Vibrio cholerae

Võ Thị Chi Mai

 Objectives
1. Describe the morphology and growth characteristics of Vibrio
cholerae.
2. Mention the antigenic structure of Vibrio cholerae.
3. Name the virulence factors and demonstrate the pathogenesis
of cholera.
4. Give the clinical features of cholera.
5. Show the diagnostic chart in the clinical lab to confirm cholera.
 Bacterial characteristics

Vibrio cholerae are

o asporogenous, facultatively anaerobic, comma-shape G-neg
rods.
o motile due to a polar flagellum.
o oxidase +, catalase +, able to reduce nitrate to nitrite.
o non-halophilic, but grow better in alkaline media.
o glucose +, but non-lactose fermenters.
 Antigenic structure

• 3 major serogroups of Vibrio cholerae:

V cholerae O1, V cholerae O139, V cholerae non-O1
- sharing a common flagellar (H) Ag
• V cholerae O1 have 3 serotypes: Ogawa (A,B), Inaba (A,C), &
Hikojima (A,B,C).
• V cholerae O1 & V cholerae O139 cause epidemic cholera.

• Epidemic V cholerae O1 occur in 2 biotypes: classic, & El Tor.

 Virulence factors of V cholerae

❑ Cholera is an acute severe diarrhea rapidly spread out

outbreak.
❑ V cholerae O1 & O139 contain the cholera toxin gene ctx.
❑ Cholera toxin is a powerful enterotoxin cause a loss of large
quantity of fluid & electrolytes hypovolemic shock,
metabolic acidosis, & death.

2 toxic A subunits & 5 binding B subunits

 Harvey_Lippincott 2013

Overview of pathogenesis of
cholera
Y.W. Tang 2015
 Clinical Manifestations

• Severe gastroenteritis: vomiting, diarrhea

• Stools: watery, color of rice water. 10-30 times/day.
 Lab diagnosis

• Specimens: stool, body fluid, or swabs in Cary-Blair.

• Stool microscopy: - detecting rapid darting vibrio-like bacilli
- Gram staining
• Cultivation: alkaline peptone agar, TCBS, McConkey, BA

• Identification: biochemical tests, multiplex PCR, MALDI-TOF MS

• Epidemiological investigation: agglutination reaction

• Antimicrobial susceptibility testing.

 Lab diagnosis

• Microscopy:
Direct: Vibrio-like bacilli exhibiting rapid motility (darting).
Gram staining: curved G-neg bacilli. On BA

• Isolating:
▪ Direct stool culture: McConkey agar, blood agar (BA),
TCBS agar (Thiosulfate-Citrate-Bile-Sucrose)
▪ Or culture after enrichment in alkaline peptone broth
6-8h.
Lab diagnosis

Identifying yellow colonies (sucrose fermenting) from TCBS agar:

• String test: emulsifying the isolates in 0,5% deoxycholate Na, Vibrio
DNA released.
• Oxidase +, catase +, biochemical test kit.

Epidemiological diagnosis
• Serotyping: Ogawa, Inaba, Hikojima types. String test positive

• Biotyping: Classic, El Tor types.

• Serogrouping: Vibrio cholerae O1, O139.

Positive
Summary

• Vibrio cholerae O1 & O139 produce cholera toxin and cause

cholera which results in impetuous diarrhea.
• The disease may become life-threatening outbreak.

References
1/ Bailey & Scott’s Diagnostic Microbiology, 2017, 14th ed. Author:
Patricia M. Tille. Elsevier. Chapter 25, pp 399-406
2/ Textbook of Diagnostic Microbiology, 2019, 6th ed. Eds: Connie R.
Mahon & Donald C. Lehman. Elsevier Saunders. Ch 20, pp 448-456
3/ Medical Microbiology, 2016, 8th ed. Eds: Patrick R. Murray,
Rosenthal K.S. & Pfaller M.A. Mosby Elsevier. Ch 26, pp 265-271