Alkaline peptone water plus 0.5% agar suitable for transport of Vibrio cholerae

Main Article Content

Meiyanti Meiyanti
Oktavianus Ch. Salim
Julius E. Surjawidjaja
Murad Lesmana


Microbiological procedures for V. cholerae isolation from clinical specimens are important factors in clinical and epidemiological management of cholera. The standard preservation medium for enteric pathogenic bacteria, including V. cholerae, is Cary-Blair medium (CB), a semisolid medium for preservation and transport of specimens containing intestinal bacteria. A special medium for Vibrio organisms is alkaline peptone water (APW), which is both a transport and an enrichment medium. The purpose of this study was to ascertain the suitability of APW supplemented with 0.5% agar (APW-0.5) as a sensititive preservation-transport medium for rectal swab specimens for isolation of V. cholerae. A total of 144 paired rectal swab specimens were collected from children and adults with acute diarrhea. Of each specimen pair, one was placed in CB and the other in APW-0.5, from which they were plated out to thiosulfate citrate bile sucrose (TCBS) agar. Altogether, from both CB and APW-0.5 transported specimens, V. cholerae non-O1 was present in 29 (20.1%) specimens, while only 2 (1.4%) specimens were positive in CB and 9 (6.3%) positive in APW-0.5 transported specimens. The number of V. cholerae non-O1 isolates from APW-0.5 transported specimens was significantly higher (p=0.000) as compared to that from Cary-Blair transported specimens. It may be concluded that for isolation of V. cholerae, specimen transport in APW-0.5 medium was more effective than transport in Cary-Blair medium.

Article Details

How to Cite
Meiyanti, M., Salim, O. C., Surjawidjaja, J. E., & Lesmana, M. (2011). Alkaline peptone water plus 0.5% agar suitable for transport of Vibrio cholerae. Universa Medicina, 30(2), 95–101.
Review Article


Simanjuntak CH, Larasati W, Arjoso S. Cholera in Indonesia in 1993-1999. Am J Trop Med Hyg 2001;65:788-97.

Lesmana M. Recent developments of cholera infections. J Kedokter Trisakti 2004;23:101-9.

Salim A, Lan R, Reeves PR. Vibrio cholerae pathogenic clones. Emerg Infect Dis 2005;11: 1758-60.

Nguyen BM, Lee JH, Cuong NT, Choi SY, Hien NT, Anh DD, et al. Cholera outbreaks caused by an altered Vibrio cholerae O1 El Tor biotype strain producing classical cholera toxin B in Vietnam in 2007 to 2008. J Clin Microbiol 2009; 47:1568-71.

Krishna BV, Patil AB, Chandrasekhar MR. Fluoroquinolone-resistant Vibrio cholerae isolated during a cholera outbreak in India. Trans R Soc Trop Med Hyg 2006;100:224-6.

Theophilo GN, Rodrigues DP, Leal NC, Hofer E. Distribution of virulence markers in clinical and environmental Vibrio cholerae non-O1, non-O139 strains isolated in Brazil from 1991-2000. Rev Inst Med Trop Sao Paolo 2006;48:65-70.

Sack DA, Sack RB, Nair GB, Siddique AK. Cholera. Lancet 2004;363:223-33.

Agtini MD, Soeharno R, Lesmana M, Punjabi NH, Simanjuntak C, Wangsasaputra F, et al. The burden of diarrhea, shigellosis, and cholera in North Jakarta, Indonesia: findings from 24 months surveillance. BMC Infect Dis 2005;17: 341-50.

Kosek M, Bern C, Guerrant RL. The global burden of diarrhoeal disease, as estimated from studies published between 1992-2000. Bull World Health Organ 2003;81:197-204.

Thielman NM, Guerrant RL.Acute infectious diarrhea. N Engl J Med 2004;350:38-47.

World Health Organization. Cholera 2001. Wkly Epidemiol Rec 2002;77:257-68.

Farmer JJ III, Janda JM, Birkhead K. Vibrio. In: Murray PR, Baron EJ, Jorgensen JH, Pfaller MA, Yolken RH, editors. Manual of Clinical Microbiology. 8th ed. Washington DC: American Society for Microbiology;2003.p.706-18.

Bhuiyan NA, Qadri F, Faruque ASG, Malek MA, Salam MA, Nato F, et al. Use of dipstick for rapid diagnosis of cholera caused by Vibrio cholerae O1 and O139 from rectal swabs. J Clin Microbiol 2003;41:3939-41.

Tamrakar AK, Goel AK, Kamboj DV, Singh L. Surveillance methodology for Vibrio cholerae in environmental samples. Int Environ Health Res 2006;16:305-12.

Lesmana M, Richie E, Subekti D, Simanjuntak C, Walz SE. Comparison of direct plating and enrichment methods for isolation of Vibrio cholerae from diarrhea patients. J Clin Microbiol 1997;35:1856-8.

Lesmana M, Subekti DS, Tjaniadi P, Simanjuntak CH, Punjabi NH, Campbell JR, et al. Spectrum of Vibrio species associated with acute diarrhea in North Jakarta, Indonesia. Diagn Microbiol Infect Dis 2002;43:91-7.

Oyofo BA, Lesmana M, Subekti D, Tjaniadi P, Larasati W, Putri M, et al. Surveillance of bacterial pathogens of diarrhea disease in Indonesia. Diagn Microbiol Infect Dis 2002;44:227-34.

Cariri FAMO, Costa APR, Melo CC, Theophilo GND, Hofer E, de Melo Neto OP, et al. Characterization of potentially virulent non-O1/non-O139 Vibrio cholerae strains isolated from human patients. Clin Microbiol Infect 2010;16: 62-7.

Dalsgaard A, Forslund A, Hesselbjerg A, Bruun B. Clinical manifestations and characterization of extra-intestinal Vibrio cholerae non-O1, non-O139 infections in Denmark. Clin Microbiol Infect 2000;6:626-8.

Pourshafie M, Grimont F, Kohestani F, Grimont PAD. A molecular and genotypic study of Vibrio cholerae in Iran. J Med Microbiol 2002;51:392-8.

Nair GB, Faruque SM, Bhuiyan NA, Kamruzzaman M, Siddique AK, Sack DA. New variants of Vibrio cholerae O1 biotype El Tor with attributes of the classical biotype from hospitalized patients with acute diarrhea in Bangladesh. J Clin Microbiol 2002;40:3296-9.

Lizarraga-Partida ML, Quilici ML. Molecular analyses of Vibrio cholerae O1 clinical strains, including new nontoxigenic variants isolated in Mexico during the cholera epidemic years between 1991-2000. J Clin Microbiol 2009;47: 1362-71.

Nair GB, Qadri F, Holmgren J, Svennerholm AM, Safa A, Bhuiyan NA, et al. Cholera due to altered El Tor strains of Vibrio cholerae O1 in Bangladesh. J Clin Microbiol 2006;44:4211-3.