Pathogenic Mechanisms of V. vulnificus and Its Role in the Development of Sepsis

Vibrio vulnificus (V. vulnificus) is a highly virulent marine pathogen responsible for severe infections, including necrotizing fasciitis and life-threatening sepsis, particularly in immunocompromised individuals. This review synthesizes current knowledge on V. vulnificus pathogenesis, focusing on key virulence factors such as cytolysins (VvhA and MARTX), iron acquisition systems, and immune evasion strategies. The bacterium's ability to induce rapid tissue damage, endothelial dysfunction, and systemic inflammation-mediated through cytokine storms and necroptosis-underpins V. vulnificus high mortality rates. Risk factors include chronic liver disease, diabetes, and environmental exposure to seafood harboring V. vulnificus or brackish water. Clinical management hinges on early diagnosis, prompt antibiotic therapy (e.g., doxycycline combined with third-generation cephalosporins), and surgical intervention for necrotizing infections. Despite advances, challenges persist, including antibiotic resistance and delayed diagnosis. Future directions emphasize novel therapeutics targeting virulence mechanisms, rapid diagnostics, and climate-adaptive public health strategies to curb the rising incidence of V. vulnificus infections in warming coastal ecosystems. This review underscores the urgent need for multidisciplinary approaches to mitigate the global burden of this formidable pathogen.