Bacteremia by non-O1/non-O139 Vibrio cholerae: Case description and literature review / Bacteriemia por Vibrio cholerae no-O1/no-O139: descripción de un caso y revisión de la literatura

Bacteremia by non-O1/non-O139 Vibrio cholerae is a rare entity associated with high mortality rates. We report a case of non-O1/non-O139 V. cholerae bacteremia confirmed by polymerase chain reaction and agglutination tests. The clinicoepidemiological characteristics and therapeutic options for this infection are also described.

La bacteriemia por Vibrio cholerae no-O1/no-O139 es una entidad poco frecuente que se asocia con altas tasas de mortalidad. Se reporta un caso de bacteriemia por V. cholerae no-O1/no-O139 confirmado por reacción en cadena de la polimerasa y test de aglutinación. Se describen las características clinicoepidemiológicas y las opciones terapéuticas para esta infección.

Las epidemias de cólera en Argentina. Breve reseña histórica / The cholera epidemics in Argentina. Brief historical review

El cólera es una toxoinfección alimentaria ocasionada por la ingesta de agua y alimentos contaminados por el Vibrio cholerae. Es una de las enfermedades más antiguas de la humanidad y las primeras descripciones corresponden a Hipócrates. La primera epidemia documentada, sucedió en la India en 1817 y se extendió a Turquía y a los países árabes. En nuestro país, el primer brote ocurrió en 1856 en la ciudad de Bahía Blanca, asociada a la llegada de navíos con enfermos y a las deficientes condiciones sanitarias de la ciudad. Los sucesivos brotes se acompañaron de una alta mortalidad, a tal punto que el Dr. José María Penna señaló que costó más vidas a la nación que la guerra con Paraguay. En el presente artículo se analizan los sucesivos brotes de cólera en nuestro país

Cholera is a food poisoning caused by the ingestion of food and water contaminated by Vibrio cholerae. It is one of the oldest diseases of humanity and the first descriptions correspond to Hippocrates. The first documented epidemic occurred in India in 1817 and spread to Turkey and the Arab countries. In our country, the first outbreak occurred in 1856 in the city of Bahía Blanca, associated with the arrival of ships with patients and poor sanitary conditions in the city. The successive outbreaks were accompanied by high mortality, to the point that Dr. José María Penna pointed out that it cost the nation more lives than the war with Paraguay. This article analyzes the successive outbreaks of cholera in our country

Molecular characteristics and drug resistance of non-O1non-O139 Vibrio cholerae in Zhongshan City, Guangdong Province / 中国热带医学

@#Abstract: Objective　To investigate the molecular characteristics and drug resistance of non-O1/non-O139 Vibrio cholerae in Zhongshan City, and to provide laboratory basis for cholera prevention and control. Methods　The strains of non-O1/non-O139 Vibrio cholerae isolated from sporadic patients and aquatic products from 2015 to 2021 in Zhongshan city were collected. The identification and cluster analysis of the strains were analyzed by matrix assisted laser desorption/ionization time of flight mass spectrometry (MALDI-TOF-MS), the ctxA virulence gene of strains were detected by real-time fluorescence quantitative PCR, the cluster analysis of the strains was analyzed by pulsed-field gel electrophoresis (PFGE), and the drug resistance of the strains were analyzed by microbroth dilution method. Results　From 2015 to 2021, 33 strains of non-O1/non-O139 Vibrio cholerae were isolated from Zhongshan City, including 28 strains from sporadic patients and 5 strains from aquatic products. Through MALDI-TOF-MS identification, 33 strains of non-O1/non-O139 Vibrio cholera can be identified to the level of species, and the identification results were all Vibrio cholerae. Among 33 non-O1/non-O139 Vibrio cholerae strains, 1 strain carried the ctxA virulence gene. The drug-resistant strains accounted for 69.7% (23/33), and the multidrug resistant strains accounted for 18.2% (6/33). A total of 7 kinds of drug resistance spectrum were produced, including 3 kinds of multidrug resistant spectrum, and showed drug resistance to 8 antibiotics, among which the resistance rates to streptomycin, cefazolin and compound sulfamethoxazole were above 30%. The 33 strains of non-O1/non-O139 Vibrio cholerae were divided into 32 PFGE fingerprints with a similarity ranging from 61.7% to 100%. MALDI-TOF-MS cluster analysis divided 33 non-O1/non-O139 Vibrio cholerae strains into two clusters. Conclusions The results of molecular typing of non-O1/non-O139 Vibrio cholerae in Zhongshan City presented diversity, and no significant correlation was found between PFGE and MALDI-TOF-MS cluster analysis. The strains demonstrated various degrees of resistance to certain antibiotics, and there were multidrug-resistant and toxigenic strains. Therefore, it is necessary to alert to the harmfulness of non-O1/non-O139 Vibrio cholerae and enhance monitoring.

Resistencia antimicrobiana y factores de virulencia en aislados de Vibrio cholerae O1. Cuba, 2012-2015 / Antimicrobial resistance and virulence factors in Vibrio cholerae O1 isolates. Cuba, 2012-2015

