DefinePK

Abstract

Background: Vibrio cholerae remains a major cause of cholera outbreaks in resource-limited countries, particularly in SouthAsia. The disease is transmitted through contaminated water and food, leading to acute watery diarrhea, dehydration, andpotentially fatal outcomes if untreated. In Pakistan, recurring outbreaks and the emergence of multidrug-resistant strains of V.cholerae have raised significant public health concerns. Understanding the epidemiology, antimicrobial resistance, andvirulence profile of circulating strains is critical to improving treatment strategies and outbreak management.
Objective: To determine the antimicrobial susceptibility pattern and molecular detection of sul1 (resistance) and ctx (virulence)genes in V. cholerae isolates from Peshawar, Pakistan.
Methods: This cross-sectional study was conducted from January to December 2024 at Hayatabad Medical Complex, Peshawar.A total of 50 stool and rectal swab samples from patients with suspected cholera were cultured and confirmed as V. choleraeO1, serotype Ogawa. Phenotypic identification included Gram staining, biochemical tests, API-20E, and string test.Antimicrobial susceptibility testing was performed using the Kirby-Bauer disk diffusion method. Molecular detection of sul1and ctx genes was carried out using PCR with specific primers.
Results: Out of 50 isolates, 28 (56%) were from females and 22 (44%) from males. Age distribution showed 29 (58%) cases inpatients >20 years, 13 (26%) in 11–20 years, and 8 (16%) in 1–10 years. Geographically, Hayatabad reported the highest cases(6). Cholera cases peaked in August (9) and September (8). Resistance to meropenem and TMP-SMX was observed in 47 (94%)and 45 (90%) cases, respectively. The ctx gene was detected in 47 (94%) and sul1 in 45 (90%) isolates.
Conclusion: The study highlights a significant prevalence of virulent, multidrug-resistant V. cholerae strains in Peshawar,particularly during the monsoon season. Targeted interventions, enhanced surveillance, and antimicrobial stewardship areurgently required.