Abstract

Background Vibrio spp. are aquatic bacteria that prefer warm seawater with moderate salinity. In humans, they can cause gastroenteritis, wound infections, and ear infections. During the summers of 2018 and 2019, unprecedented high sea surface temperatures were recorded in the German Baltic Sea.AimWe aimed to describe the clinical course and microbiological characteristics of Vibrio infections in Germany in 2018 and 2019.MethodsWe performed an observational retrospective multi-centre cohort study of patients diagnosed with domestically-acquired Vibrio infections in Germany in 2018 and 2019. Demographic, clinical, and microbiological data were assessed, and isolates were subjected to whole genome sequencing and antimicrobial susceptibility testing.ResultsOf the 63 patients with Vibrio infections, most contracted the virus between June and September, primarily in the Baltic Sea: 44 (70%) were male and the median age was 65 years (range: 2–93 years). Thirty-eight patients presented with wound infections, 16 with ear infections, six with gastroenteritis, two with pneumonia (after seawater aspiration) and one with primary septicaemia. The majority of infections were attributed to V. cholerae (non–O1/non-O139) (n = 30; 48%) or V. vulnificus (n = 22; 38%). Phylogenetic analyses of 12 available isolates showed clusters of three identical strains of V. vulnificus, which caused wound infections, suggesting that some clonal lines can spread across the Baltic Sea.ConclusionsDuring the summers of 2018 and 2019, severe heatwaves facilitated increased numbers of Vibrio infections in Germany. Since climate change is likely to favour the proliferation of these bacteria, a further increase in Vibrio-associated diseases is expected.

Highlights

  • The genus Vibrio, which belongs to the family Vibrionaceae and the class Gammaproteobacteria, includes many species that are potential human pathogens [1]

  • Reliable anamnestic information about the precise place of infection was available for 36 patients, all of whom contracted Vibrio infections after recreational exposure to the open Baltic Sea or its estuaries (n = 34) or after consumption of shrimp caught in the North Sea or the Baltic Sea (n = 2)

  • Nine patients were diagnosed while hospitalised near the Baltic Sea, so it is highly likely that their infections occurred during exposure to the Baltic Sea

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Summary

Introduction

The genus Vibrio, which belongs to the family Vibrionaceae and the class Gammaproteobacteria, includes many species that are potential human pathogens [1]. V. cholerae strains not included in these serogroups as well as other Vibrio spp. are referred to as noncholera Vibrio spp. and are ubiquitous aquatic bacteria with a worldwide distribution, especially in warm estuarine and marine ecosystems [2]. These halophilic bacteria prefer low to moderate salinity (less than 25 parts per thousand (ppt) NaCl) [4]. Vibrio spp. are aquatic bacteria that prefer warm seawater with moderate salinity In humans, they can cause gastroenteritis, wound infections, and ear infections. Since climate change is likely to favour the proliferation of these bacteria, a further increase in Vibrio-associated diseases is expected

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