Department of Pharmacy Practice, College of Pharmacy, Texas A&M Health Sciences Center, Kingsville, Texas, USA.
Int J Infect Dis. 2011 Mar;15(3):e157-66. doi: 10.1016/j.ijid.2010.11.003. Epub 2010 Dec 21.
Vibrio vulnificus is a halophilic Gram-negative bacillus found worldwide in warm coastal waters. The pathogen has the ability to cause primary sepsis in certain high-risk populations, including patients with chronic liver disease, immunodeficiency, iron storage disorders, end-stage renal disease, and diabetes mellitus. Most reported cases of primary sepsis in the USA are associated with the ingestion of raw or undercooked oysters harvested from the Gulf Coast. The mortality rate for patients with severe sepsis is high, exceeding 50% in most reported series. Other clinical presentations include wound infection and gastroenteritis. Mild to moderate wound infection and gastroenteritis may occur in patients without obvious risk factors. Severe wound infection is often characterized by necrotizing skin and soft-tissue infection, including fasciitis and gangrene. V. vulnificus possesses several virulence factors, including the ability to evade destruction by stomach acid, capsular polysaccharide, lipopolysaccharide, cytotoxins, pili, and flagellum. The preferred antimicrobial therapy is doxycycline in combination with ceftazidime and surgery for necrotizing soft-tissue infection.
创伤弧菌是一种嗜盐性革兰氏阴性杆菌，在世界范围内温暖的沿海水域中均有发现。该病原体具有在某些高危人群中引起原发性败血症的能力，包括慢性肝病、免疫缺陷、铁储存障碍、终末期肾病和糖尿病患者。在美国，大多数原发性败血症的报告病例都与食用来自墨西哥湾的生的或未煮熟的牡蛎有关。严重败血症患者的死亡率很高，在大多数报告的系列中超过 50%。其他临床表现包括伤口感染和肠胃炎。轻度至中度伤口感染和肠胃炎可能发生在没有明显危险因素的患者中。严重的伤口感染通常表现为坏死性皮肤和软组织感染，包括筋膜炎和坏疽。创伤弧菌具有多种毒力因子，包括逃避胃酸破坏的能力、荚膜多糖、脂多糖、细胞毒素、菌毛和鞭毛。首选的抗菌治疗是多西环素联合头孢他啶和手术治疗坏死性软组织感染。
