Vibrio vulnificus in Taiwan

Abstract

Residents in Taiwan are often exposed to marine microorganisms through seafood and occupational exposure. The number of reported cases of infection attributable to this organism has increased since the first case was reported in 1985. The increasing number of cases may be caused by greater disease activity or improved recognition by clinicians or laboratory workers. We analyze a clinical-case series of 84 patients with Vibrio vulnificus infection from 1995 to 2000 and describe the molecular epidemiologic features of pathogens isolated from these patients. The spectrum of clinical manifestations and outcomes, options of antimicrobial therapy, and virulence mechanisms were investigated. Results of molecular typing of isolates from humans and marine environment in this country had a high genetic divergence among these isolates. Education and measures are needed to prevent this emerging disease.

Figure 1

Estimated prevalence (per 10⁶ population) and annual number of cases of Vibrio vulnificus infection reported from 1985 to 2000 in Taiwan. The line and triangles represent the prevalence and the bars the number of cases.

Figure 2

Characteristic skin lesions of Vibrio vulnificus infection and morphotype of the microorganism. A) Gangrenous change with hemorrhagic bullae over the leg in a 75-year-old patient with liver cirrhosis in whom septic shock and V. vulnificus bacteremia developed. B) V. vulnificus bacteremia developed 1 day after a fish bone injury on the fourth finger of the left hand (arrow) in a 45-year-old patient with uremia. C) Gram-negative curved bacilli (arrowhead) isolated from a blood sample of the 45-year-old patient with uremia.

Figure 3

Rates of deaths according to different types of infection of 84 patients with Vibrio vulnificus infection.