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Alomar AI, Elhadi N, Yamani LZ, Allahham R, Alghamdi R, Alhabib I, Diab A, Mahmoud N, AlDossary B, Almejhim M, Al-Romihi N, Aldehalan F, Jindan RA. Non-O1, Non-O139 Vibrio cholerae Bacteremic Skin Infection with Multiple Skin Necrosis: Case Report. Trop Med Infect Dis 2025; 10:110. [PMID: 40278783 PMCID: PMC12031358 DOI: 10.3390/tropicalmed10040110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2025] [Revised: 04/10/2025] [Accepted: 04/14/2025] [Indexed: 04/26/2025] Open
Abstract
Non-O1, non-O139 Vibrio cholerae (NOVC) extraintestinal infections are rare, but recently, several clinical incidents have been reported worldwide. Toxigenic V. cholerae is a well-known etiological agent of cholera, responsible for acute dehydrating watery diarrhea. Outbreaks occur in an epidemic seasonal pattern, particularly in countries with poverty and poor sanitation. Strains of NOVC are usually not involved in causing the epidemic or pandemic outbreaks seen with potential strains of V. cholerae serogroup O1 and O139. However, they can still cause severe sporadic cases of intestinal as well as extraintestinal infections. In this study, we investigated a case of extraintestinal infections associated with the NOVC serogroup isolated from a deep closed wound abscess. The isolate was screened for the presence of three major virulence genes, toxR, ctxA, and tcpA. The strain tested positive for the toxR gene encoding the regulatory protein and cholera toxin (ctx) gene and tested negative for the toxin-coregulated pilus (TCP) gene, which is essential for the colonization of the human intestine, causing the severe diarrheal disease cholera. To the best of our knowledge, this is the first case of extraintestinal infection caused by toxigenic Vibrio cholerae non-O1/non-O139 in a hospitalized patient in Saudi Arabia.
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Affiliation(s)
- Amer Ibrahim Alomar
- Department of Clinical Laboratory Science, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Dammam 31441, Saudi Arabia; (A.I.A.); (L.Z.Y.); (R.A.); (R.A.); (I.A.); (F.A.)
| | - Nasreldin Elhadi
- Department of Clinical Laboratory Science, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Dammam 31441, Saudi Arabia; (A.I.A.); (L.Z.Y.); (R.A.); (R.A.); (I.A.); (F.A.)
| | - Lamya Zohair Yamani
- Department of Clinical Laboratory Science, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Dammam 31441, Saudi Arabia; (A.I.A.); (L.Z.Y.); (R.A.); (R.A.); (I.A.); (F.A.)
| | - Reema Allahham
- Department of Clinical Laboratory Science, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Dammam 31441, Saudi Arabia; (A.I.A.); (L.Z.Y.); (R.A.); (R.A.); (I.A.); (F.A.)
| | - Rana Alghamdi
- Department of Clinical Laboratory Science, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Dammam 31441, Saudi Arabia; (A.I.A.); (L.Z.Y.); (R.A.); (R.A.); (I.A.); (F.A.)
| | - Ibrahim Alhabib
- Department of Clinical Laboratory Science, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Dammam 31441, Saudi Arabia; (A.I.A.); (L.Z.Y.); (R.A.); (R.A.); (I.A.); (F.A.)
| | - Asim Diab
- Department of Microbiology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam 31441, Saudi Arabia; (A.D.); (N.M.); (R.A.J.)
| | - Nehal Mahmoud
- Department of Microbiology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam 31441, Saudi Arabia; (A.D.); (N.M.); (R.A.J.)
| | - Bashayer AlDossary
- Diagnostic Microbiology Laboratory, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Al Khobar 34445, Saudi Arabia; (B.A.); (M.A.); (N.A.-R.)
| | - Mariam Almejhim
- Diagnostic Microbiology Laboratory, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Al Khobar 34445, Saudi Arabia; (B.A.); (M.A.); (N.A.-R.)
| | - Nouf Al-Romihi
- Diagnostic Microbiology Laboratory, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Al Khobar 34445, Saudi Arabia; (B.A.); (M.A.); (N.A.-R.)
| | - Faye Aldehalan
- Department of Clinical Laboratory Science, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Dammam 31441, Saudi Arabia; (A.I.A.); (L.Z.Y.); (R.A.); (R.A.); (I.A.); (F.A.)
| | - Reem Al Jindan
- Department of Microbiology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam 31441, Saudi Arabia; (A.D.); (N.M.); (R.A.J.)