Introducción: El cólera es una infección intestinal aguda causada por cepas toxigénicas de Vibrio choleare. La rápida diseminación y emergencia de la multirresistencia que caracteriza a este patógeno, podría interferir en el éxito de la terapia antimicrobiana, por lo que constituye una prioridad monitorear los cambios en los patrones de susceptibilidad, como parte trascendental de la política de control de la resistencia antimicrobiana. Objetivo: Determinar el comportamiento de la resistencia antimicrobiana frente a los antimicrobianos de interés empleados en el tratamiento, la presencia de factores de virulencia enzimáticos y si existe relación entre ambos. Métodos: Se realizó un estudio descriptivo de corte transversal durante julio de 2012 a diciembre de 2015. Se estudiaron 500 aislamientos pertenecientes al cepario del Laboratorio Nacional de Referencia de Enfermedades Diarreicas Agudas del Instituto de Medicina Tropical Pedro Kourí, procedentes de brotes de enfermedades diarreicas agudas de la red nacional de laboratorios de Microbiología de Cuba. Se aplicaron métodos convencionales fenotípicos para determinar el comportamiento de la resistencia antimicrobiana, la presencia de factores enzimáticos y la relación de estos con la resistencia antimicrobiana. Resultados: Los mayores porcentajes de sensibilidad se obtuvieron frente a azitromicina (98 por ciento), doxiciclina (96 por ciento) y ciprofloxacina (93 por ciento) y de resistencia frente a ampicilina (100 por ciento) y trimetoprim-sulfametoxazol (99,4 por ciento). Se encontraron 44 aislados (8,8 por ciento) multirresistente. Todos los aislamientos poseían al menos dos enzimas extracelulares como factores de virulencia, las más frecuentes: gelatinasa (96 por ciento) y lecitinasa (95 por ciento). Conclusiones: Se evidencia una relación directa y proporcional entre la presencia de los factores de virulencia y resistencia antimicrobiana, sinergismo que surgiere mayor patogenicidad de los aislados estudiados procedentes de brotes epidémicos(AU)

Introduction: Cholera is an acute intestinal infection caused by toxigenic strains of Vibrio choleare. The rapid dissemination and emergence of the multiresistance that characterizes this pathogen could interfere with the success of antimicrobial therapy, so it is a priority to monitor changes in susceptibility patterns, as a transcendental part of the resistance control policy antimicrobial. Objective: To determine the behavior of antimicrobial resistance against the antimicrobials of interest used in the treatment, the presence of enzymatic virulence factors and whether there is a relationship between them. Methods: A descriptive cross-sectional study was conducted during July 2012 to December 2015. Where 500 isolates belonging to the cepary of the National Reference Laboratory for Acute Diarrheal Diseases of the Institute of Tropical Medicine Pedro Kourí, from outbreaks of EDA of the national network of Microbiology laboratories in Cuba. Conventional phenotypic methods were applied to determine the behavior of antimicrobial resistance, the presence of enzymatic factors and their relationship with antimicrobial resistance. Results: The highest percentages of sensitivity were obtained against azithromycin (98 percent), doxycycline (96 percent) and ciprofloxacin (93 percent) and resistance to ampicillin (100 percent) and trimethoprim-sulfamethoxazole (99.4 percent). 44 isolated (8.8 percent) multi-resistant were found. All isolates had at least two extracellular enzymes as virulence factors, the most frequent: gelatinase (96 percent) and lecithinase (95 percent). Conclusions: There is a direct and proportional relationship between the presence of virulence factors and antimicrobial resistance, synergism that arises greater pathogenicity of the isolates studied from epidemic outbreaks(AU)

A rare and unusual cause of Vibrio cholerae non-O1, non-O139 causing spontaneous peritonitis in a patient with cirrhosis

@#Spontaneous bacterial peritonitis caused by Vibrio cholerae non-O1/ non-O139 is a rare phenomenon. V. cholerae is known as a common aetiology of epidemic diarrheal disease and rarely causes extra-gastrointestinal infections. In this report, a 52-year-old man presented to our hospital with a clinical scenario for chronic liver cirrhosis with low grade fever and loose stools. V. cholerae was isolated from peritoneal fluid culture, which was further confirmed as non-O1/ non-O139 strain by multiplex polymerase chain reaction. The patient was successfully treated with antimicrobial therapy and peritoneal drainage. This case represents the first isolation of V. cholerae non-O1/ non-O139 strain from peritoneal fluid.

Detection of cholera toxin (ctxA and ctxAB) genes in Vibrio cholerae isolated from clinical and environmental samples in Limbang Sarawak by multiplex polymerase chain reaction (PCR)

Aims@#Cholera epidemics have been occurred in Malaysia since 1991 till 2003 which can be proved from the records by the Infectious Diseases Division of the Ministry of Health. Moreover, there were also course of cholera epidemics from the year 1994 to 2003 which had been happened in Sarawak. Cholera outbreaks in Malaysia mostly caused by the El Tor O1 Vibrio cholerae serogroup. The aims of this study were to detect the presence of V. cholerae in clinical and environmental samples (n=28) from Limbang, Sarawak by collaboration with Sarawak Government Hospital and to detect the toxin genes from the isolates.@*Methodology and results@#All the isolates were sub-cultured in alkaline peptone water (APW). The boiled-cell method was used for DNA extraction. The total DNA extracted was amplified by polymerase chain reaction (PCR). Two types of PCR were used in this study which are 16S rRNA PCR and multiplex PCR. The results obtained from the study found out that 16 out of 28 (57.14%) samples were confirmed to be V. cholerae species. Four primers specific for V. cholerae were used in multiplex PCR (O1 type, O139 type, ctxA and ctxAB) to confirm the species type and the toxin genes. All samples shown positive for V. cholerae O1 serotype and 100% positive to all genes for the identification of ctxA and ctxAB genes. @*Conclusion, significance and impact of study@#From this study, it showed that multiplex PCR can be used for research purposes in molecular genetics field involving cholera outbreak.

