Prevalence and characterisation of non-cholerae Vibrio spp. in final effluents of wastewater treatment facilities in two districts of the Eastern Cape Province of South Africa: implications for public health

Discovery of Vibrio cholerae in Urban Sewage in Copenhagen, Denmark

We report the discovery of a persistent presence of Vibrio cholerae at very low abundance in the inlet of a single wastewater treatment plant in Copenhagen, Denmark at least since 2015. Remarkably, no environmental or locally transmitted clinical case of V. cholerae has been reported in Denmark for more than 100 years. We, however, have recovered a near-complete genome out of 115 metagenomic sewage samples taken over the past 8 years, despite the extremely low relative abundance of one V. cholerae read out of 500,000 sequenced reads. Due to the very low relative abundance, routine screening of the individual samples did not reveal V. cholerae. The recovered genome lacks the gene responsible for cholerae toxin production, but although this strain may not pose an immediate public health risk, our finding illustrates the importance, challenges, and effectiveness of wastewater-based pathogen surveillance.

Antibiotic resistance and virulence genes profiling of Vibrio cholerae and Vibrio mimicus isolates from some seafood collected at the aquatic environment and wet markets in Eastern Cape Province, South Africa

The current study determines the density of Vibrio spp. and isolates V. cholerae and Vibrio mimicus from fish-anatomical-sites, prawn, crab and mussel samples recovered from fish markets, freshwater and brackish water. Virulence and antibiotic resistance profiling of isolates were carried out using standard molecular and microbiology techniques. Vibrio spp. was detected in more than 90% of samples [134/144] and its density was significantly more in fish than in other samples. Vibrio. cholerae and V. mimicus were isolated in at least one sample of each sample type with higher isolation frequency in fish samples. All the V. cholerae isolates belong to non-O1/non-O139 serogroup. One or more V. cholerae isolates exhibited intermediate or resistance against each of the eighteen panels of antibiotics used but 100% of the V. mimicus were susceptible to amikacin, gentamycin and chloramphenicol. Vibrio cholerae exhibited relatively high resistance against polymyxin, ampicillin and amoxicillin/clavulanate while V. mimicus isolates exhibited relatively high resistance against nitrofurantoin, ampicillin and polymixin. The multiple-antibiotic-resistance-index [MARI] for isolates ranges between 0 and 0.67 and 48% of the isolates have MARI that is >0.2 while 55% of the isolates exhibit MultiDrug Resistance Phenotypes. The percentage detection of acc, ant, drf18, sul1, mcr-1, blasvh, blaoxa, blatem, blaoxa48, gyrA, gyrB and parC resistance-associated genes were 2%, 9%, 14%, 7%, 2%, 25%, 7%, 2%, 2%, 32%, 25% and 27% respectively while that for virulence-associated genes in increasing other was ace [2%], tcp [11%], vpi [16%], ompU [34%], toxR [43%], rtxC [70%], rtxA [73%] and hyla [77%]. The study confirmed the potential of environmental non-O1/non-O139 V. cholerae and V. mimicus to cause cholera-like infection and other vibriosis which could be difficult to manage with commonly recommended antibiotics. Thus, regular monitoring of the environment to create necessary awareness for this kind of pathogens is important in the interest of public health.

A meta-analysis on the distribution of pathogenic Vibrio species in water sources and wastewater in Africa

