Article

Laboratory Infection by Vibrio Parahaemolyticus

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Abstract

(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. ...
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