3. CONTENT
Introduction of Cholera.
Epidemics and Pandemics of Cholera.
Causative agent of Cholera.
Cholera and V. cholerae in the view of microbiological
perspective.
Molecular perspective of V. cholerae
Possible Future Threat and Research
References 3
4. CHOLERA; A BLUE DEATH
What is
Cholera?
Acute
Secretory
diarrheal
disease
Results rice
water stools
Agents
Gram
negative
bacteria
Vibrio
cholerae
Age
group
All age
group
Children <5
years are
more
susceptible.
4
5. MICROBIOLOGY OF V. cholerae
This section deals with-
The Causative agent of Cholera
Classification of Vibrio cholerae.
Virulence factors.
5
6. Vibrio Cholerae- THE CAUSETIVE AGENT
OF CHOLERA
• Gram negative
• Facultative anaerobic
• Non-Spore forming
Morphology
• 1.4 to 2.6µm long
• Coma shapedStructure
• ˜ 105 to108 bacteria is required for
successful infection
• Natural habitat is brackish or salt
water
Other
feature 6
8. SEROGROUPS OF V. CHOLERAE
8
Produce Cholera toxin
(CT) and Toxin co
regulated pillus (TCP)
Involve in epidemics
Mechanism of
pathogenesis is known
CT negative, but
contain toxin like Cholix
toxin.
Involve in sporadic and
localized out break
Pathogenic mechanism
is not clear.
O1 &O139 Non O1 & Non O139
9. EPIDEMIOLOGY OF CHOLERA
• Both epidemic and endemic
• Both seasonal and off seasonal
Pattern
• 1.3 to 4 million affected people.
• 143000 to 210000 deaths.
(WHO,2016)
Mortality
rate/year
• Poor sanitation.
• Transmission – either human to
human or environment to human
Reason
9
12. 12
Biotype Phenotypes Genotype
CCA PB VP Phage
IV
Phage
5 tcpA rstR ctxB
Classic
al
- s - s r Cla Cla B1
El Tor + r + r s El El B3
PANDEMICS; CLASSICAL VERSES El TOR
Abbreviations: CCA- Chicken Cell Agglutination
PB – Polymixin
VP- Voges-Proskaure
Key : +, positive ; -, negative; s , sensitive; r, resistance
Ref- Safa et al,.2010
15. OTHER VIRULENCE FACTORS INCLUDES
Factors Biological Function Responsible
gene
Accessory colonization
factors
Adhesion to mucosal cell acf
Hemagglutination
protease
Helps to dissolve
glycoprotein coating of
intestinal cell
Hap
Accessory cholera
enterotoxin
Release exotoxin ace
Other membrane protein Colonization assisting
mechanism
ompW
15
16. V. cholerae: MOLECULAR PERSPECTIVE
Genome organization
Cholera toxin
Molecular mechanism of action
Antibiotics resistance mechanism
Evolution of new variants
16
17. GENOME ORGANIZATION
2 Circular chromosome.
The largest one is 2.4 Mb and the smallest one is about 1.6
Mb in length.
17
Ref- Heidelberg J.F et al., 2000
18. GENETIC ORGANIZATION OF CTXΦ
18Figure- Bacteriophage CTXφ organization
Ref- Safa et al., 2010
19. CHOLERA TOXIN
A subunit
A1 segment-ADP
ribosylates of G
protein
A2 Segment-
Facilitate binding A
with B subunit by
forming a alpha
helix
B subunit
Attachment of Toxin
to the host cell.
19
Figure- Structure of CT
Ref: Naomi LB et al.,
20. MOLECULAR MECHANISM OF ACTION
Figure- Molecular mechanism of actions of Cholera toxin
20
21. ANTIBIOTIC RESISTANCE MECHANISM
• Widespread and
inappropriate use of
antibiotics
Causes
• Major threat to public health
because it results treatment
failure
Concern
• For cholera treatment –
Azithromycine.
Drug of
choice 21
22. FIGHT AGAINST ANTIBIOTICS
22
Type of
Antibiotic
resistance
Intrinsic
mechanism
Efflux pump
Spontaneous
mutation
Acquired
mechanism
HGT
25. UNDERSTANDING EVOLUTION BY USING
MOLECULAR FINGERPRINTING
Pre
genomic
era
• Pulsed Field Gel electrophoresis
• RAPD
• MLVA
Genomic
era
• Sanger Sequencing
• Pyrosequencing
Post
Genomic
era
• Second generation sequencing
(Illumina)
• Third Generation sequencing (Taqbio) 25
Ref- Rahman et al., 2015
26. FUTURE THREAT
Don’t ever think that I am
simple I can make big
TROUBLE!!
Strains of V. cholerae.
26
27. REFERENCES
Safa, A., Nair, G.B. and Kong, R.Y., 2010. Evolution of new variants
of Vibrio cholerae O1. Trends in microbiology, 18(1), pp.46-54.
Rahaman, M., Islam, T., Colwell, R.R. and Alam, M., 2015. Molecular
tools in understanding the evolution of Vibrio cholerae. Frontiers in
microbiology, 6, p.1040.
Kim, E.J., Lee, C.H., Nair, G.B. and Kim, D.W., 2015. Whole-genome
sequence comparisons reveal the evolution of Vibrio cholerae
O1. Trends in microbiology, 23(8), pp.479-489.
Mackay, D.M., 1980. Cholera: The present pandemic. Public
health, 94(5), pp.283-287.
Li, W., Raoult, D. and Fournier, P.E., 2009. Bacterial strain typing in
the genomic era. FEMS microbiology reviews, 33(5), pp.892-916.
27
28. REFERENCES
O'shea, Y.A., Reen, F.J., Quirke, A.M. and Boyd, E.F., 2004.
Evolutionary genetic analysis of the emergence of epidemic Vibrio
cholerae isolates on the basis of comparative nucleotide sequence
analysis and multilocus virulence gene profiles. Journal of clinical
microbiology, 42(10), pp.4657-4671.
Li, W., Raoult, D. and Fournier, P.E., 2009. Bacterial strain typing in
the genomic era. FEMS microbiology reviews, 33(5), pp.892-916.
Banerjee, R., Das, B., Nair, G.B. and Basak, S., 2014. Dynamics in
genome evolution of Vibrio cholerae. Infection, Genetics and
Evolution, 23, pp.32-41.
Reidl, J. and Klose, K.E., 2002. Vibrio cholerae and cholera: out of
the water and into the host. FEMS microbiology reviews, 26(2),
pp.125-139.
28