Clinical Characteristics and Molecular Subtyping ofVibrio vulnificusIllnesses, Israel

During 1996During -1997, a , a new Vibrio vulnifi cus biotype 3, which caused severe soft tissue infection after fi shbone injury, emerged in Israel.We conducted a follow-up study from 1998 through 2005 to assess changing trends, outcomes, and molecular relatedness of the implicated strains.A total of 132 cases (71% confi rmed and 29% suspected) of V. vulnifi cus biotype 3 infection were found.Most infections (95%) were related to percutaneous fi sh exposure, mainly tilapia (83%) or common carp (13%).Bacteremia, altered immune status, and history of ischemic heart disease were identifi ed as independent risk factors for death, which reached a prevalence of 7.6%.Pulsed-fi eld gel electrophoresis patterns of strains from 1998 through 2005 and from 1996 through 1997 showed a high degree of homogeneity and were distinct from those of V. vulnifi cus biotype 1. Infections caused by V. vulnifi cus biotype 3 continue to affect the public's health in Israel.V ibrio vulnifi cus, a gram-negative bacterium of the fam- ily Vibrionaceae, is a worldwide inhabitant of salt water (1-3).V. vulnifi cus biotypes 1 and 2 are capable of causing severe human infection, including necrotizing fasciitis and septicemia; the death rate is substantial (4-6).Persons with chronic liver disease, particularly liver cirrhosis, are more prone to developing infection and at greatest risk for an adverse outcome (7,8).Other predisposing factors are iron overload and hemochromatosis and immunosuppression caused by steroid treatment, malignancy, HIV infection, renal failure, and organ transplantation (1,9,10). Clinical Characteristics and Molecular Subtyping of Vibrio vulnifi cus Illnesses, Israel