Fatal bacteremia due to immotile Vibrio cholerae serogroup O21 in Vientiane, Laos - a case report.
BACKGROUND
Human infections with non-O1, non-O139 V. cholerae have been described from Laos. Elsewhere, non cholera-toxin producing, non-O1, non-O139 V. cholerae have been described from blood cultures and ascitic fluid, although they are exceedingly rare isolates.


METHODS
We describe a farmer who died with Vibrio cholerae O21 bacteremia and peritonitis in Vientiane, Laos, after eating partially cooked apple snails (Pomacea canaliculata) and mussels (Ligumia species). The cultured V. cholerae were non-motile. PCR detected ompW and toxR gene regions but not the ctxA, ompU, omp K and TCP gene regions. Although the organisms lacked flagellae on scanning electron microscopy, they possessed the Vibrio flagellin flaA gene.


CONCLUSIONS
Severe bacteremic non-O1, non-O139 V. cholerae is reported from Laos. The organisms were unusual in being non-motile. They possessed the Vibrio flagellin flaA gene. Further research to determine the reasons for the non-motility and virulence is required.
Phetsouvanh
Rattanaphone
R
Wellcome Trust-Mahosot Hospital-Oxford Tropical Medicine Research Collaboration, Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao PD. rphetsouvanh@yahoo.co.uk
Nakatsu
Masami
M
Arakawa
Eiji
E
Davong
Viengmone
V
Vongsouvath
Manivanh
M
Lattana
Olay
O
Moore
Catrin E
CE
Nakamura
Satoshi
S
Newton
Paul N
PN
D000328:Adult; D016470:Bacteremia / Q000382:microbiology*; D001427:Bacterial Toxins / Q000235:genetics; D002771:Cholera / Q000382:microbiology*; D004269:DNA, Bacterial / Q000235:genetics; D017809:Fatal Outcome; D005260:Female; D005407:Flagella / Q000648:ultrastructure; D006801:Humans; D007812:Laos; D008124:Locomotion; D008855:Microscopy, Electron, Scanning; D010538:Peritonitis / Q000382:microbiology; D016133:Polymerase Chain Reaction; D014734:Vibrio cholerae / Q000235:genetics / Q000302:isolation & purification* / Q000502:physiology / Q000648:ultrastructure
D001427:Bacterial Toxins; D004269:DNA, Bacterial