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Skin and soft tissue infections and bacteremia caused by Vibrio cincinnatiensis

ABSTRACT: Vibrio cincinnatiensis is a halophilic species found in marine and estuarine environments worldwide. It is a rare pathogen whose impact on humans has remained unclear; only two cases of V. cincinnatiensis infection have been reported in humans, so far. A 63-year-old man with a history of myocardial infarction and type 2 diabetes mellitus presented to the emergency department with fever and dyspnea. Physical examination demonstrated notable abdominal distension and bilateral lower leg edema. marked abdominal distension and bilateral lower leg edema. The patient was diagnosed with bacteremia and exacerbated heart failure. Blood and skin cultures revealed the presence of the gram-negative pathogen V. cincinnatiensis. Combined antibiotic therapy using intravenous tazobactam /piperacillin resulted in a gradual recovery with no recurrence observed at the 9-month follow-up. To the best of our knowledge, this is the third case of V. cincinnatiensis infection reported in humans and the first one to be associated with skin and soft tissue infection. We suggest that although V. cincinnatiensis is a rare pathogen, it should be considered as a potential infective agent in the differential diagnosis of immunocompromised patients, regardless of any recent exposure to seawater or marine products. Highlights • We report a V. cincinnatiensis infection associated with skin/soft tissue infection.• A 63-year-old man with previous myocardial infarction and diabetes was treated.• V. cincinnatiensis should be considered in diagnosed immunocompromised patients.• Infection may develop regardless of recent exposure to seawater or marine products.

SUBMITTER: Kunitomo K

PROVIDER: S-EPMC9278064 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:Vibrio cincinnatiensis is a halophilic species which has been found in marine and estuarine environments worldwide. The species is considered a rare pathogen for which the significance for humans is unclear. In this study, nine veterinary isolates were investigated that were obtained from domestic animals in Germany. The isolates were mostly recovered from abortion material of pigs, cattle, and horse (amnion or fetuses). One isolate was from a goose. A human clinical strain from a case of enteritis in Germany described in the literature was also included in the study. Whole-genome sequencing (WGS) of all isolates and MALDI-TOF MS (matrix-assisted-laser-desorption/ionization time-of-flight mass spectrometry) were performed to verify the species assignment. All strains were investigated for phenotypic traits including antimicrobial resistance (AMR), biochemical properties, and two virulence-associated phenotypes (hemolytic activity and resistance to human serum). WGS data and MS spectra confirmed that all veterinary isolates are closely related to the type strain V. cincinnatiensis NCTC12012. An exception was the human isolate from Germany which is related to the other isolates but could belong to another species. The isolates were similar in most biochemical phenotypes. Only one strain showed a very weak hemolytic activity against sheep erythrocytes, and serum resistance was intermediate in two strains. AMR phenotypes were more variable between the isolates. Resistances were observed against ß-lactams ampicillin and cefoxitin and against tetracycline and the sulfonamide antibiotics trimethoprim and sulfamethoxazole. Some acquired AMR genes were identified by bioinformatics analyses. WGS and MALDI-TOF MS data reveal a close relationship of the veterinary isolates and the type strain V. cincinnatiensis NCTC12012, which is a clinical human isolate. As the veterinary isolates of this study were mostly recovered from abortion material (amnions and fetuses), a zoonotic potential of the veterinary isolates seems possible.

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Skin and soft tissue infections and bacteremia caused by Vibrio cincinnatiensis

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