A Case of Sucrose-Positive Vibrio vulnificus Isolation from Blood Culture

혈액에서 Sucrose 양성 Vibrio vulnificus 분리 1예

Vibrio vulnificus is a halophilic bacterium frequently involved in human infection of seafood-associated primary septicemia and primary wound infection, mostly in men with over 40-years of age with underlying liver disease. The primary septicemia, which is the most common form of V. vulnificus infection in Korea, is defined as a systemic illness presenting fever or hypotension with recovery of V. vulnificus from blood or tissue without the apparent primary focus of infection. V. vulnificus typically do not produce acid from sucrose, but a case of primary septisemia was found in a patient at Chonnam K hospital in 1993 from whose blood a sucrose-fermenting strain was isolated. The patient was a 62-year-old man, heavy drinker, with underlying liver disease. He consumed a raw seafood dish two days before onset of the present illness. His symptoms were tenderness and swelling on the right foot. He rapidly developed septicemia, resulting in sudden death. V. vulnificus was isolated from the venous blood culture of the patient. On subculture, the isolate formed yellow colonies on TCBS and produced acid from sucrose. Because of these characteristics, species identification was not achieved by the API 20E and was delayed. Other characteristics of the isolate were identical to those of typical V. vulnificus. The isolate was common serotype O4A and possession of V. vulnificus-specific cytolysin gene was detected by PCR. The isolate was susceptible to all the antimicrobial agents tested including tetracycline, but was intermediate to colistin. In conclusion, it is important that microbiologists be aware of the presence of sucrose-positive V. vulnificus when he or she identifies gram-negative bacilli, which is isolated from the blood of patients with a recent history of raw seafood dish consumption.