A Bacteriological Study of Vibrio cholerae Isolated from Rural Tertiary Care Hospital of Loni, Western Maharashtra.

Aim: Cholera is endemic in many parts of India and a major public health problem. The present study was carried out with the aims to understand biotype, serotype, phage type and drug resistance of Vibrio cholerae isolates obtained at a rural tertiary care hospital in Loni. Study Design: Descriptive retrospective study was carried out to study V. cholerae isolates from 544 faecal specimens of patients with acute gastroenteritis. Place and Duration of Study: The study was conducted during 2009-2012 at Rural Medical College of Pravara Institute of Medical Sciences, Loni, District Ahmednagar, Maharashtra, India. Methods: A total of 28 isolates of V. cholerae were included in the study. V. cholerae was identified by standard microbiological procedures. Biotyping, serotyping and phage typing was done. Antibiotic sensitivity testing was performed by Kirby- Bauer disc diffusion method. Results: V. cholerae strains were isolated from 28 faecal specimens. All the isolates were identified as V. cholerae O1 biotype El Tor serotype Ogawa and phage 27 was the predominant type. Male: Female ratio was 1:1.5 and high incidence was seen in 0-10 age group (35.71%). Maximal occurrence in monsoon season was recorded. All the isolates were resistant to co-trimoxazole, nalidixic acid and ampicillin. However maximum sensitivity was observed to norfloxacin (71.42%) followed by gentamycin (67.85%) and chloramphenicol (28.57%). Conclusion: A continuous surveillance for V. cholerae is required with respect to changing epidemiology and emergence of antibiotic resistance strains. The source and spread of infection should be investigated to decide the proper management strategies. Additionally, quality of water and status of sanitation should be monitored.

Phage Types of multidrug resistant Salmonella species in a rural area of Maharashtra, India.

Objective: The aim of the present study is to know Phage typing and antimicrobial susceptibility pattern of Salmonella species. Methods:Atotal of 32 Salmonella species isolated from stool and blood specimen were included in the study. They were sent for phage typing to Lady Hardinge Medical College, New Delhi. Antimicrobial susceptibility was done by using Kirby Bauer disc diffusion method. Results: Majority of Salmonella typhi belongs to phage type E1 and biotype I. Decreased susceptibility of the isolate was observed to Ampicillin, Cotrimoxazole, Cephalexin and Gentamicin. Majority of the isolates were sensitive to Ciprofloxacin. Conclusion: Predominant phage type was E1. The antibiotic sensitivity pattern is changing and resistant cases are emerging due to inappropriate use of antibiotics.

Avaliação da suscetibilidade antimicrobiana e do perfil de macrorrestrição do DNA de isolados humanos de Salmonella serovar Typhimurium fagotipo 193, no período de 1970 a 2008 / Assessment of antimicrobial susceptibility and macrorestriction DNA of human isolates of Salmonella serovar typhimurium phage type 193 in the period 1970 to 2008

Para analisar cepas de Salmonella ser. Typhimurium isoladas de processos entéricos e extraintestinais humanos ocorridos no período de 1970 a 2008 de diferentes regiões do país foram selecionadas, com base nos registros contidos no banco de dados do Laboratório de Enterobactérias do IOC/FIOCRUZ, RJ, amostras do fagotipo prevalente 193, visando precipuamente o reconhecimento de clones epidêmicos. Foram selecionadas 553 cepas de Salmonella ser. Typhimurium fagotipo 193 representadas por 91, 65, 70 e 327 amostras referentes as décadas de 70, 80, 90 e ao período de 2000 a 2008, respectivamente. Na análise global da sensibilidade destas cepas, 52% apresentaram um ou mais marcadores de resistência a antibióticos incluídos no perfil ACSSuT. Este perfil de resistência completo foi verificado em 20,9% dos isolados, sendo os 21,9% restantes, sensíveis a todas as drogas testadas, especialmente no período de 2000 a 2008, representadas por 121 amostras (37,0%) em relação as 327 culturas dessa época. O maior percentual de resistência foi observado nas amostras da década de 70 (99%) sendo o perfil ACSSuT detectado em 35,2% dos isolados, ressaltando-se que todas as amostras foram isoladas de processos gastroentéricos ocorridos na cidade de São Paulo. Ao longo das quatro décadas de estudo, descreve-se um ponto de ruptura entre a prevalência de resistência e a suscetibilidade na transição entre as décadas de 80 e 90. Embora o número de isolados de Salmonalla ser. Typhimurium fagotipo 193 tenha aumentado no último período considerado, o percentual de mono e multirresistência aos antimicrobianos se situou em nível elevado (63,0%). A análise do polimorfismo obtido após macrorrestrição com a enzima Xbal revelou que cepas isoladas na década de 90 apresentaram elevado percentual de similaridade (>-85%) com cepas isoladas recentemente (período de 2000-2008), sendo agrupadas nos mesmos "subclusters". Por outro lado, as cepas da década de 70 inserem-se em "subclusters" independentes...

