title: Molecular analysis of non-O1/non-O139 Vibrio cholerae isolated from hospitalised patients in China.
abstract: BACKGROUND
  Cholera is still a significant public health issue in developing countries. The aetiological agent is Vibrio cholerae and only two serogroups, O1 and O139, are known to cause pandemic or epidemic cholera. In contrast, non-O1/non-O139 V. cholerae has only been reported to cause sporadic cholera-like illness and localised outbreaks. The aim of this study was to determine the genetic diversity of non-O1/non-O139 V. cholerae isolates from hospitalised diarrhoeal patients in Zhejiang Province, China.
  
  
  RESULTS
  In an active surveillance of enteric pathogens in hospitalised diarrhoeal patients, nine non-O1/non-O139 V. cholerae isolates were identified from 746 diarrhoeal stool samples at a rate of 1.2%. These isolates and an additional 31 isolates from sporadic cases and three outbreaks were analysed using pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST). PFGE divided the isolates into 25 PFGE types while MLST divided them into 15 sequence types (STs). A single ST, ST80, was predominant which persisted over several years in different cities and caused two outbreaks in recent years. Antibiotic resistance varied with the majority of the isolates resistant to sulphamethoxazole/trimethoprim and nearly all isolates either resistant or intermediate to erythromycin and rifampicin. None of the isolates carried the cholera toxin genes or toxin co-regulated pilus genes but the majority carried a type III secretion system as the key virulence factor.
  
  
  CONCLUSIONS
  Non-O1/non-O139 V. cholerae is an important contributor to diarrhoeal infections in China. Resistance to commonly used antibiotics limits treatment options. Continuous surveillance of non-O1/non-O139 V. cholerae is important for control and prevention of diarrhoeal infections.
authors.affiliation: Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China.
authors.forename: Yun
authors.initials: Y
authors.lastname: Luo
authors.forename: Julian
authors.initials: J
authors.lastname: Ye
authors.forename: Dazhi
authors.initials: D
authors.lastname: Jin
authors.forename: Gangqiang
authors.initials: G
authors.lastname: Ding
authors.forename: Zheng
authors.initials: Z
authors.lastname: Zhang
authors.forename: Lingling
authors.initials: L
authors.lastname: Mei
authors.forename: Sophie
authors.initials: S
authors.lastname: Octavia
authors.forename: Ruiting
authors.initials: R
authors.lastname: Lan
mesh_terms: D002681:China; D002771:Cholera / Q000382:microbiology*; D002772:Cholera Toxin / Q000235:genetics; D004269:DNA, Bacterial / Q000737:chemistry / Q000235:genetics; D024881:Drug Resistance, Bacterial; D016521:Electrophoresis, Gel, Pulsed-Field; D014644:Genetic Variation; D006761:Hospitals; D006801:Humans; D008969:Molecular Sequence Data; D058885:Multilocus Sequence Typing; D014734:Vibrio cholerae / Q000145:classification* / Q000235:genetics / Q000302:isolation & purification*
chemical_list: D004269:DNA, Bacterial; D002772:Cholera Toxin