The deadly bacterium Vibrio vulnificus, commonly known as “carnivorous”, was detected several kilometers from Świnoujście. Its victim was a 30-year-old inhabitant of Międzyzdroje – “The carnivorous bacterium literally” ate “the muscles of the man’s leg” – wrote the iswinoujscie.pl website. The patient was admitted to the ICU in a Szczecin hospital. What is a “carnivorous bacterium” really? Where did it come from in the Baltic Sea? How can infection end? We recall the interview with prof. dr hab. Waleria Hryniewicz, a specialist in the field of medical microbiology.
- A resident of Międzyzdroje in Zachodniopomorskie came to the ICU of a specialized hospital in Szczecin, who was infected with the so-called a carnivorous bacterium, i.e. Vibrio vulnificus
- His condition was described as serious because some of the man’s thigh muscles were actually “eaten” by the bacterium Vibrio vulnificus
- These bacteria can cause various forms of infection – the most common are skin and subcutaneous tissue. Necrotising fasciitis can occur, but also gastrointestinal infections and sepsis
- As prof. Waleria Hryniewicz at the site of bacterial penetration, a rapidly enlarging erythema develops into hemorrhagic blisters, necrotic lesions and disintegrating tissues. “This bacterium produces a lot of toxins, which is why the process is electrifying”
- More information can be found on the Onet homepage
specialist in the field of medical microbiology, she headed the Department of Epidemiology and Clinical Microbiology of the National Medicines Institute, is the chairman of the National Antibiotic Protection Program, and until 2018 she was a national consultant in the field of medical microbiology.
Monika Zieleniewska, Medonet: How do commas of the genus Vibrio vulnificus threaten the health of people resting on the Baltic Sea?
Prof. Waleria Hryniewicz: Warming of the water of the Baltic Sea, which is the fastest of all such reservoirs in the world, along with lower and lower salinity, favors the multiplication of commas, especially when the water temperature exceeds 20 degrees C.
In the countries of the Baltic Sea basin, V. vulnificus is not subject to epidemiological monitoring. We only record cases of infections. They are rare, but the bacterium is new in the Baltic environment and more and more often isolated from its waters. We have the most data on cases of infection from Germany and Sweden.
Vibrio vulnificus penetrates the human body through damaged skin, but also through the digestive tract after eating raw oysters, but also shrimps and crabs. These bacteria can cause various forms of infections, the most common of which affect the skin and subcutaneous tissue, with the most severe form being necrotizing fasciitis. They are also responsible for gastrointestinal infections and sepsis.
What does their colloquial name mean, carnivorous bacteria?
This means that they damage tissues, including muscles, causing necrotic and disintegrating changes. Most often these are necrotic changes in the fascia, but also in the muscles.
What does their attack on our tissues look like?
At the site where the microorganism enters the skin, a rapidly increasing erythema develops into hemorrhagic blisters, followed by necrotic changes and disintegrating tissues.
This bacterium produces many toxins and tissue-destroying enzymes, which is why the process is electrifying. Surgical intervention in order to clean the tissues damaged by the microorganism must be as soon as possible, it is necessary to administer antibiotics. Combination therapy is usually used, and one of the antibiotics must suppress the production of toxins (proteins). The infection is easily generalized and thus leads to sepsis.
Who should be afraid of contact with commas?
People with liver diseases, especially alcoholic cirrhosis, alcohol abusers, and chronic diseases such as diabetes, chronic renal failure, rheumatoid arthritis and immunodeficiency are particularly susceptible to infection. Men are more susceptible.
The fashion for the salutary effects of sea water in the treatment of lesions that violate the continuity of the skin should be abandoned, especially by people with the above-mentioned factors of increased susceptibility (risk), when the temperature of the Baltic water reaches and exceeds 20 degrees Celsius.
Commas are also bacteria that cause cholera, are there similarities between them?
Coastal waters of warm seas are the natural reservoirs for all cuttings, in the case of V. cholerae especially deltas of the great southern rivers. Three species of mites that cause infections in humans are Vibrio cholerae, Vibrio vulnificus and Vibrio parahaemolyticus. Infections caused by them concern the gastrointestinal tract, which they get from contaminated water, or from its inhabitants (e.g. crustaceans) after their consumption.
V. parahemolyticus, the least pathogenic of them, is mainly responsible for gastrointestinal complaints related to the consumption of contaminated food. Apart from V. vulnificans, the family of comma that cause infections in humans also includes cholera, unlike V. vulnificus, it does not cause invasive infections, but is responsible for a specific disease entity, cholera.
It is characterized by severe watery diarrhea that leads to rapid dehydration and death within 8-10 hours. We have been in the 1961th cholera pandemic since 7. Annually, about 100 die from it in the world. people, but the mortality rate is about 1%, which is much less than in infections with V. vulnificans.
In treatment, the most important role is to rehydrate as quickly as possible, to administer less antibiotics, but it is also important in promoting faster recovery and reducing the incidence of secondary cases. Sometimes the dehydration is so dramatic that drips are connected to four limbs simultaneously.
The most important task in the prevention of infection with bacteria of the type of comma is continuous monitoring to assess the degree of risk, access to clean water, control of seafood sources, their storage and preparation for consumption.
Are there any other carnivorous bacteria in Poland?
Yes, we observe similar necrotic changes in the fascia and muscles during infection with Streptococcus pyogenes, i.e. bacteria commonly found in Poland, which are mainly responsible for angina. They also cause various skin infections, such as erysipelas, impetigo, and abscesses.
The most dangerous form of these infections is necrotizing fasciitis, also called “flesh eating disease”, and the clinical picture is similar to that described above for V. vulnificus and is associated with the production of a powerful toxin leading to toxic shock. The procedure is also similar. Necrotic tissues must be removed quickly. There is a race between the surgeon’s knife and the microorganism, and the first one does not always win.
The treatment is surgical together with the administration of antibiotics, including those that inhibit the synthesis of toxins that contribute to the rapid development of the infection. This infection can occur in anyone, not just immunocompromised people, even with minor skin damage or scratching.
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