Multi-drug resistant toxigenic Vibrio cholerae O1 is persistent in water sources in New Bell-Douala, Cameroon

Abstract

BackgroundCholera has been endemic in Douala, since 1971 when it was first recorded in Cameroon. Outbreaks have often started in slum areas of the city including New Bell. Despite the devastating nature of outbreaks, always resulting in high mortality and morbidity, a paucity of information exists on the reservoirs of the causative agent, V. cholerae, and factors maintaining its persistence. This has complicated disease prevention, resulting in frequent outbreaks of cholera. We investigated water sources in New Bell for contamination with V. cholerae O1 with pathogenic potential, to highlight their role in disease transmission. Antibiotic susceptibility pattern of isolates and the environmental factors maintaining its persistence were investigated.MethodWater samples from various sources (taps, dug wells, streams) were analyzed for contamination with V. cholerae O1 using standard methods. Antibiotic susceptibility was determined by disc diffusion method. Pathogenic potential of isolates was determined by analyzing for genes for cholera toxin (ctx), toxin co-regulated pilus (tcpA), and zonula occludens toxin (zot) by PCR. Physico-chemical characteristics of water (pH, temperature and salinity) were investigated using standard methods. The Spearman’s Rank correlation was used to analyze the relationship between physico-chemical factors and the occurrence of V. cholerae O1. Differences were considered significant at P≤0.05.ResultsTwenty-five V. cholerae O1 strains were isolated from stream and well samples in both dry and rainy seasons. Twenty-three (92%) isolates were multidrug resistant. All isolates had genes for at least one virulence factor. Cholera toxin gene was detected in 7 isolates. Of the 15 isolates positive for tcpA gene, two had Classical type tcpA while 13 had tcpA El Tor. All tcpA Classical positive isolates were positive for ctx gene. Isolates were grouped into nine genotypes based on the genes analyzed. pH and salinity significantly correlated with isolation of V. cholerae O1.ConclusionMultidrug resistant Vibrio cholerae O1 with pathogenic potential is present in some wells and streams in study area. pH and salinity are among the factors maintaining the persistence of the organism. Findings indicate an urgent need for potable water supply in study area and in addition, regular disinfection of water from contaminated sources to prevent outbreak of cholera.

Water sources as reservoirs of Vibrio choleraeO1 and non-O1 strains in Bepanda, Douala (Cameroon): relationship between isolation and physico-chemical factors

“…However, high activities of ofloxacin and ciprofloxacin observed in our study are similar to other studies [15, 38, 39] and corroborate the use of fluoroquinolones as new alternatives for cholera treatment in some cholera endemic regions [40]. Our data and reports from other cholera endemic localities in Douala [20] therefore suggest ciprofloxacin and ofloxacin could be very good alternatives for chemotherapy during cholera or cholera-like disease outbreaks in Douala.…”

Epidemiology and Antibiogram Profile of <i>Vibrio cholerae</i> Isolates between 2004–2013 from Odisha, India

“…In the present study furazolidone was showing constant resistance between 90% to 100% also. Results similar to this study were also reported from various region of Kenya (17) and Cameroon (18). Since cholera is a non-invasive disease, drug such as co-trimoxazole which is not absorbed from gastrointestinal tract was widely used for treatment.…”

“…Several other workers also reported 100% resistance to co-trimoxazole from North Karnataka (19) and Cameroon (18). (12,(16)(17)(18). During the study the El Tor variants of V.cholerae were reported from 2007 onwards causing cholera outbreaks and epidemics in different parts of the state and also spread to different areas of Odisha (7,30).…”

“…But unfortunately most of the V.cholerae isolated from the present study were resistant to co-trimoxazole. Several other workers also reported 100% resistance to co-trimoxazole from North Karnataka (19) and Cameroon (18). (12,(16)(17)(18).…”

Caracterização, detecção e quantificação de <i>Vibrio cholerae</i> em amostras de água.

“…Entretanto, a resistência apresentada por V. cholerae é um problema que tem aumentado, principalmente em países em desenvolvimento. Enquanto há relatos de resistência a um único antibiótico em vários países endêmicos da cólera (EIBACH et al, 2016;VILA et al, 2010), também há casos de cólera originados por isolados com resistência a vários antibióticos (cloranfenicol, eritromicina, kanamicina, tetraciclina e trimetropimsulfametoxazole), que foram relatados no Iran, Paquistão, Bangladesh, Índia, Nepal, Nigéria, Moçambique, Camarões e Malásia (AKOACHERE et al, 2013;AWASTHI et al, 2015;GUPTA et al, 2016;MANDAL et al, 2011;MANDOMANDO et al, 2007;MARIN et al, 2013;MATERU et al, 1997;ODEYEMI et al, 2016;OLUMIDE et al, 2017;SEDAGHAT et al, 2012;SHRESTHA., 2015).…”