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Microbiology Legend Cycle 46 Organism 6 Vibrio 48 Monte Carlo Crescent Kyalami Business Park, Kyalami Johannesburg, 1684 South Africa www.thistle.co.za Tel: +27 (011) 463 3260 Fax to Email: + 27 (0) 86-557-2232 e-mail : [email protected] MID - 001 Please read this section first The HPCSA and the Med Tech Society have confirmed that this clinical case study, plus your routine review of your EQA reports from Thistle QA, should be documented as a “Journal Club” activity. This means that you must record those attending for CEU purposes. Thistle will not issue a certificate to cover these activities, nor send out “correct” answers to the CEU questions at the end of this case study. The Thistle QA CEU No is: MT-19/091. Each attendee should claim ONE CEU points for completing this Quality Control Journal Club exercise, and retain a copy of the relevant Thistle QA Participation Certificate as proof of registration on a Thistle QA EQA. MICROBIOLOGY LEGEND CYCLE 46 ORGANISM 6 VIBRIO Vibrio is a genus of Gram-negative bacteria, possessing a curved-rod shape (comma shape), several species of which can cause foodborne infection, usually associated with eating undercooked seafood. Typically found in salt water, Vibrio species are facultative anaerobes that test positive for oxidase and do not form spores. All members of the genus are motile and have polar flagella with sheaths. The name Vibrio derives from Filippo Pacini, who isolated micro-organisms he called "vibrions" from cholera patients in 1854, because of their motility. Several species of Vibrio are pathogens. Most disease-causing strains are associated with gastroenteritis, but can also infect open wounds and cause septicaemia. They can be carried by numerous marine animals, such as crabs or prawns, and have been known to cause fatal infections in humans during exposure. Pathogenic Vibrio species can cause foodborne illness (infection), usually associated with eating undercooked seafood. Many Vibrio species are also zoonotic. They cause disease in fish and shellfish, and are common causes of mortality among domestic marine life. Pathophysiology The Vibrionaceae family includes the genera Vibrio, Plesiomonas, and Aeromonas. Members of the family Vibrionaceae are natural inhabitants of sea water but can also be found in fresh water. Vibrio species are oxidase-positive, gram-negative bacilli. With the exception of non-halophilic Vibrio species, such as Vibrio cholerae and Vibrio mimicus, all Vibrio species require saline for growth. Vibrio species can produce multiple extracellular cytotoxins and enzymes that are associated with extensive tissue damage and that may play a major role in the development of sepsis. Non-cholera Vibrio Species and Associated Clinical Presentations Infection Type Non-cholera Vibrio Species Cytotoxins/Enzymes V parahaemolyticus Cytotoxin Non-01 V cholerae Vibrio fluvialis V mimicus Gastroenteritis Vibrio furnissii Hemolysin Vibrio hollisae Vibrio alginolyticus V vulnificus Page 1 of 3 48 Monte Carlo Crescent Kyalami Business Park, Kyalami Johannesburg, 1684 South Africa www.thistle.co.za Tel: +27 (011) 463 3260 Fax to Email: + 27 (0) 86-557-2232 e-mail : [email protected] MID - 001 V alginolyticus V vulnificus Protease Non-01 V cholerae Hemolysin Vibrio damsela Wound infection Lipase Vibrio carchariae DNAase V fluvialis Cytolysin V parahaemolyticus V mimicus V vulnificus V fluvialis Proteases Septicemia V damsela Endotoxic lipopolysaccharide Non-01 V cholerae Vibrio cincinnatiensis Vibrio fluvialis Vibrio fluvialis is a water-borne bacterium first isolated from patients with severe diarrhoea in Bahrain in the 1970s by A. L. Furniss and his colleagues, and is considered to be an emerging pathogen with the potential to have a significant impact on public health. Upon discovery, this organism was considered to be similar to both Vibrio and Aeromonas species, but was ultimately determined to be more closely related to Vibrio. V. fluvialis can be found in salt waters globally and also has the potential to infect both humans and a variety of crustaceans. Vibrio fluvialis is a halophilic Gram-negative bacterium. It has a straight to slightly curved rod cell morphology that is motile by means of polar flagella. It is a sodium chloride-requiring, oxidase-positive, nitrate-positive organism that ferments D-glucose and other carbohydrates with the production of acid and gas; has 50% guanine-plus-cytosine in its DNA and is isolated from water, animal feces, human feces, sewage, and seafood product. V. fluvialis is an important cause of cholera-like bloody diarrhoea and causes wound infection with primary septicemia in immuno-comprised individuals from developed to underdeveloped countries, especially in regions with poor sanitation. Vibrio furnissii Strains formerly classified as the aerogenic (gas-producing) biogroup of Vibrio fluvialis were shown by DNA relatedness to be a separate species. The species was named Vibrio furnissii. V. furnissii was aerogenic (produced gas from the fermentation of carbohydrates), whereas V. fluvialis was anaerogenic (did not produce gas from the fermentation of carbohydrates). Another test of some help in differentiating the two species was fermentation of L-rhamnose (57% positive for V. furnissii and negative for V. fluvialis). In addition to the reactions above, V. furnissii is distinguished from other salt-requiring vibrios on the basis of its positive reactions in tests for Møller L- arginine, L-arabinose, maltose, and D-mannitol and its negative reactions for Møller L-lysine and L-ornithine, lactose, and Voges-Proskauer. Vibrio furnissii is a Gram-negative, rod-shaped bacterium. V. furnissii is aerogenic, and uses L-rhamnose, L- arginine, L-arabinose, maltose, and D-mannitol, but not L-lysine, L-ornithine, or lactose. It has been isolated from patients with gastroenteritis, bacteremia, skin lesions, and septicemia. Page 2 of 3 48 Monte Carlo Crescent Kyalami Business Park, Kyalami Johannesburg, 1684 South Africa www.thistle.co.za Tel: +27 (011) 463 3260 Fax to Email: + 27 (0) 86-557-2232 e-mail : [email protected] MID - 001 Figure 1: Gram-negative Vibrio bacteria possessing a curved rod shape (comma shape) Treatment Medical care depends on the clinical presentation and the presence of underlying medical conditions. Because Vibrio gastroenteritis is self-limited in most patients, no specific medical therapy is required. Patients who cannot tolerate oral fluid replacement may require intravenous fluid therapy. Although most Vibrio species are sensitive to antibiotics such as doxycycline or quinolones, antibiotic therapy does not shorten the course of the illness or the duration of pathogen excretion. However, if the patient is ill and has a high fever or an underlying medical condition, oral antibiotic therapy with doxycycline or quinolone can be initiated. References 1. https://en.wikipedia.org/wiki/Vibrio 2. https://en.wikipedia.org/wiki/Vibrio_furnissii 3. J Clin Microbiol. 1983 Oct; 18(4): 816–824. 4. https://en.wikipedia.org/wiki/Vibrio_fluvialis 5. http://www.rightdiagnosis.com/v/vibrio_infection_vibrio_furnissii/intro.htm Questions 1. Discuss the morphological characteristics of Vibrio? 2. How would you differentiate between V. fluvialis and V. furnissii? 3. Discuss the pathophysiology of Vibrio. Page 3 of 3 .
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