Virulence and multidrug resistance patterns of Vibrio cholerae O1 isolates from diarrheal outbreaks of South India during 2006-2009.

A total of 31 Vibrio cholerae O1 (4- Inaba and 27- Ogawa serotype) isolates collected during a three-year period (2006-2009) from acute diarrheal cases in Tamil Nadu, India were analyzed for antibiotic resistance profiling, virulence-associated factors, genetic profiling by enterobacterial repetitive intergenic consensus sequence polymerase chain reaction (ERIC PCR), and biofilm-forming ability. Antibiotic resistance profile revealed that most of the strains have become multidrug-resistant strains. All the isolates are resistant to ampicillin and polymyxin B, 97% of the isolates are resistant to nalidixic acid, 90% to co-trimoxazole, 32.3% to norfloxacin and ciprofloxacin, 29% to doxycycline, 10% to gentamicin, whereas only 3% to chloramphenicol. Molecular characterization of virulence-associated genes by multiplex PCR revealed the presence of ace, ctxA, tcpA, toxR, and ompU as 93.5%, followed by ompW with 33.3%. The presence of zot was restricted to only one isolate and hlyA was not encountered in any of the strains. ERIC PCR produced more than 10 bands for each isolate and the dendrogram generated based on the cluster analysis showed the presence of 29 electrophoretic types among the 31 isolates. Isolates from different area or year of isolation are intermingled in all the clusters. With respect to biofilm formation, 24 isolates were found to be biofilm formers and eight of them produced strong biofilm. This study demonstrates the presence of critical virulence factors and antibiotic resistance in the diarrhea isolates, which signifies the importance of routine monitoring and proper treatment to prevent cholera outbreaks.