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Characteristic V. alginolyticus V. parahaemolyticus V. cholerae non-O1/O139 V. vulnificus Other species
Total patients 23 (100) 20 (100) 10 (100) 7 (100) 7 (100)
Demographics
Age, y, median (SD) 50 (+26.7) 53 (+22.8) 69 (+19.7) 66 (+11.5) 40 (+24.8)
Sex
M 19 (83) 15 (75) 7 (70) 7 (100) 6 (86)
F 4 (17) 5 (25) 3 (30) 0 1 (14)
Underlying condition
Heart failure 8 (35) 6 (30) 5 (50) 4 (57) 1 (14)
Neoplasia 1 (4) 5 (25) 4 (40) 0 (0) 1 (14)
Diabetes 2 (9) 3 (15) 1 (10) 1 (14) 1 (14)
Kidney failure 2 (9) 1 (5) 1 (10) 0 3 (43)
Immune disease 2 (9) 2 (10) 1 (10) 0 2 (29)
Hemopathy 1 (4) 1 (5) 1 (10) 1 (14) 1 (14)
Liver disease 1 (4) 1 (5) 2 (20) 1 (14) 0
Alcohol use disorder 2 (9) 1 (5) 2 (20) 2 (29) 0
Preexisting wound 3 (13) 0 0 3 (43) 0
Digestive surgery 2 (9) 2 (10) 1 (10) 0 1 (14)
Time to symptom onset, d, median (SD) 2.4 (+2.0) 1.3 (+0.9) 3 (+4.4) 5.6 (+8.1) 1 (+0.0)
Infection type
Acute 14 (61) 19 (95) 10 (100) 7 (100) 5 (71)
Chronic 9 (39) 1 (5) 0 0 2 (29)
Outcome
Recovered 21 (91) 17 (85) 8 (80) 6 (86) 7 (100)
Died 2 (9) 3 (15) 2 (20) 1 (14) 0

Table 1. Clinical characteristics of patients with Vibrio infection, by species, Bay of Biscay, France, 2001–2019*

*Values are no. (%) except as indicated.

 

Antibiotic V. alginolyticus   V. parahaemolyticus   V. cholerae non-O1/O139   V. vulnificus
S I R S I R S I R S I R
Amoxicillin 1 0 15   1 6 7   2 2 3   5 0 0
Ticarcillin 5 0 10   2 2 9   5 0 1   5 0 0
First-generation cephalosporin 10 4 0   13 1 0   4 1 0   4 1 0

Table 2. Available drug-susceptibility test results for the main antibiotics used to treat Vibrio infections, by species, Bay of Biscay, France, 2001–2019*

*Data are no. of cases. I, intermediate; R, resistant; S, susceptible.

 

Characteristic No sepsis, n = 42   Septic shock, n = 13 p value
No. % (95% CI) No. % (95% CI)
Patient sex
M 35 83 (72–95)   10 77 (54–100) 0.685
F 7 17 (5–28)   3 23 (0.2–46)  
Underlying conditions
Heart failure 18 43 (28–58)   6 46 (19–73) Referent
Neoplasia 6 14 (4–25)   4 31 (6–56) 0.223
Diabetes 7 17 (5–28)   1 8 (0–22) 0.664
Kidney failure 5 12 (2–22)   2 15 (0–35) 0.664
Immune disease 5 12 (2–22)   2 15 (0–35) 0.664
Hemopathy 3 7 (0–15)   2 15 (0–35) 0.582
Liver disease 2 5 (0–11)   3 23 (0–46) 0.318
Alcohol use disorder 3 7 (0–15)   4 31 (6–56) 0.102
Preexisting wound 6 14 (4–25)   0 0 (0–0) 0.317
Digestive surgery 4 10 (1–18)   2 15 (0–35) 0.618
Species
V. alginolyticus 10 24 (11–37)   4 31 (6–56)  
V. parahaemolyticus 14 33 (19–48)   5 38 (12–65)  
V. cholerae non-O1/O139 8 19 (7–31)   2 15 (0–35)  
V. vulnificus 6 14 (4–25)   1 8 (0–22)  
Other Vibrio species 4 10 (1–18)   1 8 (0–22)
Outcome
Recovered 40 95 (89–100)   7 54 (27–81) 0.001
Died 2 5 (0–11)   6 46 (19–73)  

