Bad News: Multidrug-Resistant Cholera

Vibrio cholerae harboring two β-lactamase genes, bla_DHA-1 and bla_NDM-1, was cultured from a cholera patient in India.

Vibrio cholerae O1 El Tor Ogawa was cultured from a child in India, who recovered after treatment with fluid replacement and ciprofloxacin. The isolated strain was negative for extended-spectrum β-lactamase but resistant to ceftriaxone. Additional tests, including multiplex polymerase chain reaction, revealed genes for a carbapenemase, identified as New Delhi metallo-β-lactamase 1 (NDM-1), as well as for an AmpC β-lactamase, DHA-1. The bla_NDM-1 gene was on a plasmid.

Comment: The mainstay of cholera treatment is fluid replacement. However, administration of effective antibiotics can reduce shedding of V. cholerae in feces from ≥5 to 1–2 days, which is helpful in controlling epidemics.

Reviewing Author

Mary E. Wilson, MD

Disclosures

Consultant/Advisory BoardOneHealthTrust (formerly Center for Disease Dynamics, Economics, and Policy); Global Health Institute, University of Wisconsin

RoyaltiesUpToDate

Editorial BoardsJournal of Travel Medicine

Mary E. Wilson, MD

Disclosures

Consultant/Advisory BoardOneHealthTrust (formerly Center for Disease Dynamics, Economics, and Policy); Global Health Institute, University of Wisconsin

RoyaltiesUpToDate

Editorial BoardsJournal of Travel Medicine