Multidrug Resistant Vibrio Cholerae From Diarrheal Stool Samples of Nepalgunj Outbreak and Different Hospitals of Nepal

Abstract

Anine month study was undertaken with an objective to isolate the multidrug resistant Vibrio cholerae from the diarrheal stool samples of Nepalgunj outbreak and different hospitals of Nepal. The laboratory work was conducted in National Public Health Laboratory Teku, Kathmandu. A total of240 samples were processed in which 44 were from outbreak area and196 were from hospitals. 48 cases were positive for cholera.The cholera agent was identified by biochemical test, serological test and biotyping methods which revealed that all strains of Vibrio cholerae were belong to serogroup O1 biotype ElTor and serotype Ogawa. Antibiotic susceptibility testing by disc diffusion method for 13different antibiotics showed that 100% resistance to Nalidixic acid, Cotrimoxazole and Furazolidone, 100% sensitive to Amikacin Gentamicin, Ceftriaxone and Cefotaxime.56.4% strains were resistant to Ciprofloxacin and 60.4% were resistant to Ofloxacin,41.7% were sensitive to Chloramphenicol and Erythromycin. Minimum Inhibitory Concentration (MIC) test revealed that all the strains resistant during Antibiotic Susceptibility Test (AST)by disc diffusion method for Tetracycline, Nalidixic acid and Ampicillin were resistant. Only 4.2% out of 54.2% resistant strains detected from discdiffusion test were detected resistant in MIC test and other were intermediate for Ciprofloxacin. For Chloramphenicol none of the strains were detected resistant after MI Ctest. The mean MIC value for Ampicillin was 15.17 mg/L, Ciprofloxacin was 0.28 mg/L,Chloramphenicol was 1.42 mg/L, Nalidixic acid was 42.67 mg/L and Tetracycline was4.16 mg/L. All Tetracycline resistant cases were detected from outbreak samples. 13different R-type strains were detected after antibiogram testing. Effective monitoring and measurement of MIC level and further evaluation of the strains by molecular testing are needed. Keywords: Cholera, outbreak,AST, MIC, Ogawa, ElTor,Vibrio