Volume 14, Number 12—December 2008
CME ACTIVITY
Clinical Characteristics and Molecular Subtyping of Vibrio vulnificus Illnesses, Israel
Ronit Zaidenstein, Chantal Sadik, Larisa Lerner, Lea Valinsky, June Kopelowitz, Ruth Yishai, Vered Agmon, Michele Parsons, Cheryl Bopp, and Miriam Weinberger
Table 1
Clinical characteristics of patients with Vibrio vulnificus biotype 3 infections, Israel, 1998–2005*
| Clinical characteristics | All patients | Patients with laboratory-confirmed infection | Patients with suspected infection | p value† |
|---|---|---|---|---|
| No. patients studied (%) | 132 (100) | 94 (100) | 38 (100) | |
| Males, no. (%) | 64 (48.5) | 40 (42.6) | 24 (63.2) | 0.036 |
| M:F ratio | 0.94:1 | 0.7:1 | 1.7:1 | |
| Mean age, y; median (range) |
58.9; 66 (10–93) |
63.1; 68 (10–93) |
48.7; 47.5 (11–88) |
NS |
| Clinical presentation | ||||
| Mean incubation time, h; median (range) | 17.7; 12 (1–96) | 13.9; 12 (0.5–48) | 28; 20 (1–96) | <0.001 |
| Bacteremia, no. (%) | 31 (23.5) | 31 (33.0) | NA | |
| Septic shock, no. (%) | 11 (8.7)‡ | 10 (11.0)§ | 1 (2.9)¶ | NS |
| Necrotizing fasciitis, no. (%) | 16 (12.7)‡ | 16 (17.6)§ | 0 | 0.006 |
| Uncomplicated cellulitis, no. (%) | 92 (69.7)‡ | 62 (68.1)§ | 30 (85.7)¶ | 0.072 |
| Abscess formation, no. (%) | 12 (9.8)‡ | 7 (7.7)§ | 5 (14.3)¶ | NS |
| Peritonitis, no. (%) |
1 (0.8)‡ |
1 (1.1)§ |
0 |
NS |
| Underlying diseases# | ||||
| None, no. (%) | 59 (44.7) | 49 (52.1) | 10 (26.3) | 0.007 |
| Liver disease, no. (%) | 18(13.6) | 18 (19.1) | 0 | 0.002 |
| Diabetes mellitus, no. (%) | 18 (13.6) | 13 (13.8) | 5 (13.2) | NS |
| Ischemic heart disease, no. (%) | 9 (6.8) | 8 (8.5) | 1 (2.6) | NS |
| Altered immune status,** no. (%) | 13 (9.8) | 9 (9.6) | 4 (10.5) | NS |
| Hemolytic anemia, no. (%) |
3 (2.3) |
2 (2.1) |
1 (2.6) |
NS |
| Outcome | ||||
| Mean hospitalization time, d; median (range) | 10.9; 9 (2–50) | 12.7; 11 (2–50) | 6.2; 5 (2–20) | 0.003 |
| Amputation, no. (%) | 9 (6.8) | 9 (9.6) | 0 | 0.059 |
| Death, no. (%) |
10 (7.6) |
10 (10.6) |
0 |
0.062 |
| No. patients with known fish exposure†† | 104 | 72 | 32 | |
| Tilapia, no. (%) | 86 (82.7) | 60 (83.3) | 26 (81.3) | NS |
| Carp, no. (%) | 14 (13.5) | 10 (13.9) | 4 (12.5) | NS |
| Tilapia plus carp, no. (%) | 2 (1.9) | 1 (1.4) | 1 (3.1) | NS |
| Other, no. (%) | 2 (1.9) | 1 (1.4) | 1 (3.1) | NS |
*NA, not available; NS, not significant.
†For comparison between patients with laboratory-confirmed and suspected infections.
‡n = 126.
§n = 91.
¶n = 35.
#Patients may have >1 underlying diseases.
**Due to malignancy or immunosuppressive state.
††Percentages of exposure to each fish type based on total no. patients with known fish exposure in each category.
