Cholera Outbreak in Khon Kaen, Thailand, 2007: Warning of Multi-drug Resistance Vibrio cholerae - การระบาดของอหิวาตกโรคจังหวัดขอนแก่น พ.ศ.2550 : เตือนภัยเชื้ออหิวาห์ดื้อยา

Abstract

        In mid September 2007, Khon Kaen province, Thailand was affected by V. cholerae El Tor Ogawa resisting to multi-drugs. Bureau of Epidemiology conducted joint investigation with the local officers in order to describe the characteristics of the outbreak, including microbial resistance, and to provide recommendations for control. A descriptive study was conducted; a case was defined as any people in Khon Kaen who had diarrhea and positive for V. cholerae by rectal swab culture during 15 September - 17 October 2007. Drugs sensitivity reports of the 2007 outbreak in Khon Kaen was compared with the 1998-2000 outbreaks in the same region. Totally 218 reported cases from 9 of 25 districts (AR 12.5/100,000 population) with one death (CFR 0.4%). Of 155 isolated strains of V. cholerae El Tor Ogawa were tested for drug sensitivity by standard diffusion technique, 97-100 percent resisted to tetracycline and cotrimoxazole, 98 percent intermediately resisted to erythromycin and 100 percent were sensitive to norfloxacin. However, the mean of inhibition zone of norfloxacin comparing 1998-2000 and 2007 were significantly decreasing from 29.3 mm to 22.5 mm (mean difference 6.8 mm, 95%CI 6.2, 7.4). Accordingly awareness of quinolone resistance must be a cause for concern. Proper antibiotic used must follow the standardized guideline. Drug compliance will be completely observed. Information on cholera microbial resistance under laboratory surveillance should be shared and distributed to any responsible organizations including physicians.

Key words: V. cholerae El Tor Ogawa, Thailand, microbial drug resistant