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International Journal of Infectious... Apr 2024South Asia remains home to foodborne diseases caused by the Vibrio species. We aimed to compile and update information on the epidemiology of vibriosis in South Asia. (Meta-Analysis)
Meta-Analysis
OBJECTIVES
South Asia remains home to foodborne diseases caused by the Vibrio species. We aimed to compile and update information on the epidemiology of vibriosis in South Asia.
METHODS
For this systematic review and meta-analysis, we searched PubMed, Web of Science, EMBASE, and Google Scholar for studies related to vibriosis in South Asia published up to May 2023. A random-effects meta-analysis was used to estimate the pooled isolation rate of non-cholera-causing Vibrio species.
RESULTS
In total, 38 studies were included. Seven of these were case reports and 22 were included in the meta-analysis. The reported vibriosis cases were caused by non-O1/non-O139 V. cholerae, V. parahaemolyticus, V. fluvialis, and V. vulnificus. The overall pooled isolation rate was 4.0% (95% confidence interval [CI] 3.0-5.0%) in patients with diarrhea. Heterogeneity was high (I = 98.0%). The isolation rate of non-O1/non-O139 V. cholerae, V. parahaemolyticus, and V. fluvialis were 9.0 (95% CI 7.0-10.0%), 1.0 (95% CI 1.0-2.0%), and 2.0 (95% CI: 1.0-3.0%), respectively. Regarding V. parahaemolyticus, O3:K6 was the most frequently isolated serotype. Cases peaked during summer. Several studies reported antibiotic-resistant strains and those harboring extended-spectrum beta-lactamases genes.
CONCLUSIONS
This study demonstrates a high burden of infections caused by non-cholera-causing Vibrio species in South Asia.
Topics: Humans; Vibrio cholerae; Vibrio Infections; Foodborne Diseases; Diarrhea; Asia, Southern
PubMed: 38311027
DOI: 10.1016/j.ijid.2024.01.022 -
PLoS Medicine Sep 2023Cholera surveillance relies on clinical diagnosis of acute watery diarrhea. Suspected cholera case definitions have high sensitivity but low specificity, challenging our... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Cholera surveillance relies on clinical diagnosis of acute watery diarrhea. Suspected cholera case definitions have high sensitivity but low specificity, challenging our ability to characterize cholera burden and epidemiology. Our objective was to estimate the proportion of clinically suspected cholera that are true Vibrio cholerae infections and identify factors that explain variation in positivity.
METHODS AND FINDINGS
We conducted a systematic review of studies that tested ≥10 suspected cholera cases for V. cholerae O1/O139 using culture, PCR, and/or a rapid diagnostic test. We searched PubMed, Embase, Scopus, and Google Scholar for studies that sampled at least one suspected case between January 1, 2000 and April 19, 2023, to reflect contemporary patterns in V. cholerae positivity. We estimated diagnostic test sensitivity and specificity using a latent class meta-analysis. We estimated V. cholerae positivity using a random-effects meta-analysis, adjusting for test performance. We included 119 studies from 30 countries. V. cholerae positivity was lower in studies with representative sampling and in studies that set minimum ages in suspected case definitions. After adjusting for test performance, on average, 52% (95% credible interval (CrI): 24%, 80%) of suspected cases represented true V. cholerae infections. After adjusting for test performance and study methodology, the odds of a suspected case having a true infection were 5.71 (odds ratio 95% CrI: 1.53, 15.43) times higher when surveillance was initiated in response to an outbreak than in non-outbreak settings. Variation across studies was high, and a limitation of our approach was that we were unable to explain all the heterogeneity with study-level attributes, including diagnostic test used, setting, and case definitions.
CONCLUSIONS
In this study, we found that burden estimates based on suspected cases alone may overestimate the incidence of medically attended cholera by 2-fold. However, accounting for cases missed by traditional clinical surveillance is key to unbiased cholera burden estimates. Given the substantial variability in positivity between settings, extrapolations from suspected to confirmed cases, which is necessary to estimate cholera incidence rates without exhaustive testing, should be based on local data.