Expression in Saccharomyces boulardii of recombinant Toxin-coregulated pilus A subunit (TcpA) of Vibrio cholerae O1

Cholera is endemic in over 50 countries with an estimated mortality of 100,000-120,000. Vaccination is considered the complementary key to prevent and control cholera; therefore, alternative vaccine preparations are needed. Toxin Co-regulated Pilus is part of the toxR virulence regulon, which is necessary for colonization in the intestinal mucosa. In order to express Vibrio cholerae TcpA protein in Saccharomyces boulardii, the expression plasmid pYES2 was constructed by inserting tcpA gene isolated from local Vibrio cholerae Eltor Inaba isolates. The new construct was transferred into Saccharomyces boulardii cells and the expression of tcpA gene was induced from the GAL1 promoter by adding galactose to the medium. The SDS-PAGE and Western blot analysis showed the presence of TcpA in yeast. These results showed that Saccharomyces boulardii is a promising host to express Vibrio cholerae toxin TcpA as the first step in attempt to produce an oral Vibrio cholerae vaccine(AU)

El cólera es endémico en más de 50 países. Se estima una mortalidad entre 100.000 - 120.000 debido a esta enfermedad. La vacunación se considera una medida complementaria para prevenir y controlar el cólera, por lo tanto, se necesitan preparaciones vacunales alternativas a las existentes. El Pili corregulado con la toxina, es parte del regulón de virulencia toxR, y es necesario para la colonización en la mucosa intestinal. Para expresar la proteína tcpA de Vibrio cholerae en Saccharomyces boulardii, se construyó el plásmido de expresión pYES2 insertando el gen tcpA obtenido a partir de aislamientos locales de Vibrio cholerae El Tor Inaba. La nueva construcción se transfirió a las células de Saccharomyces boulardii y se indujo la expresión del gen tcpA a partir del promotor GAL1 mediante la adición de galactosa al medio. El análisis mediante SDS-PAGE y Western blot demostró la presencia de TcpA en levaduras. Los resultados demostraron que Saccharomyces boulardii es un hospedero prometedor para expresar el gen tcpA de Vibrio cholerae como el primer paso en el intento de producir una vacuna oral contra Vibrio cholerae(AU)

Bacteriemia por Vibrio cholerae (no-O1/no O139): reporte de caso / Vibrio cholerae bacteremia (non-O1/non-O139): case report

RESUMEN Vibrio cholerae (no-O1/no-O139) es un patógeno poco común que causa infecciones en humanos y que se encuentra en vida libre en ríos y en el mar, donde coloniza peces y moluscos, fuente principal de contagio para los humanos. Se presenta el caso de un paciente de 78 años con antecedente de diabetes mellitus y sospecha de neoplasia pancreática, quien consultó por síndrome febril asociado a dolor abdominal y se documentó bacteriemia por V. cholerae, por lo que se inició manejo antibiótico con posterior resolución del cuadro clínico. Como el caso se relacionó con el consumo de agua contaminada, se notificó a la autoridad competente para realizar el control de la fuente infecciosa, intervención que permitirá evitar la infección de la población que tiene contacto con ese pozo de agua.

ABSTRACT Vibrio cholerae (non-O1/non-O139) is an uncommon pathogen that causes infection in humans, it is a free-living microorganism in river and sea waters, where it colonizes fish and shellfish, which are the main transmission sources. We present the case of a 78-year old man with a history of diabetes mellitus and suspected pancreas malignancy; who was brought because of fever disease with abdominal pain, and Vibrio cholerae bacteremia was documented, so antibacterial therapy was started, and his clinical condition resolved. Since this case was related to the ingestion of contaminated water, we notified the authorities so the infectious source may be controlled, and this intervention will prevent the occurrence of infections in persons in contact with this particular water source.

Ensayo de inmunogenicidad y toxicidad aguda del candidato vacunal contra el cólera vax-COLER® / Immunogenicity and acute toxicity assay of the vaccine candidate against cholera vax-COLER®

Para el control y prevención del cólera humano se han llevado a cabo diferentes estrategias, entre las cuales, la vacunación es una de las medidas más eficaces. La evaluación preclínica de candidatos vacunales requiere de la demostración de la seguridad de los mismos, para lo cual los estudios toxicológicos son determinantes, al ser obligatorios y altamente regulados. Este estudio tuvo como objetivo demostrar la relevancia de las ratas Sprague Dawley como biomodelo a través de su respuesta inmunológica al candidato vacunal contra el cólera, vax-COLER®, utilizando la técnica de determinación de anticuerpos vibriocidas. Además, evaluar los efectos toxicológicos locales y sistémicos por la administración de una dosis de vax-COLER® a través de la evaluación de síntomas, del consumo de agua y alimentos, el peso corporal y estudios anatomopatológicos. La vacuna vax-COLER® resultó inmunogénica y no evidenció síntomas ni muertes, no hubo cambios en el peso corporal y los consumos de agua y alimentos se comportaron de forma similar entre todos los grupos. Los estudios anatomopatológicos solo mostraron cambios a nivel histológico en los ganglios linfáticos mesentéricos y placas de Peyer de los animales vacunados, con presencia de hiperplasia de los folículos secundarios subcapsulares, hallazgo que difirió significativamente con el resto de los grupos. Se concluye que la vacuna vax-COLER® es inmunogénica en ratas Sprague Dawley, demostrando la relevancia del biomodelo para la evaluación de la seguridad preclínica y que la aplicación de una dosis no produjo efectos tóxicos agudos generales ni locales(AU)

Different strategies have been carried out for the control and prevention of human cholera. Vaccination is one of the most effective strategies. Preclinical evaluation of vaccines needs to prove their safety; whereby toxicological studies are decisive. They are mandatory and highly regulated. This study was aimed to demonstrate the relevance of Sprague Dawley rats as a biomodel, through the immunological response to vax-COLER® cholera vaccine, using the technique of determination of vibriocidal antibodies. In addition, local and systemic toxicological effects were evaluated after administration of a dose of vax-COLER®; through the evaluation of symptoms, water and food consumption, body weight and anatomopathological studies. The vax-COLER® vaccine was immunogenic and showed no symptoms or deaths. No changes in body weight were detected, and food and water consumption were similar among all groups. The anatomopathological studies showed histological changes in the mesenteric lymph nodes and Peyer's patches of the vaccinated animals, with hyperplasia of the subcapsular secondary follicles, finding that differed significantly from the rest of the groups. It is concluded that vax-COLER® vaccine is immunogenic in Sprague-Dawley rats, demonstrating the relevance of the biomodel for the evaluation of preclinical safety, as well as that the application of a single dose did not produce acute general or local toxic effects(AU)

