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Vibrio cholerae O139 Bengal: a descriptive study.

M S Hossain1, M A Salam, G H Rabbani

  • 1ICDDR,B: Centre for Health and Population Research, Dhaka, Bangladesh. shossain@icddrb.org

Journal of Health, Population, and Nutrition
|October 3, 2000
PubMed
Summary
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Cholera caused by Vibrio cholerae O139 Bengal presents similar clinical and laboratory features to conventional cholera. Management strategies for this O139 strain are comparable to those used for Vibrio cholerae O1 infections.

Area of Science:

  • Infectious Diseases
  • Microbiology
  • Clinical Medicine

Background:

  • Cholera remains a significant public health concern globally.
  • Emergence of new strains like Vibrio cholerae O139 Bengal necessitates understanding their unique characteristics.
  • Previous studies highlight the clinical and epidemiological impact of Vibrio cholerae O1.

Purpose of the Study:

  • To prospectively investigate the clinical and laboratory features of cholera caused by Vibrio cholerae O139 Bengal.
  • To delineate the clinical course and management of patients infected with this specific strain.
  • To compare the characteristics of O139 cholera with conventional O1 cholera.

Main Methods:

  • Prospective study design involving 22 adult male patients.
  • Stool culture-proven Vibrio cholerae O139 infection.

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  • Laboratory analysis of serum and stool electrolytes (sodium, potassium, chloride, bicarbonate).
  • Assessment of fecal leukocytes and antimicrobial susceptibility testing of isolates.
  • Quantification of stool volume and fluid requirements (intravenous and oral rehydration).
  • Monitoring of diarrhea duration and pathogen excretion period.
  • Main Results:

    • Patients exhibited mean serum electrolyte concentrations: Na 134 ± 3, K 4 ± 1, Cl 102 ± 4, HCO3 13 ± 4 mmol/L.
    • Stool electrolyte concentrations were: Na 120 ± 24, K 18 ± 6, Cl 93 ± 16, HCO3 37 ± 9 mmol/L.
    • Seventeen patients (7.8%) had fecal leukocytes (11-50/HPF).
    • All O139 isolates were susceptible to tetracycline, erythromycin, and ciprofloxacin; 92% to furazolidine; 5% to trimethoprim-sulfamethoxazole.
    • Median stool volume in 24 hours was 9 L (IQR 5-12 L); total stool volume was 16 L (IQR 9-24 L).
    • Median fluid requirements: 9 L (IQR 6-18 L) IV, 14 L (IQR 9-20 L) oral.
    • Median diarrhea duration was 80 hours (IQR 48-104 hours); median V. cholerae O139 excretion was 5 days (IQR 3-6 days).

    Conclusions:

    • Clinical and laboratory findings in Vibrio cholerae O139 Bengal cholera are highly similar to conventional Vibrio cholerae O1 cholera.
    • Case management, including fluid resuscitation and antimicrobial therapy, should follow established guidelines for cholera.
    • Vibrio cholerae O139 Bengal demonstrates a distinct antimicrobial susceptibility profile, with high susceptibility to tetracycline, erythromycin, and ciprofloxacin.