Topics: Humans; Cholera; Vibrio cholerae; Disease Outbreaks; Diarrhea; Polymerase Chain Reaction
PubMed: 37708235
DOI: 10.1371/journal.pmed.1004286 -
Marine Pollution Bulletin Sep 2023Waterborne pathogenic bacteria, including faecal indicator bacteria and potentially pathogenic Vibrio, are a global concern for diseases transmitted through water. A... (Review)
Review
Waterborne pathogenic bacteria, including faecal indicator bacteria and potentially pathogenic Vibrio, are a global concern for diseases transmitted through water. A systematic review was conducted to analyse publications that investigated these bacteria in relation to macrophytes (seagrasses and macroalgae) in coastal marine environments. The highest quantities of FIB were found on brown algae and seagrasses, and the highest quantities of Vibrio bacteria were on red algae. The most extensively studied macrophyte group was brown algae, green algae were the least researched. Macrophyte wrack was found to favor the presence of FIB, but there is a lack of information about Vibrio quantities in this environment. To understand the role of Vibrio bacteria that are pathogenic to humans, molecular methods complementary to cultivation methods should be used. Further research is needed to understand the underlying mechanisms of FIB and potentially pathogenic Vibrio with macrophytes and their microbiome in the coastal marine environment.
Topics: Humans; Vibrio parahaemolyticus; Environment; Ecosystem
PubMed: 37523954
DOI: 10.1016/j.marpolbul.2023.115325 -
The Science of the Total Environment Jul 2023Vibrio species are waterborne ubiquitous organisms capable of causing diseases in humans and animals and the occurrence of infections caused by pathogenic Vibrio species... (Meta-Analysis)
Meta-Analysis Review
Vibrio species are waterborne ubiquitous organisms capable of causing diseases in humans and animals and the occurrence of infections caused by pathogenic Vibrio species among humans have increased globally. This reemergence is attributed to environmental impacts such as global warming and pollution. Africa is most vulnerable to waterborne infections caused by these pathogens because of lack of good water stewardship and management. This study was carried out to provide an in-depth inquiry into the occurrence of pathogenic Vibrio species in water sources and wastewater across Africa. In this regard, a systematic review and meta-analysis was conducted by searching five databases: PubMed, ScienceDirect, Google Scholar, Springer Search and African Journals Online (AJOL). The search yielded 70 articles on pathogenic Vibrio species presence in African aquatic environments that fit our inclusion criteria. Based on the random effects model, the pooled prevalence of pathogenic Vibrio species in various water sources in Africa was 37.6 % (95 % CI: 27.7-48.0). Eighteen countries were represented by the systematically assessed studies and their nationwide prevalence in descending order was: Nigeria (79.82 %), Egypt (47.5 %), Tanzania (45.8 %), Morocco (44.8), South Africa (40.6 %), Uganda (32.1 %), Cameroon (24.5 %), Burkina Faso (18.9 %) and Ghana (5.9 %). Furthermore, 8 pathogenic Vibrio species were identified across water bodies in Africa with the highest detection for V. cholerae (59.5 %), followed by V. parahaemolyticus (10.4 %), V.alginolyticus (9.8 %), V. vulnificus (8.5 %), V. fluvialis (6.6 %), V. mimicus (4.6 %), V. harveyi (0.5 %) and V. metschnikovii (0.1 %). Evidently, pathogenic Vibrio species occurrence in these water sources especially freshwater corroborates the continuous outbreaks observed in Africa. Therefore, there is an urgent need for proactive measures and continuous monitoring of water sources used for various purposes across Africa and proper treatment of wastewater before discharge into water bodies.
