Non-01/non-0139 V-cholerae infection through contact with sea-water

OBJECTIVE: Although the incidence in France of ii choleroe non-O1/non-O139 infection in man has increased since 1996, it remains low (7 cases in 1999) . After tile death in 1994 of an immunodepressed patient presenting a skin lesion showing superinfection by a strain of non-O1/non-O139 V. choleroe fo llowing exposure to seawater, we examined 22 samples of seawater collected from 20 French coastal areas (Mediterranean coast). METHODS: The sea-water samples were filtered and enriched with alkaline pep tone water (APW), and the strains of Vibrio were isolated on TCBS, SS and B CP media and identified using the API 20 E system (bioMerieux, France). RESULTS: We isolated 6 strains belonging to 3 species of Vibrio, 2 V. chole rae (non-O1/non-O139), 3 V. parohoemolyticus and 1 V. alginolyticus. One of the V. cholerae strains was isolated from sea-water sampled at the coastal town in which the patient had been staying. The seawater strains exhibited high sensitivity (MIC determined by agar dilution) to the following antibi otics : aminoglycosides, tetracyclines, azithromycin, cotrimoxazoie, rifamp icin and fluoroquinolones. The beta -lactams were very active against strai ns oi V. cholerae isolated from seawater, while the strain isolated from th is patient presented a new carbenicillinase (CARB-6) recently described. CONCLUSION: The presence of Vibrio in seawater along the French coastline c onstitutes a risk for immunocompromised patients, and the severity of Vibri o infections warrant improved monitoring both of these organisms and of the marine environment. In addition, awareness on the part of dodors would all ow patients at risk to be warned against these dangers.