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Clinical Usefulness of Real-Time Polymerase Chain Reaction for the Diagnosis of Vibrio vulnificus Infection Using Skin and Soft Tissues.

Abstract Vibrio vulnificus is a halophilic gram-negative bacillus isolated in seawater, fish, and shellfish. Infection by V. vulnificus is the most severe food-borne infection reported in the United States of America. Here, we aimed to examine the clinical usefulness of polymerase chain reaction (PCR) using tissue specimens other than blood samples as a diagnostic tool for V. vulnificus infection. A retrospective study was conducted with patients who underwent real-time PCR of toxR in both blood and skin tissues, including serum, bullae, swab, and operation room specimens, between 2006 and 2009. The median V. vulnificus DNA load of 14 patients in real-time PCR analysis of serum at the time of admission was 638.5 copies/mL blood, which was within the interquartile range (IQR: 37-3,225). In contrast, the median value by real-time PCR using the first tissue specimen at the time of admission was 16,650 copies/mL tissue fluid (IQR: 4,419-832,500). This difference was statistically significant (P = 0.022). DNA copy numbers in tissues were less affected by short-term antibiotic administration than that in blood samples, and antibiotic administration increased the DNA copy number in some patients. We found, for the first time, that DNA copy numbers in tissues of patients infected by V. vulnificus were higher than those in blood samples. Additionally, skin lesions were more useful than blood samples as specimens for PCR analysis in patients administered antibiotics for V. vulnificus infection before admission.
PMID
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Authors

Mayor MeshTerms
Keywords
Journal Title the american journal of tropical medicine and hygiene
Publication Year Start




PMID- 28829729
OWN - NLM
STAT- MEDLINE
DA  - 20170822
DCOM- 20170911
LR  - 20170911
IS  - 1476-1645 (Electronic)
IS  - 0002-9637 (Linking)
VI  - 97
IP  - 2
DP  - 2017 Aug
TI  - Clinical Usefulness of Real-Time Polymerase Chain Reaction for the Diagnosis of
      Vibrio vulnificus Infection Using Skin and Soft Tissues.
PG  - 443-446
LID - 10.4269/ajtmh.16-0512 [doi]
AB  - Vibrio vulnificus is a halophilic gram-negative bacillus isolated in seawater,
      fish, and shellfish. Infection by V. vulnificus is the most severe food-borne
      infection reported in the United States of America. Here, we aimed to examine the
      clinical usefulness of polymerase chain reaction (PCR) using tissue specimens
      other than blood samples as a diagnostic tool for V. vulnificus infection. A
      retrospective study was conducted with patients who underwent real-time PCR of
      toxR in both blood and skin tissues, including serum, bullae, swab, and operation
      room specimens, between 2006 and 2009. The median V. vulnificus DNA load of 14
      patients in real-time PCR analysis of serum at the time of admission was 638.5
      copies/mL blood, which was within the interquartile range (IQR: 37-3,225). In
      contrast, the median value by real-time PCR using the first tissue specimen at
      the time of admission was 16,650 copies/mL tissue fluid (IQR: 4,419-832,500).
      This difference was statistically significant (P = 0.022). DNA copy numbers in
      tissues were less affected by short-term antibiotic administration than that in
      blood samples, and antibiotic administration increased the DNA copy number in
      some patients. We found, for the first time, that DNA copy numbers in tissues of 
      patients infected by V. vulnificus were higher than those in blood samples.
      Additionally, skin lesions were more useful than blood samples as specimens for
      PCR analysis in patients administered antibiotics for V. vulnificus infection
      before admission.
FAU - Lee, Jun-Young
AU  - Lee JY
AD  - Department of Orthopedic Surgery, College of Medicine, Chosun University,
      Gwangju, South Korea.
FAU - Kim, Seok Won
AU  - Kim SW
AD  - Department of Neurosurgery, College of Medicine, Chosun University, Gwangju,
      Republic of Korea.
FAU - Kim, Dong-Min
AU  - Kim DM
AD  - Division of Infectious Disease, Department of Internal Medicine, College of
      Medicine, Chosun University, Gwangju, South Korea.
FAU - Yun, Na Ra
AU  - Yun NR
AD  - Division of Infectious Disease, Department of Internal Medicine, College of
      Medicine, Chosun University, Gwangju, South Korea.
FAU - Kim, Choon-Mee
AU  - Kim CM
AD  - Premedical Science, College of Medicine, Chosun University, Gwangju, Republic of 
      Korea.
FAU - Lee, Sang-Hong
AU  - Lee SH
AD  - Department of Orthopedic Surgery, College of Medicine, Chosun University,
      Gwangju, South Korea.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PL  - United States
TA  - Am J Trop Med Hyg
JT  - The American journal of tropical medicine and hygiene
JID - 0370507
RN  - Vibrio vulnificus infection
SB  - AIM
SB  - IM
MH  - Adult
MH  - Aged
MH  - Bacterial Load
MH  - Female
MH  - Foodborne Diseases/*blood/*diagnosis/microbiology
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Real-Time Polymerase Chain Reaction
MH  - Retrospective Studies
MH  - Skin/*microbiology
MH  - Soft Tissue Infections/*diagnosis/microbiology
MH  - United States/epidemiology
MH  - Vibrio Infections/*blood/*diagnosis/epidemiology/microbiology
MH  - Vibrio vulnificus/genetics/*isolation & purification
EDAT- 2017/08/23 06:00
MHDA- 2017/09/12 06:00
CRDT- 2017/08/23 06:00
AID - 10.4269/ajtmh.16-0512 [doi]
PST - ppublish
SO  - Am J Trop Med Hyg. 2017 Aug;97(2):443-446. doi: 10.4269/ajtmh.16-0512.