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LETTER TO EDITOR  
Year : 2011  |  Volume : 36  |  Issue : 2  |  Page : 165-166
 

Emergence of Vibrio cholerae serotype Hikojima in northern Tamil Nadu


Department of Microbiology, Government Vellore Medical College, Tamil Nadu, India

Date of Submission05-May-2010
Date of Acceptance24-May-2011
Date of Web Publication22-Aug-2011

Correspondence Address:
Gowri Veligandla
Department of Microbiology, Government Vellore Medical College, Tamil Nadu
India
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DOI: 10.4103/0970-0218.84142

PMID: 21976808

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How to cite this article:
Chandralekha C, Veligandla G, Vanaja R. Emergence of Vibrio cholerae serotype Hikojima in northern Tamil Nadu. Indian J Community Med 2011;36:165-6

How to cite this URL:
Chandralekha C, Veligandla G, Vanaja R. Emergence of Vibrio cholerae serotype Hikojima in northern Tamil Nadu. Indian J Community Med [serial online] 2011 [cited 2014 Oct 22];36:165-6. Available from: http://www.ijcm.org.in/text.asp?2011/36/2/165/84142


Sir,

In 2009, a total of 155 stool samples were collected from patients suffering from cholera like illness. 13 isolates of Vibrio cholerae were obtained. They were identified, biotyped and serotyped by standard procedures.

All the 13 Vibrio cholerae O1 isolates were of El Tor biotype, and serotype Hikojima. No other serotypes were found in this study. The serotype Hikojima is known to be very unstable, and has been demonstrated to interconvert and undergo serotype switching. [1] So the study reflects the importance of close monitoring and surveillance of the prevalent serotype.

Out of the 13 isolates first case was reported in Feb 2009. Maximum of 4 cases were reported in August 2009. Among the 13 isolates most of the patients were from Vellore and the rest from neighbouring towns. Males (61.53%) were more affected than females (38.45%). All the cholera cases were in the pediatric age group (1 to 10 years). More cases were seen in the age group less than 2 years (38.46%). This was similar to previous studies from other parts of the country which showed that the infection rate of cholera is increasingly reported in children. [2]

The antibiogram [Table 1] of 13 isolates showed 100% resistance to cotrimoxazole and nalidixic acid. However the sensitivity to ampicillin was variable, 46% isolates were highly sensitive, 31% showed moderate sensitivity and 23% showed resistance to ampicillin. This correlated with earlier studies [3],[4] that reported resistance of Vibrio cholerae isolates to ampicillin, cotrimoxazole and nalidixic acid.
Table 1: Sensitivity pattern of  Vibrio cholerae Scientific Name Search  isolates n=13

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Although ciprofloxacin resistance has been reported in India [3],[4] in case of Vibrio cholerae O1 El Tor Ogawa, Hikojima strains isolated at our place were found to be 100% sensitive to ciprofloxacin in accordance with study by Neelam Taneja et al. [5] All the 13 isolates were sensitive (100%) to azithromycin.

Previously ciprofloxacin, doxycyclin and tetracyclin were used as first line drugs in treatment of cholera. These drugs are not used in children due to their side effects. In present study only children were affected so azithromycin which showed 100% sensitivity could be used effectively and safely as the drug of choice in children to treat cholera. [6],[7]


   Acknowledgment Top


We are very greatful to Dr. R. Manjula, who was then Head of the Department of Microbiology and the Vice Principal of the Govt. Vellore Medical College, Vellore. She had been a great source of inspiration for this work to be carried out. We also would like to thank Mrs. Jayalakshmi our lab technician who was always with us in all the work that was done.

 
   References Top

1.Stroeher UH, Karageorgos LE, Morona R, Manning PA. Serotype conversion in Vibrio cholerae 01. Proc Natl Acad Sci USA 1992;89:2566-70.  Back to cited text no. 1
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2.Slathia P, Bansal MP. Incidence of Vibrio cholerae in different age groups and sex in Aurangabad province isolated during January 1994 to December 1994. Indian J Med Sci 1999;53:349-51.  Back to cited text no. 2
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3.Mukhopadhyay AK, Basu I, Bhattacharya SK, Bhattacharya MK, Nair GB. Emergence of fluoroquinolone resistance in isolates of Vibrio cholerae isolated from hospitalized patients with acute diarrhea in Calcutta, India. Antimicrob Agents Chemother 1998;42:206-7.  Back to cited text no. 3
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4.Chander J, Kaistha N, Gupta V, Mehta M, Singla N, Deep A, et al. Epidemiology and antibiograms of Vibrio cholerae isolates from a tertiary care hospital in Chandigarh, north India. Indian J Med Res 2009;129:613-7.  Back to cited text no. 4
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5.Taneja N, Biswal M, Tarai B, Sharma M. Emergence of Vibrio cholerae O1 Biotype El Tor Serotype Inaba in North India. Jpn J Infect Dis 2005;58:238-40.  Back to cited text no. 5
[PUBMED]  [FULLTEXT]  
6.Bhattacharya MK, Dutta D, Ramamurthy T, Sarkar D, Singharoy A, Bhattacharya SK. Azithromycin in the treatment of cholera in children. Acta Paediatr 2003;92:676-8.  Back to cited text no. 6
[PUBMED]  [FULLTEXT]  
7.WA, Saha D, Rahman A, Salam MA, Bogaerts J, Bennish ML. Comparison of Single -dose azithromycin and 12-dose, 3-day erythromycin for childhood cholera: A randomised, double-blind trial. Lancet 2002;360:1722-7.  Back to cited text no. 7
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