Laboratory Infection by Vibrio Parahaemolyticus

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(Sakazaki, 1965), and has since been encountered in cases of gastroenteritis in various parts of the world, including Thailand and the Philippines (Dr H. Inaba, personal communication), Australia (Battey et al., 1970), Malaysia (Dr L. M. Prescott, personal communication) and Calcutta (Chatterjee et al., 1970). In a recent study, large numbers of V. parahaemolyticus strains were obtained from patients with diarrhoea in Calcutta (Sakazaki et al., 1971). In 1972, it was isolated in England from travellers who had eaten crab meat on a flight from Bangkok to London (Drs B. C. Hobbs and G. I. Barrow, personal communication). The present report is of a case in which we believe that infection was acquired in a laboratory. Case report The patient was one of us (J. S.), normally engaged on work in the cholera laboratory and thus well aware of the necessary precautions as regards personal hygiene. The day before the onset of illness was the first time that he had handled strains of V. parahaemolyticus, having been transferred on that day to a laboratory in which he subcultured a number of strains from stock. On the following day at 9.30 a.m. he became very ill and complained of severe upper abdominal pain followed by bloodstained loose motions. This was associated with nausea and sweating. Ten loose motions were passed within 12 hr. The pulse rate was 90 to 100 per minute. The blood pressure and temperature were not recorded. The weakness and abdominal discomfort continued for 48 hr. Because the maximum incubation period of V. parahaemolyticus infection is believed to be 18 hr, we traced back the history for this length of time. Lunch on the previous day was taken between 1 and 2 p.m. and consisted of bread, butter, eggs and sweets, which he shared with his colleagues, none of whom developed any symptoms. He then subcultured the V. parahaemoZyticus strains and left for home at about 5 p.m. On the return journey he took no food or drink and his dinner at home consisted of well-cooked rice, eggs, pulse and vege- tables, which he shared with his family at about 9 p.m. In the morning he had only a cup of tea at 8 a.m. BACTERIOLOGICAL INVESTIGATIONS The first faecal specimen for microscopical and bacteriological examination was a sample of the third motion and had been passed before tetracycline treatment was begun. The second sample was collected on the 3rd day when all the symptoms had subsided. No ova, parasites or cysts were observed in either of the samples, but many red blood cells were present in the first sample. Both stools were emulsified in Trypticase Soy Broth (Baltimore Biological Laboratories) and plated on thiosulphate citrate bile-salt sucrose agar (TCBS Agar; Nissui Seiyaku Co.), Vibrio Agar (Nissui), SS Agar (Nissui) and, after three-fold dilution, on plates of deoxy- cholate hydrogen-sulphide lactose agar (DHL Agar; Nissui). Secondary enrichments were done in Monsur's broth and in Selenite Cysteine Broth (Difco) by incubation overnight and in GN Broth (BBL) by incubation for 6 hr. Secondary platings were done on TCBS and Vibrio

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... A suspected case of a laboratory-associated infection was reported in 1973 (Sanyal et al., 1973). One day prior to the development of diarrheal disease the laboratory worker had been handling V. parahaemolyticus strains for the first time. ...
A notice of availability of the Food and Drug Administration (FDA) draft risk assessment on the relationship between Vibrio parahaemolyticus in raw molluscan shellfish and public heath was published in the Federal Register of January 19, 2001 (66 FR 5517). A comment period was established during which FDA actively sought comments, suggestions, and additional data sources. The results of the draft risk assessment were presented for clarification during a public meeting on March 20, 2001 (66 FR 13544). Comments were submitted to the FDA Docket (No. 99N-1075) from nine institutions or individuals. The data and information acquired during the comment period were reviewed and used, as appropriate, to further enhance the risk assessment. We appreciate the time and effort expended to submit these comments, and have addressed these in this revised risk assessment to the best of our ability. A summary of the modifications made to the draft risk assessment in response to the comments, new data and modeling techniques is provided below. A more detailed discussion of our response to the public comments can be found in Appendix 2.
Bacterial food poisoning is defined as an illness caused by the consumption of food contaminated with bacteria or bacterial toxins. Food poisoning can also be related to parasites (e.g., trichinosis), viruses (e.g., hepatitis), and chemicals (e.g., mushrooms), but these considerations are not within the scope of this chapter. Food poisoning due to bacteria constitutes approximately two-thirds of the food poisoning outbreaks in the United States for which an etiology can be determined.(10,24,25) However, it should be noted that only 36% of such outbreaks fulfill the criteria for confirmed etiology (see below).
Vibrio parahœmolyticus has only lately been recognised as a significant cause of gastroenteritis outbreaks in the United States. By 1972, thirteen outbreaks have been reported, and the epidemiological, clinical, bacteriological, and environmental aspects of these outbreaks are reviewed here. Outbreaks were reported from eight States, ranging from the Atlantic seaboard to the Gulf of Mexico, Pacific northwest, and Hawaii. Crab, shrimp, lobster, and oysters were involved as vehicles. Cooked seafood was responsible for all but two of the outbreaks. A variety of different serotypes of the organisms were involved. Errors in refrigeration, cooking, or food-handling hygiene contributed to the incidents.
To determine possible pathogenesis of Vibrio parahaemolyticus-host-organ system interactions, studies of invasiveness were made by a direct fluorescent-antibody method. Broth cultures of live cells isolated from seafish or symptomatic humans were inoculated separately into ligated ileal loops of young New Zealand white rabbits. After suitable incubation, rabbits were sacrificed, and ileal loops and tissue specimens were aseptically removed. Ileal loops were prepared and stained with specific fluorescein-tagged antibody, and organ specimens were cultured for isolation of the inoculated Vibrio strain. All strains tested penetrated into the lamina propria of the ileum and were isolated from the cultured tissue specimens, indicating that the organism is capable of more than a superficial colonization of the gut. The presence of Vibrio in cultured tissue specimens suggests invasion of deeper tissue by either the lymphatic or the circulatory system.
Gentamicin- and methicillin-resistant strains of Staphylococcus aureus have been isolated from Spring 1979 to the present from many hospitals in New York City. A large proportion of the strains were resistant to the majority of antistaphylococcal antibiotics. The ratio of multiply resistant strains was highest among tetracycline-resistant strains. There were significant differences in phage susceptibility patterns and the resistance spectrum of strains isolated at different hospitals, whereas strains isolated at the same hospital often showed a marked degree of similarity. This suggests multiple origins of gentamicin- and methicillin-resistant strains isolated in New York City.
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