A Review of Vibrio vulnificus Infection in Recent 5 Years at Chonnam Area

You, Sang Doo; Shin, Dong Hyeon; Kim, Sei Jong

Abstract

V. vulnificus infection has been occured every year in Chonnam area. As mortality rate is still high for patients with primary septicemia, the clinical and epidemiologic features of V. vulnificus infection in recent 5 years were analyzed. Thirty-eight cases were diagnosed by microbiological culture from 1995 to Sep. 1999. The clinical records of thrity-eight cases were reviewed retrospectively. The results were as follows; The annual occurence was 10 cases in 1996 and 1998 respectively, 8 in 1997, 6 in 1995, 4 in 1995, and 4 in 1999. The diseases were noted from June to September. Primary septicemia was developed in 79 percent of patients eating raw seafood. But primary septicemia was also developed in 18 percent of patients not proved to eating raw seafood. Wound infection with secondary septicemia was developed in only one patient (3%), and there was no patient with gastrointestinal illness. 31 of 38 patients had underlying chronic liver disease. And 28 of 38 patients had habitual alcohol drinking. V. vulnificus was isolated in 34% from blood, in 34% from tissue, in 29% from blood and tissue, in 3% from blood and peritoneal fluid. All the isolates were susceptible to tetracyclin, cefoperazone, Bactrim . About ninety-five percent of the isolates were susceptible to gentamicin, amikacin, chloramphenicol, ceftazidime, cipro-floxacin, imipenem. Fifty percent of the isolates were susceptible to cephalothin, thirty-eight percent to aztreonam and eleven percent to colistin. Clinical manifestations consisted of skin lesions (95%), pain on extremities (71%), fever (68%), diarrhea (29%), vomiting (29%), and abdominal pain (21%). Skin lesions were edema (86%), purpura (67%), vesicle (61%), macule (33%), pustule (6%), and necrosis (3%). There were no significant differences between survivors and non-survivors in systolic blood pressure, incubation period, arrival time, platelet counts, AST, ALT, total protein, albumin, and total bilirubin. But median value of WBC counts was 10,800/mm3 in survivors and 5,000/mm3 in non-survivors (p<0.05). The overall mortality was 61%. The mortality was slightly decreased in 1995 and 1996, but there were a tendency to increase the mortality from 1997 to 1999 again. In conclusion, Attention for prevention of V. vulnificus infection is needed for everyone. Therefore patients with liver disease or habitual alcohol drinking should avoid eating raw seafood.