Vibrio species are waterborne ubiquitous organisms capable of causing diseases in humans and animals and the occurrence of infections caused by pathogenic Vibrio species among humans have increased globally. This reemergence is attributed to environmental impacts such as global warming and pollution. Africa is most vulnerable to waterborne infections caused by these pathogens because of lack of good water stewardship and management. This study was carried out to provide an in-depth inquiry into the occurrence of pathogenic Vibrio species in water sources and wastewater across Africa. In this regard, a systematic review and meta-analysis was conducted by searching five databases: PubMed, ScienceDirect, Google Scholar, Springer Search and African Journals Online (AJOL). The search yielded 70 articles on pathogenic Vibrio species presence in African aquatic environments that fit our inclusion criteria. Based on the random effects model, the pooled prevalence of pathogenic Vibrio species in various water sources in Africa was 37.6 % (95 % CI: 27.7-48.0). Eighteen countries were represented by the systematically assessed studies and their nationwide prevalence in descending order was: Nigeria (79.82 %), Egypt (47.5 %), Tanzania (45.8 %), Morocco (44.8), South Africa (40.6 %), Uganda (32.1 %), Cameroon (24.5 %), Burkina Faso (18.9 %) and Ghana (5.9 %). Furthermore, 8 pathogenic Vibrio species were identified across water bodies in Africa with the highest detection for V. cholerae (59.5 %), followed by V. parahaemolyticus (10.4 %), V.alginolyticus (9.8 %), V. vulnificus (8.5 %), V. fluvialis (6.6 %), V. mimicus (4.6 %), V. harveyi (0.5 %) and V. metschnikovii (0.1 %). Evidently, pathogenic Vibrio species occurrence in these water sources especially freshwater corroborates the continuous outbreaks observed in Africa. Therefore, there is an urgent need for proactive measures and continuous monitoring of water sources used for various purposes across Africa and proper treatment of wastewater before discharge into water bodies.

The African Wastewater Resistome: Identifying Knowledge Gaps to Inform Future Research Directions

Antimicrobial resistance (AMR) is a growing global public health threat. Furthermore, wastewater is increasingly recognized as a significant environmental reservoir for AMR. Wastewater is a complex mixture of organic and inorganic compounds, including antibiotics and other antimicrobial agents, discharged from hospitals, pharmaceutical industries, and households. Therefore, wastewater treatment plants (WWTPs) are critical components of urban infrastructure that play a vital role in protecting public health and the environment. However, they can also be a source of AMR. WWTPs serve as a point of convergence for antibiotics and resistant bacteria from various sources, creating an environment that favours the selection and spread of AMR. The effluent from WWTPs can also contaminate surface freshwater and groundwater resources, which can subsequently spread resistant bacteria to the wider environment. In Africa, the prevalence of AMR in wastewater is of particular concern due to the inadequate sanitation and wastewater treatment facilities, coupled with the overuse and misuse of antibiotics in healthcare and agriculture. Therefore, the present review evaluated studies that reported on wastewater in Africa between 2012 and 2022 to identify knowledge gaps and propose future perspectives, informing the use of wastewater-based epidemiology as a proxy for determining the resistome circulating within the continent. The study found that although wastewater resistome studies have increased over time in Africa, this is not the case in every country, with most studies conducted in South Africa. Furthermore, the study identified, among others, methodology and reporting gaps, driven by a lack of skills. Finally, the review suggests solutions including standardisation of protocols in wastewater resistome works and an urgent need to build genomic skills within the continent to handle the big data generated from these studies.

Virulence and antimicrobial resistance characteristics assessment of Vibrio isolated from shrimp (Penaeus vannamei) breeding system in south China

The diseases caused by Vibrio during shrimp breeding program have the risk of spreading in different aquatic areas through larvae transportation between different regions. Therefore, the population distribution and the virulence and antibiotic resistance risk of 5 pathogenic Vibrio in shrimp (Penaeus vannamei) breeding system in China were evaluated for the first time. A total of 418 isolates were recovered from shrimp, breeding water and biological baits samples, and 312 isolates were identified as Vibrio genus based on 16s rDNA, among which V. alginolyticus, V. harveyi, V. parahaemolyticus, V. cholerae and V. campbellii were the dominant species. And 10/20 kinds of virulence genes (chiA, luxR, vhh, tlh, chxA, sepro, flaA, vch, VAC and rpoS) were detected among the 5 Vibrio species. Multiple antibiotic resistance (MAR) index of the 5 dominant Vibrio isolates were 0.13-0.88 %, and 36.5 % isolates with MAR < 0.2. But the antibiotic resistance pattern abundance (ARPA) index ranged from 0.25 to 0.56, which indicated the antibiotic phenotypes of Vibrio species in the shrimp breeding system in China were homogeneity. Furthermore, resistance quotients (RQs) calculation results displayed that the dominant Vibrio species in the shrimp breeding system in China showed no or low selection pressure for resistance to cefoperazone/sulbactam, enrofloxacin, ciprofloxacin, fluoroquine, florfenicol, tetracycline and doxycycline. But only 5 resistance genes were detected, which were strA (43.8 %), strB (11.7 %), QnrVC (2.9 %), sul2 (8.8 %) and Int4 (8.8 %), respectively, and the antimicrobial resistance genotypes were not previously correlated with their phenotypes. The relevant research results provide theoretical basis for epizootic tracking in aquatic system in China, and targeting its final risk in aquatic ecosystem and public health perspectives.

