MOLECULAR EPIDEMIOLOGIC STUDY OF VIBRIO CHOLERA IN INDONESIA

本研究旨在确定腹泻疾病的病原体，特别是霍乱弧菌在印度尼西亚的流行情况，并评估分子技术在流行病学环境中的应用。研究结果如下：(1)1996年8月至9月，在印度尼西亚巴厘岛的一次考察旅行中，由于当地处于干旱季节，社区中没有从腹泻患者中分离到霍乱弧菌。对8名有急性胃肠炎相关症状的日本游客(腹泻患者)的粪便进行细菌学检查。检出河弧菌4例，拟态弧菌1例，鼠伤寒沙门氏菌1例，致病性大肠埃希菌2例。对社区部分宾馆和住宅的自来水进行细菌污染检测。所有样品中均检出河弧菌、肠杆菌属、肠球菌属，提示饮用水可能存在播散性粪便污染。此外，在部分食肆供应的食物中亦检出河流弧菌、拟态弧菌、肠杆菌属和柠檬酸杆菌属，显示食肆在烹调食物时不合乎卫生标准。(3)通过与关西机场检疫站的合作，评估了印尼游客腹泻粪便中霍乱弧菌的流行情况。未检出霍乱弧菌，未检出霍乱弧菌，但从自来水、食品和腹泻患者等环境中检出部分霍乱弧菌。这些结果表明，巴厘岛可能存在霍乱弧菌。有必要对雨季进行进一步的调查。

This study has been aimed to determine etiological agents of diarrheal diseases, especially prevalence of Vibrio cholerae in Indonesia, and assess application of molecular techniques in epidemiologic setting. Following results ware obtained in study.(1) In a research trip to Bali island, Indonesia between August and September 1996, no Vibrio cholerae was isolated from diarrheal patients, in the communities because of dry season there in such period. Stools from 8 Japanese tourists with symptoms related to acute gastroenteritis (diarreal patients) and without symptoms were obtained for bacteriological exam. Vibrio fluvioris from 4 patients, Vibrio mimicus from 1, Salmonella typhimurium from 1 and pathogenic Escherichia coli from 2 were found. One healthy person with no symptom had pathogenic E.coli.(2) Water obtained from tap in some hotels and houses in the communities ware examined for bacterial contamination. Vibrio fluvioris, Enterobacter spp., Enterococcus spp.were isolated from all samples, indicating possibility of disseminated fecal contamination of drinking water. Moreover, Vibrio fluvioris, Vibrio mimicus, Enterobacter spp., Enterococcus spp.Citrobacter spp.were also isolated from a lot of foods served by some restaurants, indicating inappropriate hygiene on cooking. However, no Vibrio cholerae was isolated from any samples.(3) By a collaboration with Kansai Airport Quarantine station, prevalence of Vibrio cholerae was assessed in diarrheal stools from the tourists from Indonesia. No Vibrio cholerae was found.Consequently, Vibrio cholerae were not found in any exam.attemped, however, some related Vibrio spp.strains were found from the enviroments including tap water and foods and the patients with diarrea. These results suggest that potential existace of Vibrio cholerae in Bali island.. Further investigations focusing on wet season would be warranted.