Topics: Humans; Animals; Wastewater; Water; Vibrio; Vibrio cholerae; Burkina Faso
PubMed: 37028683
DOI: 10.1016/j.scitotenv.2023.163332 -
Marine Pollution Bulletin Feb 2023Human vibriosis, caused by pathogenic Vibrio spp., such as Vibrio parahaemolyticus, Vibrio cholerae and Vibrio vulnificus, has been increasing worldwide, mediated by... (Meta-Analysis)
Meta-Analysis Review
Human vibriosis, caused by pathogenic Vibrio spp., such as Vibrio parahaemolyticus, Vibrio cholerae and Vibrio vulnificus, has been increasing worldwide, mediated by increasing consumption of seafood. The present study was conducted to examine the global prevalence of V. vulnificus, V. parahaemolyticus and V. cholerae in fishes. We searched PubMed, Web of Science, Scopus, and CNKI for peer-reviewed articles and dissertations prior to December 31, 2021. A total of 24,831 articles were retrieved, and 82 articles contained 61 fish families were included. The global pooled prevalence of V. cholerae, V. parahaemolyticus and V. vulnificus in fishes was 9.56 % (95 % CI: 2.12-20.92), 24.77 % (95 % CI: 17.40-32.93) and 5.29 % (95 % CI: 0.38-13.61), respectively. Subgroup and meta-regression analyses showed that study-level covariates, including temperature, country, continent, origin and detection methods partly explained the between-study heterogeneity. These heterogeneities were underpinned by differences of the three Vibrio spp. in fishes at geographical and climatic scales. These results reveal a high global prevalence of pathogenic Vibrio spp. in fishes and highlight the need for implementation of more effective prevention and control measures to reduce food-borne infection in humans.
Topics: Animals; Humans; Public Health; Prevalence; Seafood; Vibrio; Vibrio parahaemolyticus; Vibrio cholerae; Vibrio Infections; Fishes
PubMed: 36621299
DOI: 10.1016/j.marpolbul.2022.114521 -
Microorganisms Nov 2022The Red Sea is a suitable model for studying coral reefs under climate change due to its strong environmental gradient that provides a window into future global warming... (Review)
Review
The Red Sea is a suitable model for studying coral reefs under climate change due to its strong environmental gradient that provides a window into future global warming scenarios. For instance, corals in the southern Red Sea thrive at temperatures predicted to occur at the end of the century in other biogeographic regions. Corals in the Red Sea thrive under contrasting thermal and environmental regimes along their latitudinal gradient. Because microbial communities associated with corals contribute to host physiology, we conducted a systematic review of the known diversity of Red Sea coral-associated bacteria, considering geographic location and host species. Our assessment comprises 54 studies of 67 coral host species employing cultivation-dependent and cultivation-independent techniques. Most studies have been conducted in the central and northern Red Sea, while the southern and western regions remain largely unexplored. Our data also show that, despite the high diversity of corals in the Red Sea, the most studied corals were , spp., , and . Microbial diversity was dominated by bacteria from the class Gammaproteobacteria, while the most frequently occurring bacterial families included and . We also identified bacterial families exclusively associated with each of the studied coral orders: Scleractinia ( = 125), Alcyonacea ( = 7), and Capitata ( = 2). This review encompasses 20 years of research in the Red Sea, providing a baseline compendium for coral-associated bacterial diversity.
PubMed: 36557593
DOI: 10.3390/microorganisms10122340 -
Expert Review of Clinical Immunology Dec 2022Cholera is an enteric disease caused by , a water-borne pathogen, and characterized by severe diarrhea. Vaccines have been recommended for use by the WHO in...
INTRODUCTION
Cholera is an enteric disease caused by , a water-borne pathogen, and characterized by severe diarrhea. Vaccines have been recommended for use by the WHO in resource-limited settings. Efficacies of the currently licensed cholera vaccines are not optimal in endemic settings and low in children below the age of five, a section of the population most susceptible to the disease. Development of next generation of cholera vaccines would require a detailed understanding of the required protective immune responses.
AREA COVERED
In this review, we revisit clinical trials which are focused on the early transcriptional mucosal responses elicited during infection and upon vaccination along with summarizing various components of the effector immune response against .
