Heatwave-associated Vibrio infections in Germany, 2018 and 2019

Abstract

Background<i>Vibrio</i> spp. are aquatic bacteria that prefer warm seawater with moderate salinity. In humans, they can cause gastroenteritis, wound infections, and ear infections. During the summers of 2018 and 2019, unprecedented high sea surface temperatures were recorded in the German Baltic Sea.AimWe aimed to describe the clinical course and microbiological characteristics of <i>Vibrio</i> infections in Germany in 2018 and 2019.MethodsWe performed an observational retrospective multi-centre cohort study of patients diagnosed with domestically-acquired <i>Vibrio</i> infections in Germany in 2018 and 2019. Demographic, clinical, and microbiological data were assessed, and isolates were subjected to whole genome sequencing and antimicrobial susceptibility testing.ResultsOf the 63 patients with <i>Vibrio</i> infections, most contracted the virus between June and September, primarily in the Baltic Sea: 44 (70%) were male and the median age was 65 years (range: 2-93 years). Thirty-eight patients presented with wound infections, 16 with ear infections, six with gastroenteritis, two with pneumonia (after seawater aspiration) and one with primary septicaemia. The majority of infections were attributed to <i>V. cholerae</i> (non-O1/non-O139) (n = 30; 48%) or <i>V. vulnificus</i> (n = 22; 38%). Phylogenetic analyses of 12 available isolates showed clusters of three identical strains of <i>V. vulnificus</i>, which caused wound infections, suggesting that some clonal lines can spread across the Baltic Sea.ConclusionsDuring the summers of 2018 and 2019, severe heatwaves facilitated increased numbers of <i>Vibrio</i> infections in Germany. Since climate change is likely to favour the proliferation of these bacteria, a further increase in <i>Vibrio</i>-associated diseases is expected.