Bacteriology Spectrum of vibrio species associated with acute diarrhea in North Jakarta, Indonesia Murad Lesmana a,c , Decy S. Subekti a , Periska Tjaniadi a , Cyrus H. Simanjuntak b , Narain H. Punjabi a , James R. Campbell a , Buhari A. Oyofo a, * a U.S. Naval Medical Research Unit No.2, Jakarta, Indonesia b National Institute of Health Research and Development, Ministry of Health, Jakarta, Indonesia c Medical Faculty Trisakti University, Jakarta, Indonesia Received 28 September 2001; accepted 9 January 2002 Abstract Vibrio spp was isolated from 1024 (21.2%) of 4820 diarrhea patients admitted to a community hospital in North Jakarta from 1996 through 1998. Vibrio cholerae O1 (49.5%) and V. parahaemolyticus (30.1%) comprised the major species isolated, followed by V. cholerae non-O1 (16.9%), and V. fluvialis (9.4%). In 938 (19.4%) patients, Vibrio was found as single isolate. Multiple infections were detected in 86 (1.8%) patients. A small number of V. furnisii, V. metschnikovii, V. mimicus and V. hollisae were also isolated. No V. cholerae O139 was detected. The majority of patients with Vibrio spp. infections were adults between the ages of 20 to 45 years. No Vibrio spp. was isolated from infants 1 year old in this study. In vitro antibiotic susceptibility testing revealed no antibiotic resistance associated with the 507 V. cholerae O1 isolates tested, except for colistin (100%). These data implicate Vibrio spp. as a major cause of diarrhea in this region. © 2002 Elsevier Science Inc. All rights reserved. 1. Introduction Members of the family Vibrionaceae are important causes of diarrheal disease around the world. Among the species, Vibrio cholerae is the most important since it is associated with epidemic and pandemic diarrhea in many parts of the world (Kaper et al., 1995). However, during the past ten years a greater appreciation for the increasing number of Vibrio species capable of causing diarrheal dis- ease in human was documented. These species include V. parahaemolyticus, V. fluvialis, V. furnisii, V. hollisae, V. mimicus and V. metschnikovii (Hlady & Klontz, 1996; Al- tekruse et al., 2000). Hlady & Klontz (1996) reported that V. mimicus, V. hollisae and V. fluvialis collectively accounted for 20% of Vibrio infections, and 42% of patients infected with these organisms were hospitalized. Documented data also show that halophilic and non-cholera vibrios may play an important role in causing severe diarrhea (Kaper et al., 1995; Abbott & Janda, 1994; Carnahan et al., 1994; Janda et al., 1988). A surveillance study conducted over ten years in four states that share more than 90% of the U.S. Gulf of Mexico coastline showed that eating vibrio contaminated seafood was an important cause of gastroenteritis in the region (Altekruse et al., 2000). In many of the cases asso- ciated with vibrio gastroenteritis in the United States, raw oysters were the principle seafood item eaten by patients in the week before the onset of illness (Hlady & Klontz, 1996; Altekruse et al., 2000; Levine et al., 1993). Vibrio. parahaemolyticus is one of the most important food-borne pathogens in countries with long coastlines. Outbreaks with V. parahaemolyticus have been reported from different geographic regions including the United States (Centers for Disease Control and Prevention, 1999), Peru (Begue et al., 1995), Japan (Yosida et al., 1992) and Taiwan (Pan et al., 1997). In Lima, Peru, V. parahaemo- lyticus was responsible for the diarrheal outbreak among Naval recruits in a Peruvian training base (Begue et al., 1995). Other Vibrio spp. such as V. mimicus, V. hollisae and V. fluvialis, previously believed to be only rarely associated with morbidity, have reportedly contributed significantly to illness (Hlady & Klontz, 1996). A large outbreak of V. fluvialis infection was reported from Bangladesh in 1976 – 1977, which involved more than 500 patients, mostly chil- dren and young adults (Huq et al., 1980). The presence of V. * Corresponding author. Tel.: +1-011-6221-421-4457/58; fax: +1- 011-6221-424-4457. E-mail address: oyofoba@namru2.med.navy.mil. (B.A. Oyofo). www.elsevier.com/locate/diagmicrobio Diagnostic Microbiology and Infectious Disease 43 (2002) 91–97 0732-8893/02/$ – see front matter © 2002 Elsevier Science Inc. All rights reserved. PII: S0732-8893(02)00373-5