title: Cluster-analysis & patterns of dissemination of multidrug resistance among clinical strains of Vibrio cholerae in Calcutta, India.
abstract: OBJECTIVE
  Antimicrobial resistance among Vibrio cholerae has been monitored for several years in Calcutta. To investigate the changing trends in multidrug resistance (MDR) among different serogroups of V. cholerae and to perform software assisted cluster analysis the current study was undertaken.
  
  
  METHODS
  Strains isolated from patients with cholera and "cholera-like" diarrhoea admitted in the Infectious Diseases Hospital, Calcutta were analysed. Eight hundred and forty V. cholerae strains isolated from 1992 through 1997 were tested for susceptibility to 11 antibiotics. Cluster analysis was done using SPSS software.
  
  
  RESULTS
  Most of the strains exhibited MDR with fluctuating trends as the resistance profile diverged each year. A total of 119 different resistance profiles exhibited by V. cholerae O1, O139 and non-O1, non-O139 serogroups were analysed by cluster combination method. During 1993 and 1994, 53 per cent of V. cholerae O139 and 82 per cent of V. cholerae O1 serogroups, respectively, exhibited maximal number of new resistance patterns. The frequency of new resistance patterns among V. cholerae non-O1, non-O139 was constantly high (33-47%) during 1995 to 1997.
  
  
  CONCLUSIONS
  With a few exceptions, preponderance of the resistance profiles was generally not confined to any serogroup. The cluster analysis depicted dissemination of some of the resistance patterns commonly found among V. cholerae non-O1, non-O139 belonging to different serogroups to the O139 serogroup in the succeeding years. In this study we have shown that the V. cholerae strains are resistant to several antibiotics with constant change in the MDR profiles. It is imperative to define the susceptibility pattern of the strains to determine the effective drug of choice for the treatment of cholera.
authors.affiliation: National Institute of Cholera & Enteric Diseases (ICMR), Calcutta.
authors.forename: T
authors.initials: T
authors.lastname: Ramamurthy
authors.forename: K
authors.initials: K
authors.lastname: Rajendran
authors.forename: P
authors.initials: P
authors.lastname: Garg
authors.forename: T
authors.initials: T
authors.lastname: Shimada
authors.forename: A
authors.initials: A
authors.lastname: Basu
authors.forename: N R
authors.initials: NR
authors.lastname: Chowdhury
authors.forename: R K
authors.initials: RK
authors.lastname: Nandy
authors.forename: S
authors.initials: S
authors.lastname: Yamasaki
authors.forename: S K
authors.initials: SK
authors.lastname: Bhattacharya
authors.forename: Y
authors.initials: Y
authors.lastname: Takeda
authors.forename: G B
authors.initials: GB
authors.lastname: Nair
mesh_terms: D016000:Cluster Analysis; D004352:Drug Resistance, Microbial; D018432:Drug Resistance, Multiple; D014734:Vibrio cholerae / Q000145:classification / Q000187:drug effects*