Background:
@EN V. vulnificus infection is a highly fatal disease prevailing in Chonnam area. To increase understanding of V. vulnificus infection, we investigated clinical and epidemiological characteristics of V.vulnificus infection in Chonnam area.
@ES Methods:
@EN We retrospectively reviewed the clinical records of 92 cases with V. vulnificus infection which admitted to Chonnam University Hospital from 1983 to 1994 and bacteriologically were confirmed.
@ES Results:
@EN 1) V.vulnificus was isolated from blood in 22%, tissue in 47%, blood and tissue in 29%, blood and peritoneal fluid in 1%, and blood and cerebrospinal fluid in 1% of the cases. All the isolates were susceptible to tetracycline,
chloramphenicol,
ampicillin, gentamicin, pipercillin, cefoperazone and cefotaxime. About eighty-five percent of the isolates were susceptible to amikacin, kanamycin and carbenicillin and seventy-seven percent to cephalothin. All the isolates were resistant to
colistin.
2) The yearly distribution was 21 cases in 1985, followed by 12 in 1994, 10 in 1989, 9 in 1987 in decreasing. The monthly distribution was each 27 cases in July and August followed by 24 in September. 8 in June, 5 in October, 1 in May. The
majority
of
cases occurred in coastal areas and nearly inlands of Chonnam province.
3) All of V. vulnificus infections occurred in association with ingestion of raw seafoods. The age and sex distribution ranged from the thirties to the eighties and occurred mainly in adult males in the fifties(48%) and the forties(24%). Of
ninety-two
cases, 73 cases had underlying liver diseases and 67 cases were heavy alcohol consumers.
4) Almost all cases showed primary septicemia except one which had wound infection without septicemia. One case showed septicemia with meningeal symptoms. Clinical manifestations included skin lesions(96%), pain in the extremities or
myalgia(56%),
hypotension(52%), fever(47%), chills(43%), diarrhea(33%), abdominal pain(26%), oliguria(9%), dyspnea(7%) and melena(2%). Skin lesions included vesicles or bullae(56%), edema(52%), erythema(51%), necrosis(18%), purpura(11%), macules(7%) and
pustules(2%).
Most of the skin lesions developed in the lower extremities.
5) The average sea water temperature ranged from 16.3℃ to 28.7℃ which was provided by National Fisheries Research & Developement Agency from 1983 to 1994, when V. vulnificus infection occurred. As sea water temperature rose, the incidence of V.
vulnificus infection tended to be increased(r=0.43 p=0.006).
6) The overall case fatality rate was 57.6% There were no significant differences between survivors and non-survivors in vital signs, incubation period, arrival time, and liver function test except aspartate aminotransferase. However, leukocyte
and
platelet counts were significanty lower in non-survivors (P<0.05).
@ES Conclusion:
@EN In spite of the susceptible antibioties therapy and intensive care, V. vulnificus infection was highly fatal. Therefore, we stress that prevention is more important rather than treatment of the disease.
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