Saving a person infected with "man-eating bacteria"... Dr. Kalina Tsankova in front of FACT

Spring and summer are the seasons when many people plan trips and vacations. However, it is then that the risk of spreading various infections also increases. Maintaining good personal hygiene remains one of the easiest, but also the most effective means of protecting against bacteria and viruses. The reason is that many infections are transmitted not only through their main routes, but also through contact with contaminated surfaces and objects. More and more people are choosing exotic destinations for their vacations. According to their health condition, everyone should assess what precautions are necessary, including whether vaccination is needed, after consulting a specialist. How to protect ourselves from bacteria… Dr. Kalina Tsankova, head of the Clinical Laboratory at Burgas University Hospital, speaks in front of FACT.

- Dr. Tsankova, what rare bacteria are discovered by microbiologists in your hospital in recent years?
- In recent years, infectious agents that are rare for our country and can be defined as “exotic“ have been proven at UMBAL Burgas. A very recent example is the Legionella bacterium, isolated from a patient sample. In the summer of 2024, we also identified the so-called “man-eating bacterium“ (Vibrio vulnificus) and managed to save the patient. Up to now, no case of a patient surviving infection with this bacterium has been described in the scientific literature. I emphasize that in our laboratory we find the bacteria in patient samples, and not simply in a certain environment - for example, on surfaces, the environment, food, etc. Because the environment is full of different bacteria and the discovery of even rare ones is not unprecedented. The interesting thing is when they are found in humans.

- What does the Vibrio bacterium do vulnificus so dangerous and why is it called the “man-eating bacteria“?
- The word “man-eating“ itself suggests that it literally “eats“ the host – soft tissues can be destroyed extremely quickly if swallowed through the mouth or when entering the bloodstream through an open wound.

It can enter the gastrointestinal tract through raw or poorly processed seafood.

Most often, severe gastroenteritis develops, accompanied by chills, low blood pressure and pronounced weakness. When entering through the skin, blisters, ulcers and tissue necrosis appear. Particularly dangerous is the rapid spread of the bacteria through the blood, leading to generalized infection, which significantly complicates treatment. It is especially common in the USA, Florida, but due to climate change it is now also found in our country.

- How did doctors manage to save a patient infected with Vibrio vulnificus, despite the high risk of death?
- Initially, the patient was taken in by a fellow surgeon, Dr. Todor Shuplev. The surgeons treated the wound, took a sample. While we were waiting for the sample to come out, we started antibiotic treatment, because I had a suspicion that it was this bacteria, and it is important to act quickly with it. When acted on in time, antibiotic treatment, together with surgery, gives results. We also used methodical help from other colleagues, several surgical treatments of the wound followed, we managed to save the patient's legs, because amputations in these cases are also common.

- Under what conditions does the Legionella bacteria develop and how can people become infected with it?
- It is aquatic and develops in stagnant water. It can be found in hot water systems, showers, air conditioning and cooling installations, stagnant water, even in swimming pools and spas that have not been cleaned regularly. Infection occurs when fine water droplets containing the bacteria are inhaled. It is not transmitted from person to person.

- What are the symptoms and risks of the so-called “Legionnaires' disease“?
- Legionella can cause a severe form of pneumonia, known as “Legionnaires' disease“. The disease can be very severe, and some of the commonly used antibiotics are not effective.

- What is the role of accurate microbiological diagnosis in choosing the right treatment and antibiotic?
- Accurate diagnosis equals accurate treatment. We avoid taking antibiotics “blindly“. We see which antibiotic the bacteria reacts to and which it is resistant to. In this way, we do not burden the patient unnecessarily and help reduce antibiotic resistance, which is already is a great scourge for modern humanity. Some of the known antibiotics no longer work because bacteria do not react to them. In order to avoid a regression where people die from banal infections, we need to know the exact cause in order to administer the right medicine. This is in the interest of both the patient and society.

- Your team is preparing to participate in scientific forums where you can present data from your findings. How can this help medical practice in Bulgaria?
- The microbiology laboratory team is planning scientific communications in which the laboratory results, the diagnostic process and the importance of early microbiological diagnostics in such infections will be presented. The 2024 case was already presented at the national forum “BulNozo Academy“ in the capital. In our specialty - microbiology, scientific congresses are regularly held, in which we present our achievements both in the prevention of antibiotic resistance and in the control of infections in a hospital environment.