Table 3. Clinical characteristics and outcome of patients with and without septic shock after acute Vibrio infection, Bay of Biscay, France, 2001–2019*

*Median patient age ( + SD) was 60 ( + 21.4) for no sepsis and 61 ( + 15.3) for septic shock.

CME / ABIM MOC

Clinical and Epidemiologic Characteristics and Therapeutic Management of Patients With Vibrio Infections, Bay of Biscay, France, 2001–2019

  • Authors: Florence Hoefler, MD; Xavier Pouget-Abadie, MD; Mariam Roncato-Saberan, MD; Romain Lemarié, MD; Eve-Marie Takoudju, MD; François Raffi, MD; Stéphane Corvec, MD; Morgane Le Bras, MS; Charles Cazanave, MD; Philippe Lehours, MD; Thomas Guimard, MD; Caroline Allix-Béguec, PhD
  • CME / ABIM MOC Released: 11/18/2022
  • Valid for credit through: 11/18/2023
Start Activity

  • Credits Available

    Physicians - maximum of 1.00 AMA PRA Category 1 Credit(s)™

    ABIM Diplomates - maximum of 1.00 ABIM MOC points

    You Are Eligible For

    • Letter of Completion
    • ABIM MOC points

Target Audience and Goal Statement

This activity is intended for primary care physicians, infectious disease specialists, and other clinicians who treat and manage patients who may become infected with Vibrio spp.

The goal of this activity is to assess the epidemiology, microbiology, and prognosis of infection with Vibrio spp.

Upon completion of this activity, participants will:

  • Assess the epidemiology of infection with Vibrio spp. in the current study
  • Evaluate common anatomic sites of infection with Vibrio spp.
  • Distinguish the most common Vibrio spp. isolated in the current study
  • Analyze the treatment and outcomes of Vibrio infections


Disclosures

Medscape, LLC requires every individual in a position to control educational content to disclose all financial relationships with ineligible companies that have occurred within the past 24 months. Ineligible companies are organizations whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.

All relevant financial relationships for anyone with the ability to control the content of this educational activity are listed below and have been mitigated. Others involved in the planning of this activity have no relevant financial relationships.


Faculty

  • Florence Hoefler, MD

    Centre Hospitalier La Rochelle
    La Rochelle
    France
    Centre Hospitalier Troyes
    Troyes
    France

  • Xavier Pouget-Abadie, MD

    Centre Hospitalier La Rochelle
    La Rochelle
    France
     

  • Mariam Roncato-Saberan, MD

    Centre Hospitalier La Rochelle
    La Rochelle
    France
     

  • Romain Lemarié, MD

    Centre Hospitalier La Rochelle
    La Rochelle
    France
     

  • Eve-Marie Takoudju, MD

    Centre Hospitalier Départemental Vendée
    La Roche sur Yon
    France
     

  • François Raffi, MD

    Centre Hospitalier Universitaire de Nantes
    Nantes
    France
     

  • Stéphane Corvec, MD

    Centre Hospitalier Universitaire de Nantes
    Nantes
    France
     

  • Morgane Le Bras, MS

    Centre Hospitalier Universitaire de Nantes
    Nantes
    France
    Centre Hospitalier d'Auxerre
    Auxerre
    France

  • Charles Cazanave, MD

    Centre Hospitalier Universitaire de Bordeaux
    Bordeaux
    France
     

  • Philippe Lehours, MD

    Centre Hospitalier Universitaire de Bordeaux
    Bordeaux
    France

  • Thomas Guimard, MD

    Centre Hospitalier Départemental Vendée
    La Roche sur Yon
    France
     

  • Caroline Allix-Béguec, PhD

    Centre Hospitalier La Rochelle
    La Rochelle
    France

CME Author

  • Charles P. Vega, MD

    Health Sciences Clinical Professor of Family Medicine
    University of California, Irvine School of Medicine
     

    Disclosures

    Charles P. Vega, MD, has the following relevant financial relationships:
    Consultant or advisor for: GlaxoSmithKline; Johnson & Johnson Pharmaceutical Research & Development, L.L.C.
     