Computational Prediction of Novel Broad-Spectrum Drug Targets Against Vibrio Cholerae by Integrated Genomics and Proteomics Approach

@#Introduction: Vibrio cholerae is a motile, Gram-negative curved rod belonging to the Vibrionaceae family. It is the causative agent of cholera. The acute diarrheal disease cholera causes about 120 000 casualties annually and has a significant effect on the health of young kids between the ages of 1 and 5. The main cause of death is due to resistance to antibiotics. As a result, new drug targets need to be identified immediately. The study’s goal is to identify Vibrio Cholerae’s putative drug target through an integrated approach to genomics and proteomics. Methods: Through this study, 2241 core protein sequence of Vibrio Cholerae were retrieved from the Panx tool. The sequence decreased to 173 druggable sequences by undergoing different phases of the process such as determining the non-homologous sequence against human proteome by using the BlastP tool, identifying the essential genes by using the DEG database, and determining the sequence of virulent proteins by using Virulent prediction tool. Results: 11 potential drug targets were identified through molecular weight, and sub-cellular localization analysis. Conclusion: Through pan-genome analysis, we can able to find potential drug targets. This study also helps to identify the potential drug targets against Vibrio cholerae and to increase the efforts of drug and vaccine developments.

Acesso ao Saneamento básico e Incidência de Cólera: uma análise quantitativa entre 2010 e 2015 / Access to basic and analytical sanitation of cholera: a quantitative analysis between 2010 and 2015

RESUMO As condições de saneamento básico são um dos principais determinantes nos índices de agravos à saúde humana, principalmente no tocante a doenças infectocontagiosas por veiculação hídrica. Dentre todas, destacamos neste trabalho a cólera: doença entérica causada pelas cepas toxigênicas do Vibrio cholerae (sorogrupos O1 e O139), que é caracterizada por um quadro de acentuada diarreia. O objetivo deste trabalho, por meio de levantamento de dados mundiais de Incidência de Cólera (IC) e percentual populacional de Acesso ao Saneamento (AS), é quantificar, evidenciar e discutir a relação entre esses dois indicadores no período de 2010 a 2015, assim como apontar outros possíveis fatores magnificantes de vulnerabilidade socioambiental para a patologia. No período analisado, foram registrados 1.575.168 casos da doença, com as maiores incidências na região do subcontinente áfrico-asiático e em países isolados nos demais continentes, como, por exemplo, Haiti (América) e Papua Nova Guiné (Oceania), que também apresentaram sérios problemas de acessibilidade a serviços de saneamento. Desta forma, apesar de sugerirmos a análise de outros fatores socioambientais, as condições de saneamento revelaram-se como um determinante expressivo para a incidência da cólera em todas as regiões do mundo.

ABSTRACT Health conditions are among the main factors leading to human health damages, particularly concerning infectious diseases by water transmission. Among those cholera is highlighted in this work: the virus infection of Vibrio cholerae toxicity (serogroups O1 and O139), which is characterized by marked diarrhea. Using incidence data on cholera (CI) and the population percentage of Access to Sanitation (AS) collected throughout the world, the objective of this work is to quantify, highlight and discuss relationship between those two indicators over the period from 2010 to 2015, besides pointing out other possible magnifying factors of socioenvironmental vulnerability to this pathology. Over that period, 1,575,168 cases of the illness were analyzed, showing more frequent occurrences in the region of the African-Asian subcontinent and isolated countries in the other continents, such as Haiti (America) and Papua New Guinea (Oceania), which also presented serious problems regarding the access to sanitation services. Thus, although we suggest other socioenvironmental factors to also be analyzed sanitation conditions proved to be an expressive determinant for the incidence of cholera in all regions worldwide.

Caracterización clínica-epidemiológica según la edad de pacientes diagnosticados con cólera / Clinic-epidemiological description according to the age of patients diagnosed with cholera

Introducción: Se estima que 1,4 billones de personas están en riesgo de infectarse por cólera y la mitad de los fallecidos son menores de 5 años. Objetivo: Caracterizar clínica y epidemiológicamente a los pacientes afectados por vibrión colérico según la edad de los enfermos y el tiempo que medió entre la aparición de los síntomas de la enfermedad y la asistencia al Sistema Nacional de Salud. Métodos: Estudio clínico, epidemiológico, descriptivo y prospectivo desde 2013-2017 a los pacientes que se les confirmó por coprocultivo el V. cholerae como causa de enfermedad diarreica aguda en el hospital pediátrico de Centro Habana. Se analizaron variables cualitativas y cuantitativas. Resultados: Se registraron 115 niños mayores de 5 años y 44 menores de 5 años afectados por el cólera. El 54,7 por ciento del total de pacientes estudiados estuvo en la zona afectada, el 94,3 por ciento presentó deposiciones líquidas, el 18,2 por ciento con aspecto de agua de arroz, el 7,5 por ciento con olor a pescado, el 47,2 por ciento presentó vómitos, el 6,9 por ciento fiebre y el 12,8 por ciento dolor abdominal. El valor de la mediana del tiempo que medio entre la aparición de los síntomas y la asistencia al médico fue de 24 horas. Conclusiones: Los pacientes más afectados son los mayores de 5 años y los que más tardíamente acudieron al Sistema Nacional de Salud. En todos predomina la procedencia de la zona afectada, las deposiciones líquidas y los vómitos(AU)

