Pathogenic Gram-Negative

Vibrios
BY: Fikru Adere (BSC, MSc in Microbiology)
Email: fikruadere@gmail.com

Arsi university college of health sciences

06/27/2023 Fikru A. (BSc,MSc in medical microbiology) 1

• Vibrio species are small (0.5 to 1.5 to 3μm),
curved ,gram-negative rods
• Actively motile, gram-negative curved rods.

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Vibrios
• Share many characteristics with enteric bacteria
• Found in water environments worldwide
• They cause the disease cholera
• The infectious dose can be as low as 103 to 105
organisms.
• Cholera is usually seen in communities with poor
sanitation
• Infections caused by V. parahaemolyticus and V.
vulnificusis acquired through consumption of
improperly cooked seafood (particularly oysters) or
exposure to contaminated seawater.
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• V. vulnificus responsible for severe wound
• infections and a high incidence of fatal
• outcomes and septicemia

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• Vibrio species
– can grow on a variety of simple media within a
broad temperature range (from 14°C to 40°C)
– require sodium chloride (NaCl) for growth
– Tolerate a wide range of pH (e.g., pH of 6.5 to
9.0)
– but are susceptible to stomach acids.

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 Vibrio con’td….

• Have various pili that are important for virulence

• Separated from the Enterobacteriacea on the
basis of a positive oxidase reaction and the
presence of polar flagella
• possess LPS consisting of lipid A (endotoxin),
core polysaccharide, and an O polysaccharide
side chain

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• Three species are particularly important
human pathogens
• Vibrio cholerae
• Vibrio parahaemolyticus
• Vibrio vulnificus

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• O polysaccharide antigen used to classify vibrios into
serogroups
• V. cholerae O1 and O139 produce cholera toxin and
are associated with epidemics of cholera

• V. cholerae sero group O1 is further subdivided into

serotypes and biotypes
–Three serotypes are recognized: Inaba, Ogawa, and
Hikojima
–Two biotypes are recognized: Classical and El Tor
• 7 global pandemic have occurred (6th classical and
the current 7th is El Tor)
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Physiology and Structure
• V. vulnificus and non-O1 V. cholerae produce
polysaccharide capsules that are important for
disseminated infections.
• Plasmids, including those encoding AMR, are
also commonly found in Vibrio species.
• The lysogenic bacteriophage CTXΦ encodes
the genes for the two subunits of cholera
toxin (ctx A and ctx B)

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• The phage attached with pili, enter the cell and
intigratein bacteria chromosome.
• This locus also codes for other virulence factors
• the ace gene for accessory cholera enterotoxin
• Zot gene for the zonnula occludens toxin
• the cep gene for chemotaxis proteins.

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• Cholera toxin is a complex A-B toxin
• functionally similar to the heat-labile
enterotoxin of Escherichia coli
• B subunits of cholera toxin binds to the
ganglioside GM1 receptors on the intestinal
epithelial cells
• Activate adenlatecyclase and cause “rice water”
diarrhoea
• Can loose 1litre of diarrhea per hour!!!

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• V. cholerae are able to adhere to the mucosal
cell layer by means of
 TCP encoded by the tcp gene complex and
 Chemotaxis proteins encoded by the cep genes
• Protect the bacteria from flush by excessive
fluid secretion

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• In the absence of cholera toxin V.cholera O1 still
cause diarrhoea through the action of; zonnula
occludens toxin and accessory cholera
enterotoxin
• Zonnula occludens toxin loosens the tight
junctions of the small intestine mucosa
• leading to increased intestinal permeability, and
the enterotoxin produces increased fluid
secretion

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• V. cholerae O139 also possesses the same
virulence complex as that of the V .cholerae O1
and cause the same disease
• V.parahemolyticus produce thermo stable
direct hemolysin(TDH) or kingwa hemolysis
which stimulate chlorine secretion by
increasing calcium concentration
• V.vulinificus produce capsule and escape
phagocytosis

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 Diarrhea causing mechanism of cholera
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Clinical Diseases
• Cholera
• Caused by V . Cholera O1 an O139
• The clinical manifestations of cholera begin an
average of 2 to 3 days
• abrupt onset of watery diarrhea and vomiting
• Colorless odorless stool with some mucus(rice
water stool)

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• Excessive fluid loss leads to dehydration,
painful muscle cramps, metabolic acidosis
(bicarbonate loss), hypokalemia and
hypovolemic shock (potassium loss)
• The mortality rate is 60% in untreated patients
but less than 1% in patients who are promptly
treated with replacement of lost fluids and
electrolytes

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Diseases caused by V. para haemolyticus
• Develops after 5 to 72 hours
• can range from a self-limited diarrhea to a
mild, cholera-like illness
• Charachterized by explosive, watery diarrhea
• No grossly evident blood or mucus is found in
stool specimens except in severe cases
• Wound infections with this organism can
occur in people exposed to contaminated
seawater.
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V.Vulinficus Con’t….

Disease caused by V.vulinficus

• The most common presentations are;
• primary septicemia after consumption of
contaminated raw oysters
• rapidly progressive wound infection after
exposure to contaminated seawater.
• Characterized by sudden onset of fever and
chills, vomiting, diarrhea, and abdominal pain

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• skin infection is characterized by initial
swelling, erythema, and pain at the wound
site,
• followed by the development of vesicles or
Bullae and eventual tissue necrosis together
with systemic signs of fever and chills

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 Lab. Dx
Vibrios
–Diagnosis usually based on characteristic diarrhea
• Thiosulfate citrate bile salt sucrose agar (TCBS) is a selective
and differential (based on sucrose fermentation) medium
• It supports the growth of most species and is particularly
useful for isolating V. cholerae and V. parahaemolyticus.
• V. cholerae is sucrose positive and will produce yellow
colonies on TCBS agar, whereas V. parahaemolyticusis
sucrose negative.
• Most laboratories use biochemical testing to presumptively
identify species and then confirm with serology based on
somatic O antigens.
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 Treatment
• promptly treated with fluid and electrolyte
replacement
• Antibiotic therapy can reduce toxin production and
clinical symptoms, as well as decrease transmission
• A single dose of azithromycin, doxycycline, or
ciprofloxacin is currently the drug of choice for
children and adults because macrolide resistance is
relatively uncommon
• For wound infection, the combination of minocycline
or doxycycline combined with ceftriaxone or
cefotaxime appears to be the most effective treatment

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