MOLECULAR EPIDEMIOLOGIC STUDY OF VIBRIO CHOLERA IN INDONESIA

本研究的目的是确定病原体的传染病，特别是霍乱弧菌在印度尼西亚的流行，并评估应用分子技术在流行病学设置。研究取得了以下结果。(1)在1996年8月至9月间对印度尼西亚巴厘岛的一次研究旅行中，由于该时期为旱季，在社区的霍乱患者中没有分离出霍乱弧菌。对8名有急性胃肠炎症状的日本游客（腹泻患者）和无症状者的粪便进行细菌学检查，结果发现4名患者的粪便中检出河弧菌，1名患者的粪便中检出拟态弧菌，1名患者的粪便中检出鼠伤寒沙门氏菌，2名患者的粪便中检出致病性大肠杆菌，1名无症状的健康人的粪便中检出致病性大肠杆菌。(2)对社区部分宾馆、住宅的自来水进行了细菌污染检测。河流弧菌，肠杆菌属，从所有样品中分离出肠球菌属，表明饮用水可能受到播散性粪便污染。此外，河流弧菌、拟态弧菌、肠杆菌属，此外，部分食肆供应的食物中亦发现肠球菌及柠檬酸杆菌，显示烹调时的卫生情况不佳。然而，没有霍乱弧菌分离出任何样品。(3)通过与关西机场检疫站合作，评估了印度尼西亚游客腹泻粪便中霍乱弧菌的患病率。未检出霍乱弧菌，因此未检出霍乱弧菌，但从自来水、食物等环境及腹泻病人中检出相关弧菌。提示巴厘岛存在霍乱弧菌。将需要进一步调查，重点是雨季。

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.