SUMMARY Vibrio parahaemolyticus is recognized as a cause of food-borne gastroenteritis, particularly in the Far East, where raw seafood consumption is high. An unusual increase in admissions of V. parahaemolyticus cases was observed at the Infectious Diseases Hospital in Calcutta, a city in the northeastern part of India, beginning February 1996. Analysis of the strains revealed that a unique serotype, O3:K6, not previously isolated during the surveillance in Calcutta accounted for 50 to 80% of the infections in the following months. After this report, O3:K6 isolates identical to those isolated in Calcutta were reported from food-borne outbreaks and from sporadic cases in Bangladesh, Chile, France, Japan, Korea, Laos, Mozambique, Peru, Russia, Spain, Taiwan, Thailand, and the United States. Other serotypes, such as O4:K68, O1:K25, and O1:KUT (untypeable), that had molecular characteristics identical to that of the O3:K6 serotype were subsequently documented. These serotypes appeared to have diverged from the O3:K6 serotype by alteration of the O:K antigens and were defined as “serovariants” of the O3:K6 isolate. O3:K6 and its serovariants have now spread into Asia, America, Africa, and Europe. This review traces the genesis, virulence features, molecular characteristics, serotype variants, environmental occurrence, and global spread of this unique clone of V. parahaemolyticus.
The emergence of Vibrio cholerae O139 Bengal during 1992-1993 was associated with large epidemics of cholera in India and Bangladesh and, initially, with a total displacement of the existing V. cholerae O1 strains. However, the O1 strains reemerged in 1994 and initiated a series of disappearance and reemergence of either of the two serogroups that was associated with temporal genetic and phenotypic changes sustained by the strains. Since the initial emergence of the O139 vibrios, new variants of the pathogen derived from multiple progenitors have been isolated and characterized. The clinical and epidemiological characteristics of these strains have been studied. Rapid genetic reassortment in O139 strains appears to be a response to the changing epidemiology of V. cholerae O1 and also a strategy for persistence in competition with strains of the O1 serogroup. The emergence of V. cholerae O139 has provided a unique opportunity to witness genetic changes in V. cholerae that may be associated with displacement of an existing serogroup by a newly emerging one and, thus, provide new insights into the epidemiology of cholera. The genetic changes and natural selection involving both environmental and host factors are likely to influence profoundly the genetics, epidemiology, and evolution of toxigenic V. cholerae, not only in the Ganges Delta region of India and Bangladesh, but also in other areas of endemic and epidemic cholera. Vibrio cholerae is the causative agent of cholera, an acute dehydrating diarrhea that occurs in epidemic and pandemic forms (1, 2). Seven distinct pandemics of cholera have occurred since the onset of the first pandemic in 1817 (3). Except for the seventh pandemic which originated in Indonesia, six of the pandemics arose from the Indian subcontinent, usually from the Ganges Delta region, and reached to other continents (2). The species V. cholerae is classified on the basis of its somatic antigens (O-antigens) into serogroups, and there are at least 206 known serogroups of V. cholerae (4). Until the emergence of V. cholerae O139 in late 1992, the serogroup O1 was supposed to include all strains responsible for epidemic and endemic cholera. The emergence of V. cholerae O139 attracted worldwide attention, particularly because this was the first non-O1 serogroup associated with widespread epidemics of cholera (5, 6). Extensive outbreaks have occurred in various regions of Bangladesh and India, and cases caused by V. cholerae O139 have been reported in Pakistan, Nepal, China, Thailand, Kazakhstan, Afghanistan, and Malaysia (5-9). Imported cases have been reported in the United Kingdom and the United States (9, 10). Epidemics of cholera caused by this new serogroup continue to occur, apparently representing the beginning of an eighth cholera pandemic (10). Recent trends in India (11) and Bangladesh (S.M.F., M. A. Salam, A. Faruque, G.B.N., and D.A.S., unpublished data) show an escalating association of the O139 serogroup with outbreaks of cholera.Since the initial emergence of V. cholerae O139, new ...
The virulence of a pathogen is dependent on a discrete set of genetic determinants and their well-regulated expression. The ctxAB and tcpA genes are known to play a cardinal role in maintaining virulence in Vibrio cholerae, and these genes are believed to be exclusively associated with clinical strains of O1 and O139 serogroups. In this study, we examined the presence of five virulence genes, including ctxAB and tcpA, as well as toxR and toxT, which are involved in the regulation of virulence, in environmental strains of V. cholerae cultured from three different freshwater lakes and ponds in the eastern part of Calcutta, India. PCR analysis revealed the presence of these virulence genes or their homologues among diverse serotypes and ribotypes of environmental V. cholerae strains. Sequencing of a part of the tcpA gene carried by an environmental strain showed 97.7% homology to the tcpA gene of the classical biotype of V. cholerae O1. Strains carrying the tcpA gene expressed the toxin-coregulated pilus (TCP), demonstrated by both autoagglutination analysis and electron microscopy of the TCP pili. Strains carrying ctxAB genes also produced cholera toxin, determined by monosialoganglioside enzyme-linked immunosorbent assay and by passage in the ileal loops of rabbits. Thus, this study demonstrates the presence and expression of critical virulence genes or their homologues in diverse environmental strains of V. cholerae, which appear to constitute an environmental reservoir of virulence genes, thereby providing new insights into the ecology of V. cholerae.Vibrio cholerae is known to be an autochthonous inhabitant of brackish waters and estuarine systems (4, 13). Among the 193 currently recognized O serogroups of V. cholerae (43), only serogroups O1 and O139 have caused epidemics of cholera. The other serogroups of V. cholerae, collectively referred to as non-O1 non-O139 serogroups, have not been associated with epidemics but can cause sporadic diarrhea (30) and are ubiquitously distributed in the aquatic environment (22,26). This sharp distinction between serogroups which can cause cholera and those which are not associated with cholera is related to the observation that more than 95% of the strains belonging to serogroups O1 and O139 produce cholera toxin (CT), which is central to the disease process. In contrast, more than 95% of the strains belonging to non-O1 non-O139 serogroups do not produce CT (15). Another important virulence factor of V. cholerae is the toxin-coregulated pilus (TCP), which is an adhesin that is coordinately regulated with CT production (39). TCP is the only V. cholerae pilus that has been demonstrated to date to have a role in colonization of the gut mucosa of humans (9) and of infant mice (39), the latter being an experimental cholera model.It has been presumed that CT and TCP are exclusively associated with clinical strains of V. cholerae, notably those belonging to serogroups O1 and O139, whereas reports on the incidence of CT among environmental strains of V. cholerae are rare (24). Sim...
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