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 .To continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information on subscription options, click below on the option that best describes you:
- Morris JG Jr, Black RE. Cholera and other vibrioses in the United States. N Engl J Med 1985; 312:343.
- Hlady WG, Klontz KC. The epidemiology of Vibrio infections in Florida, 1981-1993. J Infect Dis 1996; 173:1176.
- Joseph SW, Colwell RR, Kaper JB. Vibrio parahaemolyticus and related halophilic Vibrios. Crit Rev Microbiol 1982; 10:77.
- Miwatani T, Takeda Y. Vibrio parahaemolyticus: A causative bacterium of food poisoning, Saikon Publishing Co, Tokyo 1976.
- Li Y, Xie X, Shi X, et al. Vibrio parahaemolyticus, Southern Coastal Region of China, 2007-2012. Emerg Infect Dis 2014; 20:685.
- Sakazaki R, Tamura K, Kato T, et al. Studies on the enteropathogenic, facultatively halophilic bacterium, Vibrio parahaemolyticus. 3. Enteropathogenicity. Jpn J Med Sci Biol 1968; 21:325.
- Miyamoto Y, Kato T, Obara Y, et al. In vitro hemolytic characteristic of Vibrio parahaemolyticus: its close correlation with human pathogenicity. J Bacteriol 1969; 100:1147.
- Sanyal SC, Sen PC. Human volunteer study on the pathogenicity of Vibrio parahaemolyticus. In: International Symposium on Vibrio parahaemolyticus, Saikon Publishing Company Ltd, Tokyo 1973. p.227.
- Nishibuchi M, Fasano A, Russell RG, Kaper JB. Enterotoxigenicity of Vibrio parahaemolyticus with and without genes encoding thermostable direct hemolysin. Infect Immun 1992; 60:3539.
- Kelly MT, Stroh EM. Urease-positive, Kanagawa-negative Vibrio parahaemolyticus from patients and the environment in the Pacific Northwest. J Clin Microbiol 1989; 27:2820.
- Abbott SL, Powers C, Kaysner CA, et al. Emergence of a restricted bioserovar of Vibrio parahaemolyticus as the predominant cause of Vibrio-associated gastroenteritis on the West Coast of the United States and Mexico. J Clin Microbiol 1989; 27:2891.
- Suthienkul O, Ishibashi M, Iida T, et al. Urease production correlates with possession of the trh gene in Vibrio parahaemolyticus strains isolated in Thailand. J Infect Dis 1995; 172:1405.
- Okuda J, Ishibashi M, Abbott SL, et al. Analysis of the thermostable direct hemolysin (tdh) gene and the tdh-related hemolysin (trh) genes in urease-positive strains of Vibrio parahaemolyticus isolated on the West Coast of the United States. J Clin Microbiol 1997; 35:1965.
- Lynch T, Livingstone S, Buenaventura E, et al. Vibrio parahaemolyticus disruption of epithelial cell tight junctions occurs independently of toxin production. Infect Immun 2005; 73:1275.
- Makino K, Oshima K, Kurokawa K, et al. Genome sequence of Vibrio parahaemolyticus: a pathogenic mechanism distinct from that of V cholerae. Lancet 2003; 361:743.
- Park KS, Ono T, Rokuda M, et al. Functional characterization of two type III secretion systems of Vibrio parahaemolyticus. Infect Immun 2004; 72:6659.
- Okada N, Iida T, Park KS, et al. Identification and characterization of a novel type III secretion system in trh-positive Vibrio parahaemolyticus strain TH3996 reveal genetic lineage and diversity of pathogenic machinery beyond the species level. Infect Immun 2009; 77:904.
- Hubbard TP, Chao MC, Abel S, et al. Genetic analysis of Vibrio parahaemolyticus intestinal colonization. Proc Natl Acad Sci U S A 2016; 113:6283.
- Kelly MT, Stroh EM. Temporal relationship of Vibrio parahaemolyticus in patients and the environment. J Clin Microbiol 1988; 26:1754.
- Parveen S, Hettiarachchi KA, Bowers JC, et al. Seasonal distribution of total and pathogenic Vibrio parahaemolyticus in Chesapeake Bay oysters and waters. Int J Food Microbiol 2008; 128:354.
- Centers for Disease Control and Prevention (CDC). Outbreak of Vibrio parahaemolyticus infections associated with eating raw oysters--Pacific Northwest, 1997. MMWR Morb Mortal Wkly Rep 1998; 47:457.
- McLaughlin JB, DePaola A, Bopp CA, et al. Outbreak of Vibrio parahaemolyticus gastroenteritis associated with Alaskan oysters. N Engl J Med 2005; 353:1463.
- Martinez-Urtaza J, Lozano-Leon A, Varela-Pet J, et al. Environmental determinants of the occurrence and distribution of Vibrio parahaemolyticus in the rias of Galicia, Spain. Appl Environ Microbiol 2008; 74:265.
- Nair GB, Ramamurthy T, Bhattacharya SK, et al. Global dissemination of Vibrio parahaemolyticus serotype O3:K6 and its serovariants. Clin Microbiol Rev 2007; 20:39.
