{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T01:03:06Z","timestamp":1792803786689,"version":"4.5.0"},"reference-count":26,"publisher":"American Society for Microbiology","issue":"11","license":[{"start":{"date-parts":[[2010,11,1]],"date-time":"2010-11-01T00:00:00Z","timestamp":1288569600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["J Clin Microbiol"],"published-print":{"date-parts":[[2010,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n          <jats:p>\n            The treatment regimen for diarrhea depends greatly on correct diagnosis of its etiology. Recent diarrhea outbreaks in Bangladesh showed\n            <jats:italic>Vibrio cholerae<\/jats:italic>\n            to be the predominant cause, although more than 40% of the suspected cases failed to show cholera etiology by conventional culture methods (CMs). In the present study, suspected cholera stools collected from every 50th patient during an acute diarrheal outbreak were analyzed extensively using different microbiological and molecular tools to determine their etiology. Of 135 stools tested, 86 (64%) produced\n            <jats:italic>V. cholerae<\/jats:italic>\n            O1 by CMs, while 119 (88%) tested positive for\n            <jats:italic>V. cholerae<\/jats:italic>\n            O1 by rapid cholera dipstick (DS) assay; all but three samples positive for\n            <jats:italic>V. cholerae<\/jats:italic>\n            O1 by CMs were also positive for\n            <jats:italic>V. cholerae<\/jats:italic>\n            O1 by DS assay. Of 49 stools that lacked CM-based cholera etiology despite most being positive for\n            <jats:italic>V. cholerae<\/jats:italic>\n            O1 by DS assay, 25 (51%) had coccoid\n            <jats:italic>V. cholerae<\/jats:italic>\n            O1 cells as confirmed by direct fluorescent antibody (DFA) assay, 36 (73%) amplified primers for the genes\n            <jats:italic>wbe<\/jats:italic>\n            O1 and\n            <jats:italic>ctxA<\/jats:italic>\n            by multiplex-PCR (M-PCR), and 31 (63%) showed El Tor-specific lytic phage on plaque assay (PA). Each of these methods allowed the cholera etiology to be confirmed for 97% of the stool samples. The results suggest that suspected cholera stools that fail to show etiology by CMs during acute diarrhea outbreaks may be due to the inactivation of\n            <jats:italic>V. cholerae<\/jats:italic>\n            by\n            <jats:italic>in vivo<\/jats:italic>\n            vibriolytic action of the phage and\/or nonculturability induced as a host response.\n          <\/jats:p>","DOI":"10.1128\/jcm.00616-10","type":"journal-article","created":{"date-parts":[[2010,8,26]],"date-time":"2010-08-26T01:45:50Z","timestamp":1282787150000},"page":"3918-3922","update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":79,"title":["Diagnostic Limitations to Accurate Diagnosis of Cholera"],"prefix":"10.1128","volume":"48","author":[{"given":"Munirul","family":"Alam","sequence":"first","affiliation":[{"name":"International Center for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nur A.","family":"Hasan","sequence":"additional","affiliation":[{"name":"International Center for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marzia","family":"Sultana","sequence":"additional","affiliation":[{"name":"International Center for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G. Balakrish","family":"Nair","sequence":"additional","affiliation":[{"name":"International Center for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh"},{"name":"National Institute of Cholera and Enteric Diseases, Kolkata, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Sadique","sequence":"additional","affiliation":[{"name":"International Center for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. S. G.","family":"Faruque","sequence":"additional","affiliation":[{"name":"International Center for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hubert P.","family":"Endtz","sequence":"additional","affiliation":[{"name":"International Center for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. B.","family":"Sack","sequence":"additional","affiliation":[{"name":"Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Huq","sequence":"additional","affiliation":[{"name":"Maryland Pathogen Research Institute, University of Maryland, College Park, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. R.","family":"Colwell","sequence":"additional","affiliation":[{"name":"Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland"},{"name":"Maryland Pathogen Research Institute, University of Maryland, College Park, Maryland"},{"name":"Center for Bioinformatics and Computational Biology, University of Maryland, College Park, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hidemasa","family":"Izumiya","sequence":"additional","affiliation":[{"name":"Department of Bacteriology, National Institute of Infectious Diseases, Shinjuku-ku, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masatomo","family":"Morita","sequence":"additional","affiliation":[{"name":"Department of Bacteriology, National Institute of Infectious Diseases, Shinjuku-ku, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haruo","family":"Watanabe","sequence":"additional","affiliation":[{"name":"Department of Bacteriology, National Institute of Infectious Diseases, Shinjuku-ku, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alejandro","family":"Cravioto","sequence":"additional","affiliation":[{"name":"International Center for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1128\/AEM.72.4.2849-2855.2006"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.2165\/00128072-200305030-00002"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1128\/jcm.28.1.128-130.1990"},{"key":"e_1_3_2_5_2","first-page":"1","volume":"5","year":"2007","unstructured":"Anonymous. 2007. 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