Non-toxigenic Vibrio cholerae non-O1/non-O139 pseudo-bacteraemia in a neonate: A case report

Wentzel B Dowling,Mené Van Der Westhuyzen,Kessendri Reddy,Michele Haumann

doi:10.4102/sajid.v36i1.263

Abstract

Toxigenic Vibrio cholerae O1/O139 is causative of cholera, which is a well characterised potentially epidemic gastrointestinal disease. Less is known about the pathogenesis and clinical presentation of non-toxigenic V. cholerae non-O1/non-O139, although they are increasingly implicated in human disease globally, have been isolated from various South African water sources and can contaminate the environment. The authors describe a case of pseudo-bacteraemia with non-toxigenic V. cholerae non-O1/non-O139 in a neonate.

Highlights

The authors describe a case of pseudo-bacteraemia with non-toxigenic V. cholerae non-O1/ non-O139 in a neonate at a secondary hospital in the Western Cape, South Africa (SA)
Toxigenic V. cholerae is endemic in many sub-Saharan African countries.[2]
A few major cholera epidemics have been described in SA, with the largest outbreak being in 2008/2009 and only one SA study from the 1980s describing toxigenic V. cholerae bacteraemia in a neonate.[2,9,10]

Summary

Introduction

Introduction and backgroundToxigenic Vibrio cholerae (V. cholerae) is causative of cholera, a long-established gastrointestinal illness, which remains a potentially epidemic infectious disease with high mortality and morbidity.[1,2] Vibrio cholerae has a widespread environmental aquatic reservoir and can cause human disease when water sources become contaminated with V. cholerae, especially in areas where there is poor sanitation infrastructure, unsafe drinking water, natural disasters or wars.[1,2,3]The two main pathogenic V. cholerae serogroups, O1 and O139, have been described extensively in the literature, but less is known about the pathogenesis and clinical presentation of nontoxigenic V. cholerae non-O1/non-O139 infections.[4,5]There are several virulence factors contributing to toxigenic V. cholerae pathogenicity: the two major virulence factors are cholera toxin and toxin co-regulated pilus (TCP).[1,2] The cholera toxin gene, harboured on a temperate bacteriophage (CTXɸ), can be transmitted horizontally, the timing of CTXɸ lysogeny, integration and replication is complex and poorly understood.[1,6,7]Compared with the severe diarrhoeal disease caused mainly by the toxin-producing O1 and O139 serogroups, non-toxigenic V. cholerae non-O1/non-O139 have been reported to cause mild gastroenteritis, wound infections, ear infections, meningitis and bacteraemia.[4]. Non-toxigenic Vibrio cholerae non-O1/non-O139 pseudo-bacteraemia in a neonate: A case report

Results

Conclusion