Incidence of antibiotic resistance genotypes of Vibrio species recovered from selected freshwaters in Southwest Nigeria

Vibrio species are classified as potent hazards because of their tendency to effect serious diseases like cholera and other gastrointestinal ailments in humans, as well as vibriosis in fish. A total of 144 freshwater samples were aseptically collected monthly across four rivers (Asejire, Ona, Dandaru and Erinle rivers) over a 12-month period from which Vibrio spp. were isolated using culture procedures, confirmed by means of biochemical test as well as Polymerase Chain Reaction (PCR) assay and further characterized for their phenotypic antibiotic susceptibilities and relevant antimicrobial resistant determinants by PCR. Three hundred and fifteen (58%) isolates confirmed across the sampled sites (Asejire = 75, Dandaru = 87, Eleyele = 72, Erinle = 81) showed high resistance against erythromycin-95%, Sulphamethoxazole-94%, rifampicin-92%, doxycycline-82%, tetracycline-75%, amoxicillin-45%, cephalothin-43% and varied susceptibilities to other antibiotics. The multiple antibiotic resistance indices of 97% of the Vibrio isolates were above the 0.2 threshold limit with MAR phenotype pattern E-SUL-RF-TET-DOX (0.38) found to be the most prevalent pattern among the isolates. The distributions of resistance determinant of the tested antibiotics were revealed as follows: sulII 33%, sulI 19% (sulfonamides); bla_OXA 27%, ampC 39%, bla_pse 11% (beta-lactams); tetA 28%, tetE 20%, tet39 8%, (tetracyclines) and strA 39%. aacC2 24%, aphA1 14% (aminoglycosides). Strong positive associations were observed among tetA, sulI, tetE and sulII. This study raises concerns as these selected rivers may contribute to the environmental spread of waterborne diseases and antibiotic resistance genes. Therefore, we recommend environmental context-tailored strategies for monitoring and surveillance of resistance genes so as to safeguard the environment from becoming reservoirs of virulent and infectious Vibrio species.

Enrichment and dissemination of bacterial pathogens by microplastics in the aquatic environment

Microplastic pollution and associated impacts in the aquatic environment are spreading at an alarming rate worldwide. Plastic waste is increasing in the environment, and microplastics (MPs) are becoming a growing issue because they serve as vectors for pathogen transmission. This is the first comprehensive review that specifically addresses MPs as a source and vector of pathogenic bacteria, mainly associated with genera Vibrio, Pseudomonas, Acinetobacter, and so on, which are discovered to be more abundant on the aquatic plastisphere than that in the surrounding wastewater, freshwater, and marine water ecosystems. The horizontal gene transfer, chemotaxis, and co-selection and cross-selection could be the potential mechanism involved in the enrichment and dissemination of bacterial pathogens through the aquatic plastisphere. Further, bacterial pathogens through aquatic plastisphere can cause various ecological and human health impacts such as disrupted food chain, oxidative stress, tissue damages, disease transmission, microbial dysbiosis, metabolic disorders, among others. Last but not least, future research directions are also described to find answers to the challenging questions about bacterial pathogens in the aquatic plastisphere to ensure the integrity and safety of ecological and human health.

