Vibrio species

Background:

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Other   (Gram Negative Bacilli)  
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>Aeromonas species:
     1] Aeromonas hydrophila
     2] Aeromonas veronii
     3] Aeromonas shubertii
>Bartonella species:
     1] Bartonella bacilliformis
     2] Bartonella henselae (organism responsible for cat scratch disease)
     3] Bartonella Quintana
     4] Other
>Campylobacter:
     1] Campylobacter fetus
     2] Campylobacter jejuni
>Capnocytophaga species:
     1] Capnocytophaga canimorsus
     2] Capnocytophaga ochracea
>Francisella tularensis
>Helicobacter pylori
>Legionella species: ( L. pneumophila)
>Plesiomonas shigelloides
>Vibrio species: Led
     1] Vibrio cholera
     2] Vibrio parahaemolyticus
     3] Vibrio damsela
     4] Vibrio vulnificus
     5] Others

Vibrio sepcies:  

  • Gram-negative bacteria with a curved rod shape (motile with polar flagella). 
  • Facultative anaerobes that test positive for oxidase. 
  • Non-spore forming. 
  • Several species are pathogenic and are frequently linked to foodborne infection
  • – gastroenteritis (usually associated with eating undercooked seafood).
  • V. cholerae (the causative agent of cholera). 

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Therapy:

Important considerations:  The choice of an agent should be based on local antimicrobial sensitivities, site of infection, cost, and comorbid conditions.   Generally, the most common agents/regimens are listed first. Listed dosages may need to be adjusted for renal dysfunction.  

Vibrio cholera:

  1. Doxycycline 300 mg orally x 1  (single dose).  [Effective as Tetracycline 500mg q6h x 3 days based on stool output, duration of diarrhea, hydration requirements, etc.]
  2. Azithromycin 1 gram orally x 1  OR  500mg orally once daily for 3 days.
  3. Erythromycin 250-500 mg orally three times daily for x 3 days
  4. Ciprofloxacin 1 gram (single dose). Other regimens listed. Not as effective as agents listed above.

Vibrio parahaemolyticus:

  1. Doxycycline 100mg orally or IV twice daily x 5 to 7 days
  2. Azithromycin 500mg orally once daily for 3 days.
  3. Ciprofloxacin 500 mg orally q12h x 3 days
  4. Patients with severe infections e.g. septicemia or wound infections- may require at least 2 weeks of therapy:
    • Doxycycline 100mg orally or IV twice daily PLUS
       [ Cefotaxime 2 grams IV q8h  OR  Ceftriaxone 1-2 grams IV q24h ]

Vibrio damsela, vulnificus:

  1. Doxycycline 100mg orally or IV twice daily  PLUS   Cefotaxime 2 grams IV q8h  OR Ceftriaxone 1-2 grams IV q24h
  2. Minocycline 200 mg x 1 (IV or oral),  followed by 100mg q12h  PLUS 
        Cefotaxime 1-2 grams IV q8h  (Life-threatening: 2 grams IV q4h)
  3. Levofloxacin 500mg – 750 mg IV/PO once daily

Vibrio species