PDF(Pubmed)
Abstract：
Despite the number of cholera outbreaks reported worldwide, only a few cases are recorded among returning European travellers. We describe the case of a 41-year-old male, returning to Italy after a stay in Bangladesh, his origin country, who presented with watery diarrhoea. Vibrio cholerae and norovirus were detected in the patient\'s stools via multiplex PCR methods. Direct microscopy, Gram staining, culture and antibiotic susceptibility tests were performed. The isolates were tested using end-point PCR for the detection of potentially enteropathogenic V. cholera. Serotype and cholera toxins identification were carried out. Whole genome sequencing and bioinformatics analysis were performed, and antimicrobial resistance genes identified. A phylogenetic tree with the most similar genomes of databases previously described was built. Sample of the food brought back by the patient were also collected and analysed. The patient was diagnosed with V. cholerae O1, serotype Inaba, norovirus and SARS-CoV-2 concomitant infection. The isolated V. cholerae strain was found to belong to ST69, encoding for cholera toxin, ctxB7 type and was phylogenetically related to the 2018 outbreak in Dhaka, Bangladesh. Adopting a multidisciplinary approach in a cholera non-endemic country ensured rapid and accurate diagnosis, timely clinical management, and epidemiological investigation at national and international level.
摘要：
尽管全球报告了霍乱暴发的数量，在返回的欧洲旅行者中只有少数案例被记录。我们描述了一个41岁男性的案例，在孟加拉国逗留后返回意大利，他的原籍国,出现水样腹泻的人。通过多重PCR方法检测患者粪便中的霍乱弧菌和诺如病毒。直接显微镜,革兰氏染色,进行了培养和抗生素药敏试验.使用终点PCR对分离物进行测试，以检测潜在的肠致病性霍乱弧菌。进行血清型和霍乱毒素鉴定。进行全基因组测序和生物信息学分析,并鉴定了抗菌素抗性基因。建立了具有先前描述的数据库的最相似基因组的系统发育树。还收集并分析了患者带回的食物样品。患者被诊断为霍乱弧菌O1，血清型Inaba，诺如病毒和SARS-CoV-2合并感染。发现分离的霍乱弧菌菌株属于ST69，编码霍乱毒素，ctxtB7型，与2018年达卡爆发的系统发育相关，孟加拉国。在非霍乱流行国家采用多学科方法确保了快速准确的诊断，及时的临床管理，以及国家和国际层面的流行病学调查。
