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      Distribution of Virulence Markers among Vibrio vulnificus Isolates of Clinical and Environmental Origin and Regional Characteristics in Japan

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          Abstract

          Background

          Vibrio vulnificus is an opportunistic human pathogen that is widely distributed in estuarine environments and is capable of causing necrotizing fasciitis and sepsis. In Japan, based on epidemiological research, the incidences of V. vulnificus were concentrated in Kyusyu, mainly in coastal areas of the Ariake Sea. To examine the virulence potential, various genotyping methods have recently been developed. This study aimed to investigate the distribution of virulence markers among V. vulnificus isolates of clinical and environmental origin in three coastal areas with different infection incidences and to determine whether these isolates have the siderophore encoding gene viuB.

          Methodology/Principal Findings

          We examined the distribution of genotypes of the 16S ribosomal ribonucleic acid (rRNA) gene, vvhA, vcg, and capsular polysaccharide (CPS), and the presence of viuB in 156 isolates collected from patients and environmental samples in Japan. The environmental samples were collected from three coastal areas: the Ariake Sea, Ise & Mikawa Bay, and Karatsu Bay. The results showed disparity in the ratios of genotypes depending on the sample origins. V. vulnificus isolates obtained from patients were classified into the clinical type for all genotypes. In the environmental isolates, the ratios of the clinical type for genotypes of the 16S rRNA gene, vvhA, and vcg were in the order of the Ariake Sea>Ise & Mikawa Bay>Karatsu Bay. Meanwhile, CPS analysis showed no significant difference. Most isolates possessed viuB.

          Conclusions

          Many V. vulnificus belonging to the clinical type existed in the Ariake Sea. Three coastal areas with different infection incidences showed distinct ratios of genotypes. This may indicate that the distribution of clinical isolates correlates with the incidence of V. vulnificus infection.

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          Most cited references34

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          The epidemiology of Vibrio infections in Florida, 1981-1993.

          The epidemiology of 690 Vibrio infections reported in Florida during 1981-1993 is described. Most infections resulted in one of three clinical syndromes: gastroenteritis (51%), wound infections (24%), or primary septicemia (17%). Case-fatality rates were 1% for gastroenteritis, 5% for wound infections, and 44% for primary septicemia. While gastroenteritis had little seasonal variation, 91% of primary septicemias and 86% of wound infections occurred from April through October, mostly due to the seasonality of Vibrio vulnificus and Vibrio parahaemolyticus infections. Infected wounds were largely a result of occupational activities around seawater. Some 68% of gastroenteritis cases and 83% of the primary septicemias were associated with raw oyster consumption. Preexisting liver disease was present in 48% of patients with primary septicemia and was associated with a fatal outcome in both wound infections (relative risk [RR], 28.3; 95% confidence interval [CI], 6.3-127.5; P < .0001) and primary septicemia (RR, 1.9; 95% CI, 1.2-3.1; P < .01).
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            Epidemiology and pathogenesis of Vibrio vulnificus.

            Vibrio vulnificus is capable of causing severe and often fatal infections in susceptible individuals. It causes two distinct disease syndromes, a primary septicemia and necrotizing wound infections. This review discusses the interaction of environmental conditions, host factors, and bacterial virulence determinants that contribute to the epidemiology and pathogenesis of V. vulnificus.
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              Disease caused by a marine Vibrio. Clinical characteristics and epidemiology.

              We studied the clinical characteristics and epidemiology of disease associated with a rare, unnamed halophilic lactose-fermenting Vibrio species in 39 persons from whom the organism had been isolated. Two distinct clinical presentations were seen. In the first, the illness began with septicemia, often within 24 hours after raw oysters had been eaten; 18 of 24 such patients had pre-existing hepatic disease, and 11 of the 24 died. In the second, there was a wound infection after exposure to seawater or an injury incurred during the handling of crabs; none of these persons had pre-existing hepatic disease, and one of 15 died. Most cases (85 per cent) occurred during relatively warm months (May to October) in men (90 per cent) 40 or more years of age (95 per cent). This Vibrio species is a pathogen and should be considered in the differential diagnosis of septicemia with secondary skin lesions and of wound infections after exposure to seawater.
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                Author and article information

                Contributors
                Role: Editor
                Journal
                PLoS One
                PLoS ONE
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, USA )
                1932-6203
                2013
                30 January 2013
                : 8
                : 1
                : e55219
                Affiliations
                [1 ]Department of Applied Biochemistry and Food Science, Faculty of Agriculture, Saga University, Saga, Japan
                [2 ]Biomaterials and Commodity Chemicals Research Division, Osaka Municipal Technical Research Institute, Osaka, Japan
                [3 ]Department of Anesthesiology and Critical Care Medicine, Faculty of Medicine, Saga University, Saga, Japan
                [4 ]Institute of Advanced Study, Kyusyu University, Higashi-ku, Fukuoka, Japan
                [5 ]Tosa Food Business Creator Project Team, Kochi University, Nankoku, Kochi, Japan
                The Australian National University, Australia
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                Collected samples: NY KM HO YY MN. Conceived and designed the experiments: NY ST KK GK. Performed the experiments: NY ST YT. Analyzed the data: YY KM HO MN. Contributed reagents/materials/analysis tools: NY KK GK. Wrote the paper: NY ST GK.

                Article
                PONE-D-12-16218
                10.1371/journal.pone.0055219
                3559389
                23383115
                b4d53281-22f9-439b-9103-4887c3ec39a6
                Copyright @ 2013

                This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 7 June 2012
                : 20 December 2012
                Page count
                Pages: 7
                Funding
                This study was supported by the Ariake Sea Research Project, Saga University, Japan ( http://www.ariake.civil.saga-u.ac.jp/index_e.html). The funder had no role in study design,data collection and analysis, decision to publish, or preparation of the manuscript. No additional external funding received for this study.
                Categories
                Research Article
                Biology
                Ecology
                Ecological Environments
                Aquatic Environments
                Microbiology
                Microbial Pathogens
                Population Biology
                Epidemiology
                Environmental Epidemiology
                Infectious Disease Epidemiology
                Medicine
                Diagnostic Medicine
                Pathology
                Clinical Pathology
                Clinical Microbiology
                Epidemiology
                Environmental Epidemiology
                Infectious Diseases
                Bacterial Diseases
                Vibrio Vulnificus

                Uncategorized
                Uncategorized

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