Cholera outbreaks (2012) in three districts of Nepal reveal clonal transmission of multi-drug resistant Vibrio choleraeO1

Dixit, Sameer; Johura, Fatema-Tuz; Manandhar, Sulochana; Sadique, Abdus; Rajbhandari, Rajesh Man; Mannan, Shahnewaj B.; Rashid, Mahamud-ur; Islam, Saiful; Karmacharya, Dibesh; Watanabe, Haruo; Sack, R. Bradley; Cravioto, Alejandro; Alam, Munirul

doi:10.1186/1471-2334-14-392

Cited by 42 publications

(41 citation statements)

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“…1; Supplementary Table S1). It could be hypothesized that V. cholerae strains with the short VSP-II may have a selection advantage over those with typical VSP-II, as we observed that strains with the short VSP-II had been circulated and become predominant in the 2007-2010 cholera endemic seasons and epidemic areas (13,(28)(29)(30)(31).…”

Section: Discussionmentioning

confidence: 76%

“…It is important to note that this short VSP-II was identified in strains isolated from many concurrent outbreaks in 2008-2010 seasons in many Asian countries, Bangladesh, Pakistan, Nepal, and Thailand, and marked a global transmission of the short VSP-II (5,28,29). In wave 3, the typical VSP-II was displaced by CIRS101 VSP-II and the short VSP-II in many endemic areas in Nepal, Pakistan, Bangladesh and Haiti (13,(28)(29)(30)(31). Imamura et al examined 79 V. cholerae O1 strains of wave 3 and found that after 2010, the typical VSP-II was completely replaced by CIRS101 VSP-II in cholera Negative 66 9 96 2 4 Total 70 9 96 2 11 †O1 pre-seventh pandemic.…”

Section: Discussionmentioning

confidence: 99%

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Analysis of Vibrio seventh pandemic island II and novel genomic islands in relation to attachment sequences among a wide variety of Vibrio cholerae strains

Nguyen

Pham

Higa

et al. 2018

Microbiology and Immunology

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Vibrio cholerae O1 El Tor, the pathogen responsible for the current cholera pandemic, became pathogenic by acquiring virulent factors including Vibrio seventh pandemic islands (VSP)‐I and −II. Diversity of VSP‐II is well recognized; however, studies addressing attachment sequence left (attL) sequences of VSP‐II are few. In this report, a wide variety of V. cholerae strains were analyzed for the structure and distribution of VSP‐II in relation to their attachment sequences. Of 188 V. cholerae strains analyzed, 81% (153/188) strains carried VSP‐II; of these, typical VSP‐II, and a short variant was found in 36% (55/153), and 63% (96/153), respectively. A novel VSP‐II was found in two V. cholerae non‐O1/non‐O139 strains. In addition to the typical 14‐bp attL, six new attL‐like sequences were identified. The 14‐bp attL was associated with VSP‐II in 91% (139/153), whereas the remaining six types were found in 9.2% (14/153) of V. cholerae strains. Of note, six distinct types of the attL‐like sequence were found in the seventh pandemic wave 1 strains; however, only one or two types were found in the wave 2 or 3 strains. Interestingly, 86% (24/28) of V. cholerae seventh pandemic strains harboring a 13‐bp attL‐like sequence were devoid of VSP‐II. Six novel genomic islands using two unique insertion sites to those of VSP‐II were identified in 11 V. cholerae strains in this study. Four of those shared similar gene clusters with VSP‐II, except integrase gene.

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Section: Discussionmentioning

confidence: 76%

Section: Discussionmentioning

confidence: 99%

Analysis of Vibrio seventh pandemic island II and novel genomic islands in relation to attachment sequences among a wide variety of Vibrio cholerae strains

Nguyen

Pham

Higa

et al. 2018

Microbiology and Immunology

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“…The V . cholerae O1 variants were later reported in several countries in Africa and Asia [16–19]. Since 2013, after the containment of the cholera outbreak in Haiti, the number of reported cholera cases has decreased globally.…”

