Abstract
BackgroundCholera is still a significant public health issue in developing countries. The aetiological agent is Vibrio cholerae and only two serogroups, O1 and O139, are known to cause pandemic or epidemic cholera. In contrast, non-O1/non-O139 V. cholerae has only been reported to cause sporadic cholera-like illness and localised outbreaks. The aim of this study was to determine the genetic diversity of non-O1/non-O139 V. cholerae isolates from hospitalised diarrhoeal patients in Zhejiang Province, China.ResultsIn an active surveillance of enteric pathogens in hospitalised diarrhoeal patients, nine non-O1/non-O139 V. cholerae isolates were identified from 746 diarrhoeal stool samples at a rate of 1.2%. These isolates and an additional 31 isolates from sporadic cases and three outbreaks were analysed using pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST). PFGE divided the isolates into 25 PFGE types while MLST divided them into 15 sequence types (STs). A single ST, ST80, was predominant which persisted over several years in different cities and caused two outbreaks in recent years. Antibiotic resistance varied with the majority of the isolates resistant to sulphamethoxazole/trimethoprim and nearly all isolates either resistant or intermediate to erythromycin and rifampicin. None of the isolates carried the cholera toxin genes or toxin co-regulated pilus genes but the majority carried a type III secretion system as the key virulence factor.ConclusionsNon-O1/non-O139 V. cholerae is an important contributor to diarrhoeal infections in China. Resistance to commonly used antibiotics limits treatment options. Continuous surveillance of non-O1/non-O139 V. cholerae is important for control and prevention of diarrhoeal infections.
Highlights
Cholera is still a significant public health issue in developing countries
V. cholerae isolates were identified from 746 diarrhoeal stool samples at a rate of 1.2%
pulsed-field gel electrophoresis (PFGE) divided the isolates into 25 PFGE types while multilocus sequence typing (MLST) divided them into 15 sequence types (STs)
Summary
The aetiological agent is Vibrio cholerae and only two serogroups, O1 and O139, are known to cause pandemic or epidemic cholera. Non-O1/non-O139 V. cholerae has only been reported to cause sporadic cholera-like illness and localised outbreaks. Cholera is an acute diarrhoeal disease caused by toxigenic. Non-O1/non-O139 serogroups have been linked with cholera-like-illness sporadically [2,3,4,5,6]. Patients generally suffer a less severe form of the disease than those infected by O1 toxigenic strains [8,9,10]. Non-O1/non-O139 V. cholerae strains have caused localised outbreaks in many countries, including India and Thailand [3,11,12,13,14,15]. An O75 V. cholerae outbreak associated with the consumption of oysters was reported in the USA [5,6]
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