Vibrio cholerae O1 and O139, and Other Pathogenic Vibrios. In: Barron's Medical Microbiology (Barron S et al, eds.) (4th ed. ed.). Univ of Texas Medical Branch. (via NCBI Bookshelf) ISBN 0-9631172-1-1.
- ↑ Baffone W, Casaroli A, Campana R, Citterio B, Vittoria E, Pierfelici L, Donelli G (2005). "'In vivo' studies on the pathophysiological mechanism of Vibrio parahaemolyticus TDH(+)-induced secretion". Microb Pathog. 38 (2–3): 133–7. PMID 15748815.
- ↑ Invalid
<ref>tag; no text was provided for refs namedPhillips - ↑ Penland RL, Boniuk M, Wilhelmus KR (2000). "Vibrio ocular infections on the U.S. Gulf Coast". Cornea. 19 (1): 26–9. PMID 10632004.
- ↑ Bartlett, John (2012). Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases. Burlington, MA: Jones and Bartlett Learning. ISBN 978-1449625580.