弧菌种是海洋和咸水中的天然生物。它们存在于牡蛎、贻贝、蛤蜊、虾和螃蟹等贝类的组织中。在已经发现的 140 多个弧菌种中,有十种与人类疾病相关。其中,创伤弧菌、副溶血性弧菌和溶藻弧菌是大多数人类感染的病因。其中以创伤弧菌毒力最强。[16]Hsueh PR, Lin CY, Tang HJ, et al. Vibrio vulnificus in Taiwan. Emerg Infect Dis. 2004;10:1363-1368.http://wwwnc.cdc.gov/eid/article/10/8/04-0047_articlehttp://www.ncbi.nlm.nih.gov/pubmed/15496235?tool=bestpractice.com[17]Neill MA, Carpenter CCJ. Chapter 212, Other pathogenic vibrios. In: Mandell GL, Douglas RG, Bennett JE, eds. Mandell, Douglas, and Bennett's principles and practice of infectious diseases. 6th ed. Philadelphia, PA: Elsevier, Churchill Livingstone; 2005:2544-2548.
开放性皮肤病损或贯通伤口接触咸水或海水,或者摄食生的或未煮熟的贝类,都可能被海洋/河水中的非霍乱弧菌感染。基础性酒精性肝硬化、慢性乙型肝炎或丙型肝炎、血色病、糖尿病或恶性肿瘤患者,接受皮质类固醇治疗的患者或者免疫功能受损人群的感染风险和死亡率最高。对于肝功能障碍或铁贮积紊乱(例如肝硬化、血色病)患者或者免疫功能受损人群而言,通过进食或伤口感染的创伤弧菌会迅速导致致命性的脓毒性休克,可能伴或不伴相关的坏死性软组织感染。[1]Farmer JJ, Janda JM, Birkhead K. Chapter 46: Vibrio. In: PR Murray, ed. Manual of clinical microbiology. 8th ed. Washington, DC: ASM Press; 2003.[2]Thompson FL, Gevers D, Thompson CC, et al. Phylogeny and molecular identification of vibrios on the basis of multilocus sequence analysis. Appl Environ Microbiol. 2005;71:5107-5115.http://aem.asm.org/content/71/9/5107.fullhttp://www.ncbi.nlm.nih.gov/pubmed/16151093?tool=bestpractice.com[3]Thompson FL, Iida T, Swings J. Biodiversity of vibrios. Microbiol Mol Biol Rev. 2004;68:403-431.http://mmbr.asm.org/content/68/3/403.fullhttp://www.ncbi.nlm.nih.gov/pubmed/15353563?tool=bestpractice.com
[Figure caption and citation for the preceding image starts]: 发生脓毒性休克和创伤弧菌菌血症的肝硬化患者出现伴有血性大疱的坏疽性变化来自美国疾病控制与预防中心图像库 [Citation ends].
对于其他方面正常的宿主,副溶血性弧菌最常导致与食用海鲜相关的自限性胃肠炎。该细菌偶尔引起败血症病例和死亡。
溶藻弧菌较少导致胃肠病,但经常导致其他方面健康的年轻人因在海水中游泳或冲浪而感染浅表耳部或眼部疾病。[5]Dechet AM, Yu PA, Koram N, et al. Nonfoodborne Vibrio infections: an important cause of morbidity and mortality in the United States, 1997-2006. Clin Infect Dis. 2008;46:970-976.http://www.ncbi.nlm.nih.gov/pubmed/18444811?tool=bestpractice.com[18]Oliver JD. Wound infections caused by Vibrio vulnificus and other marine bacteria. Epidemiol Infect. 2005;133:383-391.http://www.ncbi.nlm.nih.gov/pubmed/15962544?tool=bestpractice.com它还会导致受海水污染的伤口出现软组织感染。[19]Schmidt U, Chmel H, Cobbs C. Vibrio alginolyticus infections in humans. J Clin Microbiol. 1979;10:666-668.http://jcm.asm.org/content/10/5/666.full.pdf+htmlhttp://www.ncbi.nlm.nih.gov/pubmed/397221?tool=bestpractice.com[20]Patterson TF, Bell SR, Bia FJ. Vibrio alginolyticus cellulitis following coral injury. Yale J Biol Med. 1988;61:507-512.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2590478/pdf/yjbm00078-0020.pdfhttp://www.ncbi.nlm.nih.gov/pubmed/3242316?tool=bestpractice.com[21]Gomez JM, Fajardo R, Patino JF, et al. Necrotizing fasciitis due to Vibrio alginolyticus in an immunocompetent patient. J Clin Microbiol. 2003;41:3427-3429.http://jcm.asm.org/content/41/7/3427.fullhttp://www.ncbi.nlm.nih.gov/pubmed/12843111?tool=bestpractice.com[22]Opal SM, Saxon JR. Intracranial infection by Vibrio alginolyticus following injury in salt water. J Clin Microbiol. 1986;23:373-374.http://jcm.asm.org/content/23/2/373.full.pdf+htmlhttp://www.ncbi.nlm.nih.gov/pubmed/3700619?tool=bestpractice.com