Central Florida Man Dies From Vibrio Vulnificus Bacteria Infection

A 56-year-old resident of Winter Haven is the latest Floridian to die from the Vibrio vulnificus bacteria, according to local media reports, including TCPalm.

The victim contracted the disease after he want saltwater fishing. He was dead from the bacterial infection in three days.

As the Florida Department of Health  notes, Vibrio vulnificus is a bacterium that normally lives in warm seawater. It is part of a group of vibrios that are called "halophilic" because they require salt. Vibrio vulnificus is a naturally occurring bacteria in warm, brackish seawater.

While Vibrio vulnificus infections are rare, it has been responsible for at least a dozen deaths in 2015.

The Florida Department of Health  provides the following tips for preventing Vibrio vulnificus infections:

• Do not eat raw oysters or other raw shellfish.
• Cook shellfish (oysters, clams, mussels) thoroughly.
• For shellfish in the shell, either a) boil until the shells open and continue boiling for five more minutes, or b) steam until the shells open and then continue cooking for nine more minutes. Do not eat those shellfish that do not open during cooking. Boil shucked oysters at least three minutes, or fry them in oil at least 10 minutes at 375°F.
• Avoid cross-contamination of cooked seafood and other foods with raw seafood and juices from raw seafood.
• Eat shellfish promptly after cooking and refrigerate leftovers.
• Avoid exposure of open wounds or broken skin to warm salt or brackish water, or to raw shellfish harvested from such waters.
• Wear protective clothing (e.g., gloves) when handling raw shellfish.

Phenelle Segal
Oct 13, 2015

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Warning to Florida Beachgoers: Watch Out for Vibrio Vulnificus Infections

The Florida Department of Health (DOH) is reminding visitors to the state's beaches to take proper precautions to reduce the risk of contracting infections due to the Vibrio vulnificus bacterium.

The DOH stated that there have been eight reported cases of Vibrio vulnificus infections in 2015 through June 12, which include two deaths.

According to the DOH, Vibrio vulnificus is a bacterium that normally lives in warm seawater and is part of a group of vibrios that are called 'halophilic' because they require salt. It is a naturally occurring bacteria in warm, brackish seawater, and infections are rare.

According to an online resource about Vibrio vulnificus developed by the DOH, people can become infected with Vibrio vulnificus when they eat raw shellfish, particularly oysters. The bacterium is frequently isolated from oysters and other shellfish in warm coastal waters during the summer months. Since it is naturally found in warm marine waters, people with open wounds can be exposed to Vibrio vulnificus through direct contact with seawater. The infection is diagnosed by stool, wound, or blood cultures. There is no evidence of person-to-person transmission of Vibrio vulnificus.

According to the Centers for Disease Control and Prevention (CDC), among healthy people, ingestion of Vibrio vulnificus can cause vomiting, diarrhea and abdominal pain. In immunocompromised persons, particularly those with chronic liver disease, Vibrio vulnificus can infect the bloodstream, causing a severe and life-threatening illness characterized by fever and chills, decreased blood pressure (septic shock) and blistering skin lesions. Vibrio vulnificus bloodstream infections are fatal about 50% of the time.

There are a number of cooking-related tips for preventing Vibrio vulnificus infections, including not eating raw oysters or other raw shellfish, and wearing protective clothing (e.g., gloves) when handling raw shellfish. For beachgoers, the DOH recommends the following:

• Avoid exposure of open wounds or broken skin to warm salt or brackish water, or to raw shellfish harvested from such waters.
• Individuals who are immunocompromised (e.g., chronic liver disease, kidney disease, weakened immune system) should wear proper foot protection to prevent cuts and injury caused by rocks and shells on the beach.

Healthcare professionals are advised to have a high suspicion for this organism when patients present with stomach illness, fever or shock following the ingestion of raw seafood, especially oysters, or with a wound infection after exposure to seawater. If Vibrio vulnificus is suspected, treatment should be initiated immediately because antibiotics improve survival. Aggressive attention should be given to the wound site; for patients with wound infections, amputation of the infected limb is sometimes necessary.

Phenelle Segal
Jun 24, 2015

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Healthcare-Associated Infections in Breast Implant Patients

Healthcare-associated surgical site infections in patients undergoing breast implant surgery have been documented at an increasing rate and are identified more often in patients undergoing construction versus augmentation. Infections have become the leading cause of postoperative morbidity in this population.

When working up a post-operative surgical site infection in breast implant patients, it is important to note the patient's medical or surgical condition. For example, patients who are undergoing mastectomy and radiation therapy for cancer will run a higher risk of infection than a healthy woman who is undergoing augmentation.

Operating room procedures and surgical technique are important to review as well. The origin of infection in women with breast implants can be complex, and may require the expertise of a clinical infection prevention specialist who can assist with an investigation and determine the nature of the infection and possible causes.

Of note in recent years is the emergence of an important group of opportunistic pathogens known as nontuberculous mycobacteria or NTM. They grow rapidly and are often thought to be a cause of infection in breast implant patients.

Phenelle Segal, RN, CIC, President of Infection Control Consulting Services, recently began consulting in Florida and has been hired by several office-based surgery practices as well as ambulatory surgery centers (ASCs) to assist with outbreaks or clusters of NTM. Breast implant infections related to mycobacterium fortuitum, abscessus and chelonae have been the predominant cases she has investigated. NTM is challenging and requires a specific workup for the potential causes. Plastic surgery practices, particularly those located in South Florida due to the heavy concentration of breast reconstruction and cosmetic services in the area, need to recognize the importance of vigilant infection prevention and control practices.

Phenelle has encountered patient infections with various bacterial offending organisms in other plastic surgery procedures in Florida besides breast implants. These include, but are not limited to, Brazilian Butt Lift infections and abdominoplasty infections. Staphylococcus aureus, MRSA and coagulase negative Staphylococcus surgical site infections have also been reviewed in the plastic surgery setting. On-site observation of the environment as well as specific clinical practices is imperative in order to mitigate the risk of infection.

Phenelle Segal
Nov 17, 2014

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