Introduction: It is estimated that 1.4 billion people are at risk of being infected by cholera and half of them are children under 5 years old. Objective: To describe clinically and epidemiologically the patients affected by Vibrio cholerae according to their age and the time passed from the onset of symptoms of disease to their attendance to the National Health System. Methods: Clinical, epidemiological, descriptive and prospective study from 2013 to 2017 in patients with confirmed V. cholerae by stool culture as a cause of acute diarrheal disease in the Pediatric Hospital of Centro Habana municipality.Qualitative and quantitative variables were analyzed. Results: There was a record of 115 children over 5 years and 44 children under 5 years affected by cholera. The 54.7percent of the total number of patients studied was in the affected area, 94.3 percent presented liquid stool, 18.2 percent of those looked like rice water, 7.5 percent with fishy smell; 47.2 percent of the patients presented vomiting, and 6.9 percent fever and 12.8 percent abdominal pain. The value of the mean time between the onset of symptoms and the assistance to the physician was of 24 hours. Conclusions: Most affected patients and that attended late to the National Health System were the ones over 5 years. In all predominated coming from the affected area, liquid stools and vomiting(AU)

Neuroinfección por Vibrio cholerae no O1/ no O139 secundaria a la derivación ventriculoperitoneal. Reporte de caso / Vibrio cholerae no o1/ no 0139 neuroinfection secondary to ventriculoperitoneal shunt: case report

RESUMEN La infección de la derivación ventriculoperitoneal es una de las complicaciones más frecuentes en este procedimiento. Vibrio cholerae O1 y O139 es una bacteria gram negativa conocida principalmente por ser la responsable del cólera epidémico. No obstante, existen serotipos no O1/ no O139 capaces de causar afecciones extraintestinales, entre ellas se han reportado casos de neuroinfección. Presentamos el caso de una paciente con 9 meses de edad que posterior a la colocación de una derivación ventriculoperitoneal como tratamiento de hidrocefalia obstructiva congénita, presentó un cuadro de neuroinfección y el síndrome de malfunción valvular; se pudo aislar la Vibrio cholerae no O1/ no O139 en el líquido cefalorraquídeo y en la punta del catéter. Es el primer reporte en la literatura en la que se aísla la Vibrio cholerae no O1/ no O139 en líquido cefalorraquídeo secundario a infección de una derivación ventriculoperitoneal.

SUMMARY The infection of the ventriculoperitoneal shunt is one of most frequent complications for this procedure. Vibrio cholera O1 and O139 is a Gram negative bacteria known mainly for being responsible of the epidemic cholera, however, there are serotypes no O1/ no O139 capable of causing extraintestinal conditions, among them neuroinfection cases have been reported. We present the case of a 9 months old patient who after the placement of a ventriculoperitoneal shunt as treatment for connate obstructive hydrocephalus, presents a neuroinfection condition and valve malfunction syndrome, being able to isolate the Vibrio cholerae no O1/ no O139 in the cerebrospinal fluid and the tip of the catheter. It is the first report in the literature in which the Vibrio cholerae no O1/ no O139 is isolated in the cerebrospinal liquid secondary to an infection from a ventriculoperitoneal shunt.

Vibriocidal activity of leaf and rhizome extracts of Maranta arundinacea L

Globally, the gastroenteritis or diarrhoea has become a more significant problem today due to infection causedby water-or foodborne pathogen Vibrio cholera. In this concern, an investigation was carried out to evaluatethe vibriocidal potential of the different solvent extracts of leaf and rhizome of Maranta arundinacea under invitro condition. For this, aqueous, methanolic, ethanolic, and hexane extracts of both leaf and rhizome of M.arundinacea were tested against the pre-isolated strains of V. cholerae, such as SPAB1, SPAB4, and SPAB5by agar well diffusion and minimum inhibitory concentration (MIC) method. All the solvent extracts of bothleaf and rhizome were found to be active against the tried strains of V. cholera; however, ethanolic extractshowed maximum inhibitory effect against SPAB1 strain with an inhibition zone of 26.23 ± 0.53 mm (MIC of80.00 ± 10.06 µg/ml) and 24.27 ± 0.12 mm (MIC of 100.00 ± 12.82 µg/ ml) in rhizome and leaf samples, respectively.Then, the effectiveness was followed in SPAB4 and SPAB5; however, it was not much more significant to that ofSPAB1. Therefore, it was suggested that the rhizome and leaf extracts which proved to be potentially effective canbe used as the natural alternative for the treatment of diarrhoea caused by Vibrio infection

Determinación de biopelículas y betalactamasas de espectro extendido en Vibrio cholerae no-O1, no-O139 aislados de pacientes con diarreas en Cuba / Determination of biofilms and extended-spectrum beta-lactamases in Vibrio cholerae non-O1, non-O139 isolates from patients with diarrhea in Cuba

. Vibrio cholerae no-O1, no-O139 es el tercer grupo de bacterias del género Vibrio que con más frecuencia producen diarreas. Sobrevive en los ambientes acuáticos, utilizando la formación de biopelícula como mecanismo de supervivencia que propicia la transmisión de la enfermedad diarreica. Desde 1977 se caracterizan aislados de V. cholerae con resistencia múltiple, y algunos de los mecanismos involucrados incluyen la producción de β-lactamasas de espectro extendido (BLEE). Este trabajo tuvo como objetivo determinar la formación de biopelícula en los aislados cubanos de V. cholerae no-O1, no-O139, causantes de enfermedad diarreica aguda (EDA), y detectar la producción de BLEE en aquellos con resistencia total e intermedia a ampicilina. Se realizó un estudio descriptivo de corte transversal, entre enero 2014 y junio 2015. Se estudiaron 55 aislados caracterizados previamente, que formaban parte del cepario del Laboratorio Nacional de Referencia de EDA del Instituto Pedro Kourí. Para la determinación fenotípica de BLEE se estudiaron 43, de los que ya se conocía su susceptibilidad a ampicilina. El 54,5 por ciento de los aislados resultaron positivos a la formación de biopelícula, y predominaron los clasificados como formadores moderados (46,6 por ciento ) y débiles (36,6 por ciento ). De los 34 resistentes a ampicilina, 26,5 por ciento resultaron positivos a la producción de BLEE. En el caso de los nueve aislados con resistencia intermedia a ampicilina, 44,4 por ciento resultaron positivos. Los resultados del presente estudio contribuyen al conocimiento sobre la capacidad que tienen de persistir en el ambiente y permiten profundizar sobre los mecanismos de resistencia a los antimicrobianos(AU)

