Correlations between Clinical Features and Mortality in Patients with <i>Vibrio vulnificus</i> Infection

<div><p><i>Vibrio vulnificus</i> is a common gram-negative bacterium, which might cause morbidity and mortality in patients following consumption of seafood or exposure to seawater in Southeast China. We retrospectively analyzed clinical data of patients with laboratory confirmed <i>V</i>. <i>vulnificus</i> infection. Twenty one patients were divided into a survival group and a non-surviving (or death) group according to their clinical outcome. Clinical data and measurements were statistically analyzed. Four patients (19.05%) died and five patients gave positive cultures from bile fluid, and 16 other patients gave positive culture from blood or blisters. Ten patients (47.62%) had an underlying liver disease and marine-related events were found in sixteen patients (76.2%). Patients with heavy drinking habits might be at increased mortality (p = 0.028). Clinical manifestations of cellulitis (47.6%), septic shock (42.9%) and multiple organ failure (28.6%) were statistically significant when comparing survivors and non-survivors (p = 0.035, p = 0.021 and p = 0.003, respectively). The laboratory results, including hemoglobin < 9.0 g/L (p = 0.012), platelets < 2.0×10⁹ /L, prothrombin time activity (PTA) <20%, decreased serum creatinine and increased urea nitrogen were statistically significant (p = 0.012, p = 0.003, p = 0.028 and p = 0.028, respectively). Patients may be at a higher risk of mortality under situations where they have a history of habitual heavy alcoholic drink consumption (p = 0.028, OR = 22.5, 95%CI 1.5–335.3), accompanied with cellulitis, shock, multiple organ failure, and laboratory examinations that are complicated by decreased platelets, hemoglobin and significantly prolonged prothrombin time (PT).</p></div

Laboratory results measured between survivors group and deaths group.

<p>Note: ULN, the upper limit of normal. At our hospital, the normal range for ALT was 5–40 U/L, the normal range for AST was 5–37 U/L, the normal range for serum creatinine was 40–108 μmol/L, and the normal range for urea nitrogen was 1.7–8.3 mmol/L.</p><p>Laboratory results measured between survivors group and deaths group.</p

<i>V</i>. <i>vulnificus</i> infection that presented as swelling, Hemorrhagic bulla and phlegmon are observed on the right hand.

<p><i>V</i>. <i>vulnificus</i> infection that presented as swelling, Hemorrhagic bulla and phlegmon are observed on the right hand.</p

Seasonal distribution of <i>V</i>. <i>vulnificus</i> infections at the First Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China.

<p>Seasonal distribution of <i>V</i>. <i>vulnificus</i> infections at the First Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China.</p

Clinical syndromes of <i>V</i>. <i>vulnificus</i> infections in the First Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China.

<p>Clinical syndromes of <i>V</i>. <i>vulnificus</i> infections in the First Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China.</p

Treatment strategies and clinical outcomes.

<p>Treatment strategies and clinical outcomes.</p