The Isolation of &amp;lt;i&amp;gt;Vibrio cholera&amp;lt;/i&amp;gt; and Other Enteric Bacteria with Molecular Characterization of &amp;lt;i&amp;gt;Vibrio cholera&amp;lt;/i&amp;gt; during the Outbreak of Baghdad/Iraq in 2015

Sarab K. Jameel,Mostafa A. Shafek,Tuhama T. Mohammed,Nadira S. Mohamed,Ali M. Abdulmohsen,Sarmad R. Naji

doi:10.4236/aim.2016.69069

Abstract

Vibrio cholera, causing acute watery diarrhea known as cholera disease, affects all ages and both genders. Cholera infection outbreaks in Iraq have been reported for several years. The recent cholera outbreak, emerged throughout 2015, was investigated using bacteriological laboratory tests, singleplex and multiplex PCR technique for the detection of V. cholera from stool samples. Furthermore the toxigenic potential coupled with the antibiotic susceptibility test for cholera and other bacteria were also investigated. The stool samples were collected from 5698 patients admitted to Al-Yarmouk Teaching hospital and health care centers in Baghdad/Al-Karkh, Iraq, from the 1st of August to the 30th of December 2015. The V. cholera was isolated from 194 cases (3.4% of the cases age between 21 - 50 years). In addition, other enteric infections: Salmonellosis and Shigellosis 7 and 21 respectively, protozoan parasite Giardia lamblia and Entamoeba histolytica 2 and 43 cases respectively were also reported. High percentage of V. cholera infection was detected in October (122 cases, 62.8%), compared with other enteric infections that show high percentage of diarrheal disease in September and November. The results have confirmed that the cholera outbreak was caused by V. cholera O1, biotype El Tor, and serotype Inaba. Seven virulence genes were identified ctxA, toxR, zot, ace, rfbO1, tcpA and ompW. Moreover, the cholera isolated strains were found sensitive to most antibiotic but resistant to nalidixic acid.

Highlights

Across the globe, infectious gastroenteritis (IGE) is a cause of global morbidity and mortality [1]
It has been suggested that people who have enteric infections should be excluded from the work in a high risk setting because those people represent a source of IGE even when they are clinically asymptomatic for 24 - 48 hrs and have normal stools test [11]
This cholera genotype did not exist prior to this period. These results give indication that Iraq cholera disease represents epidemics spreading from some neighboring countries visitors to holy shrine sites in Iraq [28]. This may be due to inadequate supplies and a shortage of health personnel, among other factors which provide adequate conditions for V. cholera O1, biotype El Tor, serotype Inaba to survive better in the warm environment and crowded areas which give better transmission from human to human by food and water since the El Tor strains have efficiency transmission from host to host when compared with classical cholera strains [56] [57]

Summary

Introduction

Infectious gastroenteritis (IGE) is a cause of global morbidity and mortality [1]. Enteric infections commonly transmitted through fecal-oral route (food and water contamination) [9]. To reduce this risk of the transmission, a good personal hygiene practice and good food handling practice are required [10]. It has been suggested that people who have enteric infections should be excluded from the work in a high risk setting (i.e. workers in health care, residential care and child care, food handlers, young children in child care, etc.) because those people represent a source of IGE even when they are clinically asymptomatic for 24 - 48 hrs and have normal stools test [11]

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