Vibrio cholerae non-O1, non-O139 is the third bacterium group from the genus Vibrio most commonly causing diarrhea. It survives in aquatic environments, using the formation of biofilm as a survival mechanism facilitating the transmission of diarrheal disease. Multi-drug resistant V. cholerae isolates have been characterized since the year 1977, and some of the mechanisms involved include the production of extended-spectrum β-lactamases (ESBLs). The purpose of the study was to determine the formation of biofilm in Cuban isolates of V. cholerae non-O1, non-O139 causing acute diarrheal disease (ADD), and detect the production of ESBLs in those with total or intermediate resistance to ampicillin. A descriptive cross-sectional study was conducted from January 2014 to June 2015. The study sample was 55 previously characterized isolates obtained from the strain collection at the ADD National Reference Laboratory of Pedro Kourí Institute. For phenotypic determination of ESBLs, 43 were studied which were known to be susceptible to ampicillin. 54.5 percent of the isolates tested positive for biofilm formation, with a predominance of those classified as moderate (46.6 percent) and weak (36.6 percent) biofilm producers. Of the 34 isolates resistant to ampicillin, 26.5 percent were positive for ESBL production. Of the 9 with intermediate ampicillin resistance, 44.4 % were positive. The results of the present study contribute knowledge about their ability to persist in the environment, and provide insight into antimicrobial resistance mechanisms(AU)

Cepas chilenas de origen clínico de Vibrio cholerae no-O1, no-O139 portan los genes vcsN2, vcsC2, vcsV2, vspD, toxR2 y vopF del sistema de secreción T3SS2 presentes en una isla de patogenicidad / Chilean strains of clinical origin of non-O1, non-O139 Vibrio cholerae carry the genes vcsN2, vcsC2, vcsV2, vspD, toxR2 y vopF from secretion system T3SS2 present in an island of pathogenicity

Resumen Introducción. Los factores de virulencia de las cepas de Vibrio cholerae no-O1, no-O139 no son claramente conocidos. La cepa de origen septicémico NN1 Vibrio cholerae no-O1, no-O139 fue secuenciada previamente mediante la plataforma Illumina, detectándose en su genoma un fragmento de la isla de patogenicidad VPaI-7 de V. parahaemolyticus. Objetivo: detectar los genes de virulencia vcsN2, vcsC2, vcsV2, vspD, toxR2 y vopF en cepas chilenas clínicas de V. cholerae no-O1, no-O139. Material y Métodos: Un total de 9 cepas chilenas de origen clínico de Vibrio cholerae no-O1, no-O139 aisladas entre 2006-2012 fueron analizadas mediante ensayos de reacción de polimerasa en cadena (RPC, en inglés PCR) convencional para los genes de secreción tipo III codificados en dicha isla: vcsN2, vcsC2, vcsV2, vspD, toxR2 y vopF. Adicionalmente se determinó la presencia de los genes de virulencia hylA y rtxA. Además, se realizaron ensayos de repetitive element palindromic PCR (REP-PCR) y Enterobacterial repetitive intergenic consensus PCR (ERIC-PCR). Resultados: la mayoría (6/9) de las cepas chilenas de V. cholerae no-O1, no-O139 contiene todos los genes de secreción tipo III vcsN2, vcsC2, vcsV2, vspD, toxR2 y vopF, codificados en una isla de patogenicidad. Además, el total de las cepas (9/9) contiene los genes de virulencia hylA y rtxA. Conclusión: Estos resultados sugieren fuertemente la posibilidad que dichas cepas posean un potencial de virulencia importante en seres humanos.

Backgound: The virulence factors of the Vibrio cholerae non-O1, non-O139 strains are not clearly known. The strain of septicemic origin NN1 Vibrio cholerae non-O1, non-O139 was sequenced previously by the Illumina platform. A fragment of the pathogenicity island VPaI-7 of V. parahaemolyticus was detected in its genome. Aim: To detect the virulence genes vcsN2, vcsC2, vcsV2, vspD, toxR2 y vopF in Chilean strains of V. cholerae non-O1, non-O139. Methods: A total of 9 Chilean strains of clinical origin of Vibrio cholerae non-O1, non-O139 isolated between 2006-2012 were analyzed by conventional PCR assays for type III secretion genes encoded on that island: vcsN2, vcsC2, vcsV2, vspD, toxR2 and vopF. Additionally, the presence of the virulence genes hylA and rtxA was determined. In addition, REP-PCR and ERIC-PCR assays were performed. Results: most (6/9) Chilean V. cholerae non-O1, non-O139 strains contain the type III secretion genes vcsN2, vcsC2, vcsV2, vspD, toxR2 and vopF, encoded in an island of pathogenicity. In addition, all (9/9) the strains contain the virulence genes hylA and rtxA. Conclusion: These results strongly suggest the possibility that those strains possess an important virulence potential in humans.

