title: Vibrio cholerae O1 can assume a chlorine-resistant rugose survival form that is virulent for humans.
abstract: Vibrio cholerae can shift to a "rugose" colonial morphology associated with expression of an amorphous exopolysaccharide that promotes cell aggregation. Flow cytometric studies indicated that up to 3% of particles in rugose cultures represented aggregates of >5 bacterial cells. Rugose variants of our test strains displayed resistance to killing by chlorine, with viable cells persisting for >30 min in 2 mg/L free chlorine; strains also showed resistance to killing by complement-mediated serum bactericidal activity. Six volunteers fed 10(6) cfu of a rugose variant of V. cholerae O1 El Tor Inaba N16961 developed symptoms typical of cholera, with a mean diarrheal stool volume of 2.2 L (range, 1.4-4.3). Isolates recovered from the stool of infected volunteers retained the rugose phenotype. The data suggest that rugose strains cause human disease. The role of these strains in the epidemiology of cholera remains to be determined.
authors.affiliation: Center for Vaccine Development, University of Maryland School of Medicine, Baltimore, USA.
authors.forename: J G
authors.initials: JG
authors.lastname: Morris
authors.forename: M B
authors.initials: MB
authors.lastname: Sztein
authors.forename: E W
authors.initials: EW
authors.lastname: Rice
authors.forename: J P
authors.initials: JP
authors.lastname: Nataro
authors.forename: G A
authors.initials: GA
authors.lastname: Losonsky
authors.forename: P
authors.initials: P
authors.lastname: Panigrahi
authors.forename: C O
authors.initials: CO
authors.lastname: Tacket
authors.forename: J A
authors.initials: JA
authors.lastname: Johnson
mesh_terms: D000328:Adult; D000907:Antibodies, Bacterial / Q000276:immunology; D002449:Cell Aggregation; D002470:Cell Survival; D002713:Chlorine / Q000633:toxicity*; D002771:Cholera / Q000382:microbiology*; D015169:Colony Count, Microbial; D003165:Complement System Proteins / Q000276:immunology; D003602:Cytotoxicity, Immunologic; D004352:Drug Resistance, Microbial; D005434:Flow Cytometry; D006801:Humans; D019081:O Antigens / Q000378:metabolism*; D014734:Vibrio cholerae / Q000737:chemistry* / Q000187:drug effects / Q000472:pathogenicity*
chemical_list: D000907:Antibodies, Bacterial; D019081:O Antigens; D002713:Chlorine; D003165:Complement System Proteins