Section: Introductionmentioning

confidence: 99%

Characterization and Genetic Variation of Vibrio cholerae Isolated from Clinical and Environmental Sources in Thailand

et al. 2017

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Cholera is still an important public health problem in several countries, including Thailand. In this study, a collection of clinical and environmental V. cholerae serogroup O1, O139, and non-O1/non-O139 strains originating from Thailand (1983 to 2013) was characterized to determine phenotypic and genotypic traits and to investigate the genetic relatedness. Using a combination of conventional methods and whole genome sequencing (WGS), 78 V. cholerae strains were identified. WGS was used to determine the serogroup, biotype, virulence, mobile genetic elements, and antimicrobial resistance genes using online bioinformatics tools. In addition, phenotypic antimicrobial resistance was determined by the minimal inhibitory concentration (MIC) test. The 78 V. cholerae strains belonged to the following serogroups O1: (n = 44), O139 (n = 16) and non-O1/non-O139 (n = 18). Interestingly, we found that the typical El Tor O1 strains were the major cause of clinical cholera during 1983–2000 with two Classical O1 strains detected in 2000. In 2004–2010, the El Tor variant strains revealed genotypes of the Classical biotype possessing either only ctxB or both ctxB and rstR while they harbored tcpA of the El Tor biotype. Thirty O1 and eleven O139 clinical strains carried CTXϕ (Cholera toxin) and tcpA as well four different pathogenic islands (PAIs). Beside non-O1/non-O139, the O1 environmental strains also presented chxA and Type Three Secretion System (TTSS). The in silico MultiLocus Sequence Typing (MLST) discriminated the O1 and O139 clinical strains from other serogroups and environmental strains. ST69 was dominant in the clinical strains belonging to the 7th pandemic clone. Non-O1/non-O139 and environmental strains showed various novel STs indicating genetic variation. Multidrug-resistant (MDR) strains were observed and conferred resistance to ampicillin, azithromycin, nalidixic acid, sulfamethoxazole, tetracycline, and trimethoprim and harboured variants of the SXT elements.For the first time since 1986, the presence of V. cholerae O1 Classical was reported causing cholera outbreaks in Thailand. In addition, we found that V. cholerae O1 El Tor variant and O139 were pre-dominating the pathogenic strains in Thailand. Using WGS and bioinformatic tools to analyze both historical and contemporary V. cholerae circulating in Thailand provided a more detailed understanding of the V. cholerae epidemiology, which ultimately could be applied for control measures and management of cholera in Thailand.

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“…Although surveillance systems to monitor DR cholera are poor, resistance to first-line therapies such as tetracycline derivatives, ciprofloxacin, and chloramphenicol is prevalent in some geographical regions (12)(13)(14). Lower rates of resistance to azithromycin, potentially contributing to the drug's superior efficacy against cholera diarrhea in clinical trials, have been reported (15,16).…”

Section: Discussionmentioning

confidence: 99%

Antimicrobial Resistance Risks of Cholera Prophylaxis for United Nations Peacekeepers

Kunkel

Lewnard

Pitzer

et al. 2017

Antimicrob Agents Chemother

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More than 5 years after a United Nations peacekeeping battalion introduced cholera to Haiti, over 150,000 peacekeepers continue to be deployed annually from countries where cholera is endemic. The United Nations has thus far declined to provide antimicrobial chemoprophylaxis to peacekeepers, a policy based largely on concerns that the risks of drug resistance generation and spread would outweigh the potential benefits of preventing future cholera importations. In this study, we sought to better understand the relative benefits and risks of cholera chemoprophylaxis for peacekeepers in terms of antibiotic resistance. Using a stochastic model to quantify the potential impact of chemoprophylaxis on importation and transmission of drug-resistant and drug-sensitive Vibrio cholerae, we found that chemoprophylaxis would decrease the probability of cholera importation but would increase the expected number of drug-resistant infections if an importation event were to occur. Despite this potential increase, we found that at least 10 drug-sensitive infections would likely be averted per excess drug-resistant infection under a wide range of assumptions about the underlying prevalence of drug resistance and risk of acquired resistance. Given these findings, policymakers should reconsider whether the potential resistance risks of providing antimicrobial chemoprophylaxis to peacekeepers are sufficient to outweigh the anticipated benefits.

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Cholera outbreaks (2012) in three districts of Nepal reveal clonal transmission of multi-drug resistant Vibrio choleraeO1

Cited by 42 publications

References 50 publications

Analysis of Vibrio seventh pandemic island II and novel genomic islands in relation to attachment sequences among a wide variety of Vibrio cholerae strains

Analysis of Vibrio seventh pandemic island II and novel genomic islands in relation to attachment sequences among a wide variety of Vibrio cholerae strains

Characterization and Genetic Variation of Vibrio cholerae Isolated from Clinical and Environmental Sources in Thailand

Antimicrobial Resistance Risks of Cholera Prophylaxis for United Nations Peacekeepers

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