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Jia M, Li P, Yan Y, Liu X, Gao L, Zhu G, Chen Z. Antimicrobial susceptibility and genomic characterization of Vibrio cholerae non-O1/non-O139 isolated from clinical and environmental samples in Jiaxing City, China. FEMS Microbiol Lett 2025; 372:fnaf009. [PMID: 39824655 DOI: 10.1093/femsle/fnaf009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2024] [Revised: 12/29/2024] [Accepted: 01/16/2025] [Indexed: 01/20/2025] Open
Abstract
Non-O1/non-O139 (NOVC) strains inhabit aquatic environments and sporadically induce human illnesses. This study involved the virulence and antimicrobial genetic characterization of 176 NOVC strains, comprising 25 from clinical samples and 151 from environmental sources, collected between 2021 and 2023. The antimicrobial susceptibility of the examined NOVC population was predominantly high, exhibiting only poor susceptibility to colistin, with 89.2% resistance. The examination of virulence genes revealed that the majority of strains were positive for glucose metabolism (als gene) (169/176, 96.0%). Through multilocus sequence typing, the 176 NOVC strains were categorised into 121 sequence types, 79 of which were novel. NOVC strains demonstrate significant genetic variability and frequently engage in recombination. This work offers genetic characterization of the pathogenicity and antimicrobial resistance of a NOVC community. Our findings offer insights that may aid in the development of preventative and treatment methods for this pathogen.
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Affiliation(s)
- Miaomiao Jia
- Jiaxing Key Laboratory of Pathogenic Microbiology, Jiaxing Center for Disease Control and Prevention, Jiaxing 314050, China
| | - Ping Li
- Jiaxing Key Laboratory of Pathogenic Microbiology, Jiaxing Center for Disease Control and Prevention, Jiaxing 314050, China
| | - Yong Yan
- Jiaxing Key Laboratory of Pathogenic Microbiology, Jiaxing Center for Disease Control and Prevention, Jiaxing 314050, China
| | - Xuejuan Liu
- Jiaxing Key Laboratory of Pathogenic Microbiology, Jiaxing Center for Disease Control and Prevention, Jiaxing 314050, China
| | - Lei Gao
- Jiaxing Key Laboratory of Pathogenic Microbiology, Jiaxing Center for Disease Control and Prevention, Jiaxing 314050, China
| | - Guoying Zhu
- Jiaxing Key Laboratory of Pathogenic Microbiology, Jiaxing Center for Disease Control and Prevention, Jiaxing 314050, China
| | - Zhongwen Chen
- Jiaxing Key Laboratory of Pathogenic Microbiology, Jiaxing Center for Disease Control and Prevention, Jiaxing 314050, China
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Al-Adham ISI, Jaber N, Ali Agha ASA, Al-Remawi M, Al-Akayleh F, Al-Muhtaseb N, Collier PJ. Sporadic regional re-emergent cholera: a 19th century problem in the 21st century. J Appl Microbiol 2024; 135:lxae055. [PMID: 38449342 DOI: 10.1093/jambio/lxae055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 02/24/2024] [Accepted: 03/04/2024] [Indexed: 03/08/2024]
Abstract
Cholera, caused by Vibrio cholerae, is a severe diarrheal disease that necessitates prompt diagnosis and effective treatment. This review comprehensively examines various diagnostic methods, from traditional microscopy and culture to advanced nucleic acid testing like polymerase spiral reaction and rapid diagnostic tests, highlighting their advantages and limitations. Additionally, we explore evolving treatment strategies, with a focus on the challenges posed by antibiotic resistance due to the activation of the SOS response pathway in V. cholerae. We discuss promising alternative treatments, including low-pressure plasma sterilization, bacteriophages, and selenium nanoparticles. The paper emphasizes the importance of multidisciplinary approaches combining novel diagnostics and treatments in managing and preventing cholera, a persistent global health challenge. The current re-emergent 7th pandemic of cholera commenced in 1961 and shows no signs of abeyance. This is probably due to the changing genetic profile of V. cholerae concerning bacterial pathogenic toxins. Given this factor, we argue that the disease is effectively re-emergent, particularly in Eastern Mediterranean countries such as Lebanon, Syria, etc. This review considers the history of the current pandemic, the genetics of the causal agent, and current treatment regimes. In conclusion, cholera remains a significant global health challenge that requires prompt diagnosis and effective treatment. Understanding the history, genetics, and current treatments is crucial in effectively addressing this persistent and re-emergent disease.
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Affiliation(s)
- Ibrahim S I Al-Adham
- Faculty of Pharmacy and Medical Sciences, University of Petra, Amman 961343, Jordan
| | - Nisrein Jaber
- Faculty of Pharmacy, Al Zaytoonah University of Jordan, Amman 11733, Jordan
| | - Ahmed S A Ali Agha
- Faculty of Pharmacy and Medical Sciences, University of Petra, Amman 961343, Jordan
| | - Mayyas Al-Remawi
- Faculty of Pharmacy and Medical Sciences, University of Petra, Amman 961343, Jordan
| | - Faisal Al-Akayleh
- Faculty of Pharmacy and Medical Sciences, University of Petra, Amman 961343, Jordan
| | - Najah Al-Muhtaseb
- Faculty of Pharmacy and Medical Sciences, University of Petra, Amman 961343, Jordan
| | - Phillip J Collier
- Faculty of Pharmacy and Medical Sciences, University of Petra, Amman 961343, Jordan
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