Vibrio parahaemolyticus infections
- J Glenn Morris, Jr, MD, MPHTM
J Glenn Morris, Jr, MD, MPHTM
- Professor of Medicine
- Director, Emerging Pathogens Institute
- University of Florida
Vibrio parahaemolyticus is a gram-negative bacterium that can cause seafood-associated diarrheal illness; it has also been associated with wound infections and septicemia [1,2].
V. parahaemolyticus was first isolated in 1950 from clinical samples and "shirasu" (dried sardines) during an outbreak of gastroenteritis in Osaka, Japan. It subsequently was identified as the leading cause of foodborne illness in Japan, and is a frequent global cause of diarrhea in areas where seafood consumption is common [3-5].
The pathogenesis, epidemiology, clinical features, diagnosis, and treatment of V. parahaemolyticus infections will be reviewed here. Vibrio vulnificus, other "non-cholera" Vibrios, and Vibrio cholerae are discussed separately. (See "Vibrio vulnificus infections" and "Overview of cholera" and "Infections due to non-O1/O139 Vibrio cholerae".)
The pathogenicity of V. parahaemolyticus has been correlated with production of thermostable direct hemolysin (Vp-TDH), which is responsible for the beta-hemolysis observed when the organisms are plated on a modified blood agar (Wagatsuma agar) [3,6,7]. This is known as the Kanagawa phenomenon, named after the region in Japan where it was discovered.
The Kanagawa phenomenon was originally demonstrated in 96 percent of Japanese clinical isolates but in only 1 percent of environmental strains. In one study of human volunteers, Kanagawa-positive strains produced diarrhea, while Kanagawa-negative strains did not (even in doses of up to 10(9) organisms) . Deletion of the Vp-TDH gene results in loss of enterotoxic activity in laboratory models .
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