Bacteriemia por Vibrio cholerae no-O1/no-O139 que porta una región homóloga a la isla de patogenicidad VpaI-7 / Bacteremia caused by Vibrio cholerae non-O1/non-O139 carrying a region homologous to pathogenicity island VpaI-7

Resumen Presentamos un caso de bacteriemia por Vibrio cholerae no-O1/ no-O139 en una mujer de 81 años con un cuadro de dolor abdominal, fiebre, vómitos, diarrea, coluria e ictericia, mientras visitaba una zona rural sin acceso a agua potable. La identificación se realizó por la técnica de espectrometría de masa MALDI-TOF, confirmándose una cepa no toxigénica no-O1/no-139. La caracterización molecular del aislado demostró la ausencia del gen de la toxina del cólera (CTX), y pilus TCP; sin embargo, presentó cinco de los seis genes de virulencia presentes en la isla de patogenicidad homóloga denominada VPaI-7 del V. parahaemolyticus (vcs N2+, vcs C2+, vcs V2+,toxR-, vspD+, T vopF+). Además, el aislado presentó los genes de virulencia hylA y rtxA. Este es el primer caso reportado en Chile de una cepa clínica de V. cholerae no-O1, no-O139 aislada de hemocultivos portador de un segmento homólogo de la isla de patogenicidad denominada VPaI-7 de V. parahaemolyticus, el cual codifica para un sistema de secreción tipo III (TTSS), que probablemente contribuye a su virulencia.

We report a case of V. cholerae non-O1 / non-O139 bacteremia in an 81-year-old woman with abdominal pain, fever, vomiting, liquid stools, choluria and jaundice, while visiting a rural area without access to potable water. The identification was made by the MALDI-TOF mass spectrometry technique and subsequently the non-toxigenic non-O1 / non-139 strain was confirmed in the national reference laboratory. The molecular characterization demonstrated the absence of the cholera toxin gene (CTX), and the TCP pilus, however, presented 5 of 6 virulence genes present in an island of homologous pathogenicity named VPaI-7 of V. parahaemolyticus (vcs N2 +, vcs C2 +, vcs V2 +, toxR-, vspD +, T vopF +) and in addition it was positive for hylAy rtxA virulence genes recognized outside the island. This is the first case reported in Chile of a clinical strain of V. cholerae non-O1, non-O139 isolated from blood culture that carries in its genome a homologous segment of the pathogenicity island named VPaI-7 of V. parahaemolyticus, which codifies for a type III secretion system (TTSS) that probably contributes to his virulence.

Una vacuna de vesículas de membrana externa de Vibrio cholerae es aún una promesa: Caracterización proteómica / Outer membrane vesicle vaccine from Vibrio cholerae is still a promise: Proteomic characterization

Las epidemias de cólera afectan a un gran número de países africanos, asiáticos y del Caribe. Los cambios climatológicos y las constantes migraciones hacen que esta enfermedad se extienda, por lo que resulta necesario disponer de vacunas protectoras. En el presente trabajo se caracterizó una nueva vacuna de vesículas de membrana externa (VMEs) obtenidas de Vibrio cholerae O1 biotipo El Tor serotipo Ogawa cepa C7258, en el Instituto Finlay de vacunas (Cuba), a través de métodos proteómicos. Se identificaron 53 proteínas presentes en las VME (4 proteínas por banda electroforética) separadas por electroforesis unidimensional (1D) y digeridas con tripsina. Los fragmentos obtenidos fueron separados por cromatografía líquida de alta resolución (HPLC) acoplada a espectrometría de masa, secuenciados e identificados mediante bases de datos de proteínas Swiss-Prot y TrEMBL. El patrón proteico obtenido presentó algunas de las proteínas (12 proteínas citoplasmáticas y 5 proteínas de membrana externa) sugeridas dentro del proteoma de buena calidad para candidatos vacunales. Se estudiaron las mejores condiciones para la separación de las proteínas a través de electroforesis bidimensional. Las VME evaluadas cuentan con una composición fundamentada en proteínas necesarias para garantizar una respuesta inmune que proteja contra Vibrio cholerae O1 biotipo El Tor serotipo Ogawa.

Cholera epidemics affect a large number of African, Asian and Caribbean countries. The climate changes and the constant migrations cause this disease to spread, making it is necessary to obtain protective vaccines. In the present work, a new vaccine of outer membrane vesicles (OMV) from V. cholerae O1 El Tor biotype Ogawa serotype strain C7258 at Finlay Institute of vaccines (Cuba) was characterized by proteomic methods. A total of 53 proteins present in the OMV (approximate ratio of 4 proteins by electrophoresis band) were identified, separated by one dimension electrophoresis and digested by tripsin method. The fragments were separated by high performance liquid chromatography (HPLC) coupled to mass spectrometry, sequenced and identified, using Swiss-Prot and TrEMBL protein databases. The pattern showed some proteins (12 cytoplasmic proteins and 5 outer membrane proteins) suggested within the highest quality proteome for vaccine candidate. The best conditions for proteins separation by two dimension electrophoresis were studied. The OMV composition was based on proteins described to the immunity response and protection against V. cholerae O1 El Tor biotype Ogawa serotype.

As epidemias de cólera afetam um grande número de países africanos, asiáticos e caribenhos. As mudanças climáticas e as constantes migrações fazem com que esta doença se espalhe, portanto é necessário ter vacinas protectoras. No presente trabalho, uma nova vacina de vesículas de membrana externa (VMEs) obtidas de Vibrio cholerae 01 biotipo El Tor sorotipo Ogawa cepa C7258, no Instituto de Vacinas Finlay (Cuba), através de métodos proteômicos. Foram identificadas 53 proteínas presentes nas VME (4 proteínas por banda eletroforética) separadas por eletroforese unidimensional (1D) e digeridas com tripsina. Os fragmentos obtidos foram separados por cromatografia de alta resolução (HPLC) acoplada a espectrometria de massa, sequenciados e identificados usando bancos de dados de proteínas Swiss-Prot e TrEMBL. O padrão proteico obtido apresentou algumas das proteínas (12 proteínas citoplasmáticas e 5 proteínas de membrana externa) sugeridas dentro do proteoma de boa qualidade para candidatos vacinais. As melhores condições para a separação de proteínas através de eletroforese bidimensional foram estudadas. As VME avaliados possuem uma composição baseada em proteínas necessárias para garantir uma resposta imune que proteja contra Vibrio cholerae O1 biotipo El Tor sorotipo Ogawa.