Editor

  • Jude Rutledge, BA

    Copyeditor
    Emerging Infectious Diseases

Compliance Reviewer

  • Leigh Schmidt, MSN, RN, CNE, CHCP

    Associate Director, Accreditation and Compliance, Medscape, LLC

    Disclosures

    Leigh Schmidt, MSN, RN, CNE, CHCP, has no relevant financial relationships.


Accreditation Statements


In support of improving patient care, this activity has been planned and implemented by Medscape, LLC and Emerging Infectious Diseases. Medscape, LLC is jointly accredited with commendation by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

    For Physicians

  • Medscape, LLC designates this Journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™ . Physicians should claim only the credit commensurate with the extent of their participation in the activity.

    Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 1.0 MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

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CME / ABIM MOC

Clinical and Epidemiologic Characteristics and Therapeutic Management of Patients With Vibrio Infections, Bay of Biscay, France, 2001–2019: Methods

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Methods

Study Design and Participants

We conducted a multicenter case-series study based on data collected from 8 tertiary and secondary care hospitals in the Bay of Biscay, France. We included all cases of vibriosis other than those caused by V. cholerae O1/O139 diagnosed during January 2001–December 2019.

Diagnosis and Susceptibility Test

We defined a Vibrio infection as a positive biologic sample (e.g., blood, skin sample, surgical biopsy, stool sample, bronchoalveolar lavage, and ear sample) to a Vibrio species other than V. cholerae O1/O139. Conventional microbiologic methods were used to isolate bacteria from the different types of samples. BACTEC automated blood culture system (Becton, Dickinson and Company, https://www.bd.com) was used before conventional culture for the rapid detection of microorganisms in blood samples. Since 2018, automated diagnostic testing of stool samples for direct qualitative detection and differentiation of enteric bacterial pathogens has been performed with the BD MAX Enteric Bacterial Panel performed on the BD MAX system (Becton, Dickinson and Company). Before 2014, API 20 E biochemical tests (bioMérieux, https://www.biomerieux.com) were used for species identification. Since 2014, those tests have been replaced by the use of the Bruker Biotyper matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (https://www.bruker.com). Antibiotic susceptibility was tested on the main class of antibiotics, including penicillins, cephalosporins, carbapenems, and fluoroquinolones. Antimicrobial susceptibility testing was performed using Mueller–Hinten agar disk diffusion tests (AST Disks; Bio-Rad, https://www.bio-rad.com) in accordance with the recommendations of the Committee on Antimicrobial Susceptibility of the French Society for Microbiology. Most isolates were sent to the national reference center for confirmation of species identification and susceptibility results.

Ethics and Regulation

This study received a favorable opinion from the Committee of Expertise for Health Research, Studies, and Evaluations (registration no. TPS 1170745). It was authorized by the Commission Nationale de l’Informatique et des Libertés (decision no. DR-2020–125). A letter explaining the study and the patients’ rights regarding the use of their data was sent to the last known address of the patients. This study was registered on clinicaltrials.gov (identifier NCT04451707).

Variables and Statistical Methods

We retrieved sociodemographic data, sea-related activity, and clinical and therapeutic data from patient medical records. We used means (+SD) to describe continuous variables, and percentages and 95% CIs to describe categoric variables. We explored associated factors with sepsis. We used Mann–Whitney tests to compare continuous data of independent samples where appropriate. We used the Fisher test of homogeneity for categoric variables. We used an α level of 0.05 for statistical tests, for which we also calculated SDs and 95% CIs.