Serology, virulence, antimicrobial susceptibility and molecular characteristics of clinical Vibrio parahaemolyticus strains circulating in southeastern China from 2009 to 2013.

Vibrio parahaemolyticus is a leading cause of food-borne diarrhoea in coastal countries. Although V. parahaemolyticus cases have been reported since 1950, they have been poorly documented. From July 2009 to June 2013, we collected 6951 faecal specimens for pathogen detection; V. parahaemolyticus strains were isolated from 563 specimens (8.1%). We then analysed the characteristics of the 501 V. parahaemolyticus strains that were isolated as the sole pathogen. Twenty-one serotypes were identified among these strains; O3:K6 was the most common serotype (65.1%), followed by O4:K8, O4:K68 and O1:K36. One strain of the O4:K18 serotype was isolated from clinical patients for the first time. Pandemic O3:K6 clones were predominant and accounted for 69.1% of all of the pandemic strains. This is the first report of one strain expressing the O3:K8 serotype with a pandemic genotype. The presence of the haemolysin gene tdh (93.0%) was the key characteristic of the virulent strains; however, a few strains carried the trh gene. We also confirmed the presence of the type III secretion system 2 (T3SS2) genes in all of the pathogenic strains. Subsequent multilocus sequence typing split the isolates into 16 sequence types (STs), with ST3 and ST88 as the most prevalent in southeastern China. Most isolates were sensitive to common antimicrobial agents, apart from ampicillin. However, the resistance rate to ampicillin has apparently increased in this area. In conclusion, our results indicate that pandemic O3:K6 V. parahaemolyticus isolates are predominant in southeastern China, and additional surveillance should be conducted to facilitate control of the transmission of this pathogen.

A description and illustration of a necrotizing fasciitis by John Bell in 1801, hypothetically caused by Vibrio vulnificus.

We present an overlooked and noteworthy historical case and illustration of a necrotizing fasciitis, observed and written by John Bell (1763-1820), first published in 1801. Considering the setting and the clinical presentation, we hypothesize that the pathogen responsible was the species Vibrio vulnificus. The typical clinical course of a rapidly progressive illness preceded by saltwater exposure shortly followed by the development of a hemorrhagic skin lesion, with a fatal outcome, should strongly suggest a V. vulnificus infection. To our knowledge, there are few historical case reports with illustrations included describing cases of necrotizing fasciitis, particularly with V. vulnificus as the suggested pathogen.

Infectious diseases associated with molluscan shellfish consumption.

A history of shellfish-vectored illnesses (i.e., those associated with consumption of clams, oysters, mussels, and scallops) occurring in the past nine decades is presented. Typhoid fever was a significant public health problem among consumers of raw molluscan shellfish earlier in this century. The development of more effective sewage treatment procedures and the institution of a national program following these outbreaks led to a series of measures which eventually eliminated shellfish-associated typhoid fever. Present-day problems associated with this food source still involve some wastewaterborne bacterial illnesses. However, the principal public health concerns are with wastewater-derived viral pathogens and with bacterial agents of an environmental origin. The nature, occurrence, and magnitude of these public health problems are described.

Vibrio vulnificus: did Hippocrates describe a fatal case?

In the fifth century B.C., Hippocrates described a fatal illness in a man who lived on an island in the Aegean Sea. This acute infection was characterized by black bullous skin lesions, rapidly progressive septicemia, and death on the second day. It is hypothesized that this disease was caused by Vibrio vulnificus.