ABSTRACT
Background & objectives: Cholera is endemic in Chandigarh and its surrounding areas. This retrospective study was undertaken over a period of nine years (January 1999-December 2007) from a tertiary care hospital in north India to understand the changing epidemiology aspects and antibiotic resistance patterns in Vibrio cholerae isolates. Methods: A total of 277 isolates of V. cholerae were included in the study. V. cholerae was identifi ed by standard microbiological procedures. Antibiotic sensitivity testing was performed by disc diffusion method and isolates phage typed. Results: All the isolates were identifi ed as V. cholerae O1 biotype El Tor serotype Ogawa; phage 27 was the predominant type. Men were more commonly affected with maximum number in the age group 0-5 yr. Majority of the isolates were resistant to furazolidone but sensitive to gentamicin and cefotaxime. Resistance pattern to amoxycillin was variable. Three isolates were found to be resistant to ciprofl oxacin. All the patients presented during June-October coinciding with the monsoon season and a majority were from suburbs. Interpretation & conclusions: The emergence of resistance amongst V. cholerae especially towards ciprofl oxacin may signifi cantly infl uence the control strategies in future outbreaks. Phage 27 remained the predominant type in all the years. Continuous surveillance with regard to drug resistance, early detection and a strong regional commitment may help contain the disease.
ABSTRACT
BACKGROUND & OBJECTIVE: Outbreaks of cholera caused by Vibrio cholerae O1 Ogawa occurred in and around Chandigarh during two successive year 2002 and 2003. This study highlights the antibiotic sensitivity and phage typing pattern of V. cholerae isolates during 2002 and 2003. METHODS: Faecal specimens from acute gastroenteritis cases from July to September, 2002 and in the same month in 2003 were collected. Isolation and identification of pathogen was done according to standard methodology. Simultaneously water samples from the areas reporting the maximum number of cholera cases were also processed. Antibiotic susceptibility pattern of the isolates was studied and isolates were sent to National Institute of Cholera and Enteric Diseases (NICED), Kolkata for confirmation and phage typing. RESULTS: Of the 156 patients in 2002 and 125 in 2003, 59 and 40 isolates respectively were found to be positive for V. cholerae O1 serotype Ogawa biotype El tor. Of the 45 water samples tested in 2002, eight were found to be positive for V. cholerae O1 serotype Ogawa biotype El tor. None of the 52 water samples tested in 2003 was found to be positive for V. cholerae. Phage type 27 was found to be the predominant type for both the years. Majority of the clinical isolates were found to be resistant to more than two drugs. INTERPRETATION & CONCLUSION: The drug resistance in V. cholerae was on the rise during the subsequent outbreak. Phage 27 remained the predominant type in both the years. The major reason for the outbreak was traced to be contaminated water of the hand pumps in the affected area. Continuous surveillance of the outbreak is necessary to contain the spread of transmission.