Edible ice in Jakarta, Indonesia, is contaminated with multidrug-resistant Vibrio cholerae with virulence potential

Abstract

Consumption of street food is considered a major health risk in the absence of public-health inspection programmes in Indonesia. It is hypothesized that ice used in street food could be one of the major sources of Vibrio cholerae contamination. This study documented V. cholerae contamination in edible ice from different areas of Jakarta, the capital city of Indonesia, and attempted to characterize the virulence potential of the strains. A selective medium was used to isolate 98 V. cholerae strains and their identity was confirmed using biochemical assays. Serological tests classified the majority (78 %) in the non-O1 serogroup. Multiplex PCR was used to detect the presence of V. cholerae virulence genes, namely ctxA, ompU, tcpA, ace, zot and toxR. The toxR, ctxA, ompU and zot genes were detected in 75, 26, 15 and 1 % of isolates, respectively. The ace and tcpA genes were not detected in any of the isolates. The ctxA gene encoding the cholera toxin subunit A, which has been associated only with clinical strains of O1, here was present in both serogroups. The antibiotic-resistance profile showed that 65, 60, 52, 39, 37, 19 and 3 % of the isolates were resistant to ampicillin, streptomycin, kanamycin, sulfamethoxazole-trimethoprim, erythromycin, tetracycline and ciprofloxacin, respectively. A large proportion of V. cholerae isolates came from west and south Jakarta, and these strains exhibited multidrug resistance to ampicillin, streptomycin, tetracycline, erythromycin, kanamycin and sulfamethoxazole-trimethoprim. Many of these isolates from west and south Jakarta also harboured toxR, encoding a regulator, and ctxA. The presence of multidrug-resistant V. cholerae with virulence genes in edible ice, which could cause a severe outbreak, reflects the poor water quality in Jakarta, and indicates an urgent need for better surveillance and management. INTRODUCTIONIce products are often used in street foods and are consumed by most people, especially in tropical countries such as Indonesia. Microbial infections acquired from contaminated ice are not uncommon and have been reported for Escherichia coli O157 : H7, Legionella pneumophila, Salmonella enteritidis and Norwalk-like virus (Kim & Harrison, 2008;Seo et al., 2006;Boccia et al., 2002;Graman et al., 1997). A significant number of cholera cases are due to consumption of contaminated water rather than personto-person transmission (Schild et al., 2008).The causative agent of cholera is Vibrio cholerae. Although it is a marine organism, it can also be found in fresh-water rivers. There are two V. cholerae serogroups, O1 and non-O1. Members of the O1 group are associated with epidemic cholera, whereas non-O1 members isolated from estuaries are associated with sporadic illness. The presence of virulence genes is usually associated with the O1 group (Sack et al., 2004). However, this scenario has been evolving slowly in recent years, and several studies have reported the presence of virulence genes in non-O1 environmental isolates (Kumar et al., 2008;Jagadeeshan et al., 2009...

Detection of genes encoding ompW and ctxA of Vibrio cholerae isolated from shrimp and shellfish at Kedonganan fish market, Bali-Indonesia

“…Although all isolates of V. cholerae isolated from shrimp and shellfish did not carry the ctxA gene, it does not mean that the isolates cannot cause disease in humans. In addition V. cholerae has Ace gene encoding accessory cholerae enterotoxin and Zot gene encoding zonula occludens toxin which can cause diarrhea but is usually mild and sporadic in contrast to ctxA capable of causing death and into a worldwide pandemic (Faruque et al, 1998;Waturangi et al, 2013).…”

“…Vol 2 No 1 Jan -Jun 2019 lipopolysaccharides, and proteins that act as a physical protector between bacteria and their environment (Lin et al, 2002). (Waturangi et al, 2013).…”

“…cholerae is usually used PCR method with specific target genes that act as a virulence factor (Huq et al, 2012;Waturangi et al, 2013;Ramazanzadeh et al, 2015). In addition, the PCR method is a more sensitive and specific molecular laboratory test, fast and accurate when compared to conventional methods (Angeliya and Kurdiwa, 2013;Kharirie, 2013).…”

“…The expression of the virulence genes is a factor that contributes to the pathogenicity of V. cholerae. Some virulence factors present in V. cholera are ToxR regulator, cholerae toxin (consisting of ctxA and ctxB), toxin-coregulated pilus subunit (TcpA), outer membrane protein U (ompU), outer membrane protein W (ompW), accessory cholerae enterotoxin (Ace), and zonula occludens toxin (Zot) (Waturangi et al, 2013;Ramazanzadeh et al, 2015). Cholerae toxin is responsible for the occurrence of diarrhea in cholera outbreaks (Sikora, 2013, Pal, 2014.…”

Survival of enteroaggregative Escherichia coli and Vibrio cholerae in frozen and chilled foods

“…2 and V. cholerae (B.NJ.1.1, toxR + ) originally isolated from edible ice [9]. Both strains were activated by streaking on nutrient agar (NA) (Oxoid, Basingstoke, England) and were then incubated at 37°C overnight.…”