The etiological agents of diarrhea in Vientiane, Lao People’s Democratic Republic (Lao PDR), were studied in the period from October 1996 to August 1997. A total of 880 patients with diarrhea visiting medical facilities were examined for Shigella,Salmonella, diarrheagenic Escherichia coli,Vibrio, Aeromonas, Campylobacter, and rotavirus. Shigella spp., heat-stable enterotoxin (ST)-producing E. coli, and serogroup-based enteropathogenic E. coli were found to be the main organisms causing diarrhea in Vientiane, with frequencies of 16.8% (148 of 880), 17.2% (111 of 645), and 11.0% (97 of 880), respectively. Relatively low incidences were observed in the cases ofSalmonella spp., (0.6%; 5 of 880),Campylobacter spp. (4.4%; 39 of 880), and rotavirus (6.1%; 9 of 148), and no isolates of V. cholerae O1 or O139 or Aeromonas were recovered. An analysis of the incidences of enteropathogens with respect to age and seasonal variations demonstrated that the frequencies of isolation ofShigella spp. and heat-labile enterotoxin-producingE. coli were significantly higher in those aged 1 to 5 years than in those younger than 1 year of age and those older than 5 years of age (P < 0.0001 and P < 0.05, respectively) and that the frequencies of isolation ofShigella spp. and ST-producing E. coli were significantly higher in the rainy season than in the dry season (P < 0.005 and P < 0.001, respectively). Almost all strains of Shigella spp. tested were resistant to ampicillin, tetracycline, and erythromycin and were susceptible to cefdinir and ofloxacin. This is the first intensive and longitudinal study to define the etiologic agents of diarrheal diseases in Lao PDR.
Drug susceptibility of Neisseria gonorrhoeae in the past 3 years in Lao People's Democratic Republic (Lao PDR) was examined. The organisms were collected from the patients visiting Center for Laboratory and Epidemiology, Ministry of Health, Vientiane, Lao PDR. A total of 131 isolates of N. gonorrhoeae (45 in 2000. 27 in 2001, and 59 in 2002) were collected, and the drug susceptibilities of the isolates were examined by disc method using 5 anti-microbial agents (ciprofloxacin, ceftriaxone, penicillin, spectinomycin, and tetracycline). The susceptibility was expressed as sensitive (S), intermediate (M) and resistant (R) depending on the Zone Diameter Interpretive Chart attached to the disc preparation. As the results, almost all isolates were resistant to penicillin and tetracycline, but sensitive to ceftriaxone and spectinomycin. Most of the penicillin resistant isolates were regarded as penicillinase producing N. gonorrhoeae (PPNG) depending on the effect of clavulanic acid. N. gonorrhoeae is getting resistant to ciprofloxacin in the 3-year examination period. About 10% of the isolates were resistant to ciprofloxacin in 2000, but the rate of resistant strains went up to 70% in 2002. There were very few isolates showing intermediate susceptibility.
By examining 99 Vibrio cholerae 01 isolates from cholera epidemics in a variety of areas in Laos in 1998, we found two unusual characteristics of the organisms. All except 4 isolates were moderately resistant to tetracycline without having plasmids, and susceptibilities to the other drugs were as expected. Eleven isolates showed the same level of susceptibility to polymyxin B as classical V. cholerae 01. With the exception of 4 tetracycline-susceptible strains, all the isolates were resistant to or poorly sensitive to the vibriostatic agent 0/129 (2,4-diamino-6,7-di-iso-propyl pteridine phosphate) . All isolates, including those susceptible to polymyxin B, produced El Tor hemolysin which was neutralized by anti-El Tor hemolysin and were resistant to cholera phage IV, indicating that they were of the El Tor biotype.
A cholera outbreak in Laos in July 2010 involved 237 cases, including 4 deaths. Molecular subtyping indicated relatedness between the Vibrio cholerae isolates in this and in a 2007 outbreak, uncovering a clonal group of V. cholerae circulating in the Mekong basin. Our finding suggests the subtyping methods will affect this relatedness.
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