EXPERT OPINION
The inability of currently licensed killed/inactivated vaccines to elicit key inflammatory pathways locally may explain their restricted efficacy in endemic settings. More studies are required to understand the immunogenicity of the live attenuated cholera vaccine in these regions. Various extrinsic and intrinsic factors influence anti-cholera immunity and need to be considered to develop region-specific next generation vaccines.
Topics: Child; Humans; Administration, Oral; Antibodies, Bacterial; Cholera; Cholera Vaccines; Immunity; Vaccines, Attenuated; Vibrio cholerae
PubMed: 36255170
DOI: 10.1080/1744666X.2022.2136650 -
Pathogens and Global Health May 2023Non-O1/non-O139 (NOVC) are nonpathogenic or asymptomatic colonizers in humans, but they may be related to intestinal or extra-intestinal (severe wound infections or... (Meta-Analysis)
Meta-Analysis
Non-O1/non-O139 (NOVC) are nonpathogenic or asymptomatic colonizers in humans, but they may be related to intestinal or extra-intestinal (severe wound infections or sepsis) infections in immunocompromised patients.The present study aimed to evaluate the weighted pooled resistance (WPR) rates in clinical NOVC isolates based on different years, areas, quality, antimicrobial susceptibility testing (AST), and resistance rates. We systematically searched the articles in PubMed, Scopus, and Embase (until January 2020). Data analyses were performed using the Stata software program (version 17). A total of 16 studies that had investigated 824 clinical NOVC isolates were included in the meta-analysis. The majority of the studies were conducted in Asia (n = 14) and followed by Africa (n = 2). The WPR rates were as follows: erythromycin 10%, ciprofloxacin 5%, cotrimoxazole 27%, and tetracycline 13%. There was an increase in resistance to ciprofloxacin, nalidixic acid, and gentamicin, norfloxacin during the period from 2000 to 2020. On the contrary, there was a decreased resistance to erythromycin, tetracycline, chloramphenicol, cotrimoxazole, ampicillin, streptomycin, kanamycin, and neomycin during the period from 2000 to 2020. The lowest resistance rate were related to gentamicin, kanamycin, ciprofloxacin, and chloramphenicol against NOVC strains. However, temporal changes in antimicrobial resistance rate were found in our study. We established continuous surveillance, careful appropriate AST, and limitations on improper antibiotic usage, which are essential, especially in low-income countries.
Topics: Humans; Vibrio cholerae non-O1; Anti-Bacterial Agents; Cholera; Trimethoprim, Sulfamethoxazole Drug Combination; Drug Resistance, Bacterial; Ciprofloxacin; Tetracycline; Chloramphenicol; Kanamycin; Erythromycin; Gentamicins; Microbial Sensitivity Tests
PubMed: 35983997
DOI: 10.1080/20477724.2022.2114620 -
Expert Review of Anti-infective Therapy Sep 2022O1/O139 is responsible for cholera epidemics that remains a huge public health menace across the globe. Furthermore, an increasing resistance rate among strains has... (Meta-Analysis)
Meta-Analysis
OBJECTIVES
O1/O139 is responsible for cholera epidemics that remains a huge public health menace across the globe. Furthermore, an increasing resistance rate among strains has been reported around the world. Therefore, the objective of this meta-analysis was to evaluate the weighted pooled resistance (WPR) rates in clinical O1/O139 isolates based on different years, areas, antimicrobial susceptibility testing, and resistance rates.
RESEARCH DESIGN AND METHODS
We searched the studies in PubMed, Scopus, Embase, and Web of Science (until January 2020). Statistical analyses were conducted using STATA software (ver. 14.0).
RESULTS
A total of 139 studies investigating 24,062 O1/O139 isolates were analyzed. The majority of the studies originated in Asia ( = 102). The WPR rates were as follows: azithromycin 1%, erythromycin 36%, ciprofloxacin 3%, cotrimoxazole 79%, doxycycline 7%, and tetracycline 20%. There was increased resistance to cotrimoxazole, ciprofloxacin, and tetracycline during the 1980-2020 years.