Vibrio cholerae: doença, manifestações clínicas e microbiologia / Vibrio cholerae: disease, clinical manifestations and microbiology / Vibrio cholerae: enfermedad, manifestaciones clínicas y microbiologia

Justificativa e Objetivos: A cólera é uma doença infecciosa intestinal aguda causada pela toxina do Vibrio cholerae. A transmissão é oral-fecal e ocorre predominantemente em ambientes aquáticos contaminados. Pode ser fatal, mas é facilmente evitada e tratada. Associa-se a sua propagação com a falta de saneamento básico pois cresce exponencialmente nesses ambientes. O diagnóstico é clínico-epidemiológico, laboratorial com meios seletivos para o microrganismo e teste rápido, este último não é sensível e nem especifico. O tratamento é com sais de reidratação oral e antibioticoterapia, indica-se a suplementação com zinco. Existe vacinação para Vibrio cholerae, e essa é a melhor medida para o controle da doença. As pesquisas em cólera já não são mais frequentes, pois ela é considerada uma doença de países que não são desenvolvidos. Conclusão: Nesse contexto, ainda são necessárias pesquisas sobre sistemas de esgoto, monitorização de efluentes, vigilância da qualidade da água de abastecimento público e vigilância da qualidade de alimentos.(AU)

Background and Objectives: Cholera is an acute intestinal infectious disease caused by the toxin of Vibrio cholerae. Transmission is oral-fecal and occurs predominantly in contaminated aquatic environments. It can be fatal, but it is easily avoided and treated. Its propagation is associated with lack of basic sanitation because it grows exponentially in environments. The diagnosis is clinical-epidemiological, laboratory with selective media for the micro-organism and rapid test, the latter is not sensitive or specific. Treatment is with oral rehydration salts and antibiotic therapy, zinc supplementation is indicated. There is vaccination for Vibrio cholerae, and this is the best measure for the control of the disease. Conclusion: Cholera research is no longer frequent, as it is considered a disease of countries that are not developed. In this context, research is still needed on sewage systems, effluent monitoring, public water supply quality surveillance and food quality monitoring.(AU)

Justificación y objetivos: La cólera es una enfermedad infecciosa intestinal aguda causada por la toxina del Vibrio cholerae. La transmisión es oral-fecal y ocurre predominantemente en ambientes acuáticos contaminados. Puede ser fatal, pero es facilmente evitada y tratada. Se asocia su propagación con la falta de saneamiento básico pues crece exponencialmente en ambientes. El diagnóstico es clínico-epidemiológico, de laboratorio con medios selectivos para el microorganismo y la prueba rápida, este último no es sensible ni específico. El tratamiento es con sales de rehidratación oral y antibioticoterapia, se indica la suplementación con cinc. Hay vacunación para Vibrio cholerae, y esa es la mejor medida para el control de la enfermedad. Conclusión: Las investigaciones en cólera ya no son más frecuentes, ya que se considera una enfermedad de países que no se desarrollan. En este contexto todavía son necesarias investigaciones sobre sistemas de alcantarillado, monitorización de efluentes, vigilancia de la calidad del agua de abastecimiento público y vigilancia de la calidad de alimentos.(AU)

Bacteremia por Vibrio cholerae NO-O1/NO-O139 en un paciente cirrótico: Primer reporte de caso en el Perú y revisión de la literatura / Vibrio cholerae NO-O1/NO-O139 bacteremia in a cirrhotic patient: First case report in Peru and literatura review

Vibrio cholerae serogrupo NO-O1/NO-O139 (VCNO) es causa infrecuente de gastroenteritis. Sin embargo, se le asocia a infección extra-intestinal severa en huéspedes inmunocomprometidos, y entre ellas, la bacteremia en pacientes con cirrosis hepática es digna de mención. A continuación, presentamos el caso de una mujer de 58 años, con el diagnóstico de cirrosis hepática de fondo, que desarrolló progresivamente choque séptico, disfunción orgánica múltiple y desenlace fatal al cuarto día de su admisión. Los resultados obtenidos post mortem, de los hemocultivos previamente tomados, aislaron bacilos gram negativos compatibles con Vibrio cholerae. Posteriormente, se identificó el serogrupo NO-O1/NO-O139, a través de aglutinación en placa y PCR negativo para el gen ctxA. El antibiograma mostró susceptibilidad conservada a ampicilina, cloranfenicol, tetraciclina y ciprofloxacino, con resistencia al trimetoprim-sulfametoxazol. El presente caso, descrito en el Hospital Nacional Dos de Mayo, es hasta la fecha, el primer reporte de bacteremia VCNO en el Perú.

Non-O1, non-O139 Vibrio cholerae (NOVC) strains are an uncommon cause of gastroenteritis. However, they have been recently associated with severe extraintestinal infections in immunocompromised hosts. Among them, bacteremia in cirrhotic patients is noteworthy. We present the case of a 58-year-old woman with cirrhosis that developed septic shock, multiple organ failure and died four days after admission. Blood cultures yielded Gram-negative rods identified as Vibrio cholerae. Further serogrouping by slide agglutination and a negative PCR for ctxA gen confirmed the strain to be NOVC. Antimicrobial susceptibility testing showed sensitivity to ampicillin, chloramphenicol, tetracycline and ciprofloxacin; and resistance to trimethoprim-sulfamethoxazole. To the best of our knowledge, this is first report in Peru, described in the Hospital Nacional Dos de Mayo, of NOVC bacteremia.