To analyze strains of Salmonella ser. Typhimurium isolated from human cases of enteric and extraintestinal occurred during the period 1970 to 2008 of different regions of Brazil were selected, based on records in the database from Enterobacteria Laboratory of IOC/FIOCRUZ, RJ, samples prevalent phage type 193 in order to recognition of epidemic clones. We selected 553 strains of Salmonella ser. Typhimurium phage type 193 represented by 91, 65, 70 and 327 samples concerning the 1970s, 1980s, 1990s and the period from 2000 to 2008, respectively. In a global analysis of the sensitivity of these strains, 52% had one or more antibiotic resistance markers included in the profile ACSSuT. This resistance profile was found complete in 20.9% of isolates and the remaining 21.9%, sensitive to all drugs tested, especially in the period 2000 to 2008, represented by 121 samples (37.0%) compared the 327 cultures of that time. The highest percentage of resistance was observed in the samples of the 70 (99%) being the profile ACSSuT detected in 35.2% of isolates, emphasizing that all strains were isolated from gastrointestinal processes occurring in São Paulo city. Over the four decades of study, we describe a breaking point between the prevalence of resistance and susceptibility in the transition between the 1980s and 1990s. Although the number of isolates of Salmonella ser. Typhimurium phage type 193 has increased in the last period, the percentage of mono-and-multidrug resistance to antimicrobial agents stood at high level (63.0%). The analysis of polymorphism obtained after macrorestriction with the enzyme Xbal showed that isolates in the 1990s showed a high percentage of similarity (>-85%) with strains isolated recently (2000-2008) and are grouped in the same subclusters. Moreover, the strains of the 1970s fall into subclusters independent, although the percentage of similarity between such subsclusters and the other is >- 70%, the same was observed for the strains...

Epidemic by Salmonella I 4,5,12:i:- and Characteristics of Isolates in Korea / 감염과화학요법

BACKGROUND: Salmonella I 4,[5],12:i:- was first reported as a new serovar by the Spanish National Reference Laboratory in 1997. Thereafter, several outbreaks caused by this serovar have been reported, indicating worldwide transmission. MATERIALS AND METHODS: Stool samples and patient data were collected from diarrhea cases in an outbreak at Daegu city in 2008. Salmonella isolates were characterized by phage typing, antibiotic resistance profile and flagella gene deletion. Deposited isolates in the EnterNet-Korea, acute diarrheal surveillance system, were also screened for this serovar. RESULTS: Isolates from diarrhea patients in the Daegu outbreak (2008) were identified as Salmonella I 4,[5],12:i:-. Screening the deposited isolates in the EnteroNet-Korea revealed that an unidentifed isolate in 2001 was the Salmonella I 4,[5], 12:i:-. CONCLUSIONS: Salmonella I 4,[5],12:i:-. was the causative pathogen of the 2008 foodborne outbreak of salmonellosis in Daegu City. Retrospective screening revealed that Salmonella I 4,[5],12:i:- was present in Korea as early as 2001.

Epidemiology & antibiograms of Vibrio cholerae isolates from a tertiary care hospital in Chandigarh, north India.

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.

A Clinical and Epidemiological Analysis on an Outbreak of Typhoid Fever During 1996 Summer Through Autumn in Chunju Area / 감염

BACKGROUND: We experienced an outbreak of typhoid fever in Chunju area which manifested as severe symptoms and signs, and variable complications. To chracterize the epidemic and to identify a possible source of infection, the clinical findings of patients from the outbreak were analyzed, and the patterns of antimicrobial susceptibility and phage typing of Salmonella Typhi isolates were determined. METHODS: We analyzed a total of 232 patients from the outbreak who admitted to Chunju Presbyterian Medical Center during 1996 August through October. The medical records of the patients were reviewed retrospectively. All isolates of S. Typhi from the outbreak were analyzed for serotyping, antibiogram, and phage typing. Phage typing were performed using Vi- phages for 50 strains isolated from the patients who showed atypical clinical manifestations and unusal complications. RESULTS: The outbreak attacked mainly young femalegroup. The complications observed were: 155 casesof hepatitis, 47 pancytopenia, 20 acute pancreatitis, 13 urinary tract infection, 12 intestinal hemorrhage, 5 disseminated intravascular coagulation, 4 meningitis, 3 septic shock, 2 sensorineural hearing loss, 2 myocardial ischemia, 2 pneumonia, 1 stillbirth, and 1 death. S. Typhi were isolated in 129 cases including 111 from blood, 17 stool and 1 urine. All isolates were susceptible to all antimicrobial agents tested. All 50 isolates from severe patients with unusal complications were identified as Salmonella, serogroup D1, serotype Typhi, phage type D1. CONCLUSIONS: We experienced an outbreak of typhoid fever associated with severe, atypical symptoms and unusual complications, caused by Salmonella, serogroup D1, serotype Typhi, phage type D1.