- Chowdhury NR, Chakraborty S, Ramamurthy T, et al. Molecular evidence of clonal Vibrio parahaemolyticus pandemic strains. Emerg Infect Dis 2000; 6:631.
- Bhuiyan NA, Ansaruzzaman M, Kamruzzaman M, et al. Prevalence of the pandemic genotype of Vibrio parahaemolyticus in Dhaka, Bangladesh, and significance of its distribution across different serotypes. J Clin Microbiol 2002; 40:284.
- Yeung PS, Hayes MC, DePaola A, et al. Comparative phenotypic, molecular, and virulence characterization of Vibrio parahaemolyticus O3:K6 isolates. Appl Environ Microbiol 2002; 68:2901.
- Han H, Wong HC, Kan B, et al. Genome plasticity of Vibrio parahaemolyticus: microevolution of the 'pandemic group'. BMC Genomics 2008; 9:570.
- DePaola A, Ulaszek J, Kaysner CA, et al. Molecular, serological, and virulence characteristics of Vibrio parahaemolyticus isolated from environmental, food, and clinical sources in North America and Asia. Appl Environ Microbiol 2003; 69:3999.
- Ansaruzzaman M, Lucas M, Deen JL, et al. Pandemic serovars (O3:K6 and O4:K68) of Vibrio parahaemolyticus associated with diarrhea in Mozambique: spread of the pandemic into the African continent. J Clin Microbiol 2005; 43:2559.
- Martinez-Urtaza J, Simental L, Velasco D, et al. Pandemic Vibrio parahaemolyticus O3:K6, Europe. Emerg Infect Dis 2005; 11:1319.
- González-Escalona N, Cachicas V, Acevedo C, et al. Vibrio parahaemolyticus diarrhea, Chile, 1998 and 2004. Emerg Infect Dis 2005; 11:129.
- Martinez-Urtaza J, Huapaya B, Gavilan RG, et al. Emergence of Asiatic Vibrio diseases in South America in phase with El Niño. Epidemiology 2008; 19:829.
- Gonzalez-Escalona N, Gavilan RG, Toro M, et al. Outbreak of Vibrio parahaemolyticus Sequence Type 120, Peru, 2009. Emerg Infect Dis 2016; 22:1235.
- Centers for Disease Control and Prevention. 2015 Food Safety Report. http://www.cdc.gov/foodnet/pdfs/foodnet-mmwr-progress-508-final.pdf (Accessed on June 29, 2016).
- Centers for Disease Control and Prevention. National Enteric Disease Surveillance: COVIS Annual Summary 2014. http://www.cdc.gov/nationalsurveillance/pdfs/covis-annual-summary-2014-508c.pdf (Accessed on June 29, 2016).
- Newton AE, Garrett N, Stroika SG, et al. Increase in Vibrio parahaemolyticus infections associated with consumption of Atlantic Coast shellfish--2013. MMWR Morb Mortal Wkly Rep 2014; 63:335.
- Bean NH, Maloney EK, Potter ME, et al. Crayfish: a newly recognized vehicle for vibrio infections. Epidemiol Infect 1998; 121:269.
- Daniels NA, MacKinnon L, Bishop R, et al. Vibrio parahaemolyticus infections in the United States, 1973-1998. J Infect Dis 2000; 181:1661.
- Centers for Disease Control and Prevention (CDC). Outbreak of Vibrio parahaemolyticus infection associated with eating raw oysters and clams harvested from Long Island Sound--Connecticut, New Jersey, and New York, 1998. MMWR Morb Mortal Wkly Rep 1999; 48:48.
- Dechet AM, Yu PA, Koram N, Painter J. Nonfoodborne Vibrio infections: an important cause of morbidity and mortality in the United States, 1997-2006. Clin Infect Dis 2008; 46:970.
- Yoder JS, Hlavsa MC, Craun GF, et al. Surveillance for waterborne disease and outbreaks associated with recreational water use and other aquatic facility-associated health events--United States, 2005-2006. MMWR Surveill Summ 2008; 57:1.
- Centers for Disease Control and Prevention (CDC). Vibrio illnesses after Hurricane Katrina--multiple states, August-September 2005. MMWR Morb Mortal Wkly Rep 2005; 54:928.
- Hughes JM, Boyce JM, Aleem AR, et al. Vibrio parahaemolyticus enterocolitis in Bangladesh: report of an outbreak. Am J Trop Med Hyg 1978; 27:106.
- Bolen JL, Zamiska SA, Greenough WB 3rd. Clinical features in enteritis due to Vibrio parahemolyticus. Am J Med 1974; 57:638.
- Bej AK, Patterson DP, Brasher CW, et al. Detection of total and hemolysin-producing Vibrio parahaemolyticus in shellfish using multiplex PCR amplification of tl, tdh and trh. J Microbiol Methods 1999; 36:215.
- Depaola A, Jones JL, Noe KE, et al. Survey of postharvest-processed oysters in the United States for levels of Vibrio vulnificus and Vibrio parahaemolyticus. J Food Prot 2009; 72:2110.