CONCLUSIONS
Temporal changes in antibiotic resistance rate found in this study demonstrated the critical continuous surveillance of antibiotic resistance. Also, ciprofloxacin, azithromycin, gentamicin, cephalexin, imipenem, ofloxacin, and norfloxacin were found to be the best antibiotics against , with the highest and the lowest effectiveness resistance rate.
Topics: Anti-Bacterial Agents; Azithromycin; Cholera; Ciprofloxacin; Drug Resistance, Bacterial; Humans; Microbial Sensitivity Tests; Tetracyclines; Trimethoprim, Sulfamethoxazole Drug Combination; Vibrio cholerae O1; Vibrio cholerae O139
PubMed: 35790112
DOI: 10.1080/14787210.2022.2098114 -
International Journal of Environmental... Jun 2022Approximately 2.9 million people worldwide suffer from cholera each year, many of whom are destitute. However, understanding of immunity against cholera is still... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Approximately 2.9 million people worldwide suffer from cholera each year, many of whom are destitute. However, understanding of immunity against cholera is still limited. Several studies have reported the duration of antibodies following cholera; however, systematic reviews including a quantitative synthesis are lacking.
OBJECTIVE
To meta-analyze cohort studies that have evaluated vibriocidal, cholera toxin B subunit (CTB), and lipopolysaccharide (LPS) antibody levels following a clinical cholera case.
METHODS
Design: Systematic review and meta-analysis. We searched PubMed and Web of science for studies assessing antibodies against in cohorts of patients with clinical cholera. Two authors independently extracted data and assessed the quality of included studies. Random effects models were used to pool antibody titers in adults and older children (aged ≥ 6 years). In sensitivity analysis, studies reporting data on young children (2-5 years) were included.
RESULTS
Nine studies met our inclusion criteria for systematic review and seven for meta-analysis. The pooled mean of vibriocidal antibody titers in adults and older children (aged ≥ 6 years) was 123 on day 2 post-symptom onset, which sharply increased on day 7 (pooled mean = 6956) and gradually waned to 2247 on day 30, 578 on day 90, and 177 on day 360. Anti-CTB IgA antibodies also peaked on day 7 (pooled mean = 49), followed by a rapid decrease on day 30 (pooled mean = 21), and further declined on day 90 (pooled mean = 10), after which it plateaued from day 180 (pooled mean = 8) to 360 (pooled mean = 6). Similarly, anti-CTB IgG antibodies peaked in early convalescence between days 7 (pooled mean = 65) and 30 (pooled mean = 69), then gradually waned on days 90 (pooled mean = 42) and 180 (pooled mean = 30) and returned to baseline on day 360 (pooled mean = 24). Anti-LPS IgA antibodies peaked on day 7 (pooled mean = 124), gradually declined on day 30 (pooled mean = 44), which persisted until day 360 (pooled mean = 10). Anti LPS IgG antibodies peaked on day 7 (pooled mean = 94). Thereafter, they decreased on day 30 (pooled mean = 85), and dropped further on days 90 (pooled mean = 51) and 180 (pooled mean = 47), and returned to baseline on day 360 (pooled mean = 32). Sensitivity analysis including data from young children (aged 2-5 years) showed very similar findings as in the primary analysis.
CONCLUSIONS
This study confirms that serological antibody (vibriocidal, CTB, and LPS) titers return to baseline levels within 1 year following clinical cholera, i.e., before the protective immunity against subsequent cholera wanes. However, this decay should not be interpreted as waning immunity because immunity conferred by cholera against subsequent disease lasts 3-10 years. Our study provides evidence for surveillance strategies and future research on vaccines and also demonstrates the need for further studies to improve our understanding of immunity against cholera.
Topics: Adolescent; Adult; Antibodies, Bacterial; B-Lymphocytes; Child; Child, Preschool; Cholera; Humans; Immunoglobulin A; Immunoglobulin G; Immunologic Memory; Kinetics; Lipopolysaccharides; Vibrio cholerae O1
PubMed: 35742404
DOI: 10.3390/ijerph19127141