Non-serogroup O1/O139 agglutinable Vibrio cholerae: a phylogenetically and genealogically neglected yet emerging potential pathogen of clinical relevance

Somatic antigen agglutinable type-1/139 Vibrio cholerae (SAAT-1/139-Vc) members or O1/O139 V. cholerae have been described by various investigators as pathogenic due to their increasing virulence potential and production of choleragen. Reported cholera outbreak cases around the world have been associated with these choleragenic V. cholerae with high case fatality affecting various human and animals. These virulent Vibrio members have shown genealogical and phylogenetic relationship with the avirulent somatic antigen non-agglutinable strains of 1/139 V. cholerae (SANAS-1/139- Vc) or O1/O139 non-agglutinating V. cholerae (O1/O139-NAG-Vc). Reports on implication of O1/O139-NAGVc members in most sporadic cholera/cholera-like cases of diarrhea, production of cholera toxin and transmission via consumption and/or contact with contaminated water/seafood are currently on the rise. Some reported sporadic cases of cholera outbreaks and observed change in nature has also been tracable to these non-agglutinable Vibrio members (O1/O139-NAGVc) yet there is a sustained paucity of research interest on the non-agglutinable V. cholerae members. The emergence of fulminating extraintestinal and systemic vibriosis is another aspect of SANAS-1/139- Vc implication which has received low attention in terms of research driven interest. This review addresses the need to appraise and continually expand research based studies on the somatic antigen non-serogroup agglutinable type-1/139 V. cholerae members which are currently prevalent in studies of water bodies, fruits/vegetables, foods and terrestrial environment. Our opinion is amassed from interest in integrated surveillance studies, management/control of cholera outbreaks as well as diarrhea and other disease-related cases both in the rural, suburban and urban metropolis.

Impact of engineered nanoparticles on the fate of antibiotic resistance genes in wastewater and receiving environments: A comprehensive review

Nanoparticles (NPs) and antibiotic resistance elements are ubiquitous in wastewater and consequently, in receiving environments. Sub-lethal levels of engineered NPs potentially result in a selective pressure on antibiotic resistance gene (ARG) propagation in wastewater treatment plants. Conversely, emergent NPs are being designed to naturally attenuate ARGs based on special physical and electrochemical properties, which could alleviate dissemination of ARGs to the environment. The complex interactions between NPs and antibiotic resistance elements have heightened interest in elucidating the potential positive and negative implications. This review focuses on the properties of NPs and ARGs and how their interactions could increase or decrease antibiotic resistance at wastewater treatment plants and in receiving environments. Further, the potential for sub-lethal level NPs to facilitate horizontal gene transfer of ARGs and increase mutagenesis rates, which adds a layer of complexity to combatting antibiotic resistance associated with wastewater management, is discussed. Notably, the literature revealed that sub-lethal exposure of engineered NPs may facilitate conjugative transfer of ARGs by increasing cell membrane permeability. The enhanced permeability is a result of direct damage via NP attachment and indirect damage by generating reactive oxygen species (ROS) and causing genetic changes relevant to conjugation. Finally, current knowledge gaps and future research directions (e.g., deciphering the fate of NPs in the environment and examining the long-term cytotoxicity of NPs) are identified for this emerging field.

Food, Beverage, and Feedstock Processing Facility Wastewater: a Unique and Underappreciated Source of Contaminants to U.S. Streams

Process wastewaters from food, beverage, and feedstock facilities, although regulated, are an under-investigated environmental contaminant source. Food process wastewaters (FPWWs) from 23 facilities in 17 U.S. states were sampled and documented for a plethora of chemical and microbial contaminants. Of the 576 analyzed organics, 184 (32%) were detected at least once, with concentrations as large as 143 μg L^-1 (6:2 fluorotelomer sulfonic acid), and as many as 47 were detected in a single FPWW sample. Cumulative per/polyfluoroalkyl substance concentrations up to 185 μg L^-1 and large pesticide transformation product concentrations (e.g., methomyl oxime, 40 μg L^-1; clothianidin TMG, 2.02 μg L^-1) were observed. Despite 48% of FPWW undergoing disinfection treatment prior to discharge, bacteria resistant to third-generation antibiotics were found in each facility type, and multiple bacterial groups were detected in all samples, including total coliforms. The exposure-activity ratios and toxicity quotients exceeded 1.0 in 13 and 22% of samples, respectively, indicating potential biological effects and toxicity to vertebrates and invertebrates associated with the discharge of FPWW. Organic contaminant profiles of FPWW differed from previously reported contaminant profiles of municipal effluents and urban storm water, indicating that FPWW is another important source of chemical and microbial contaminant mixtures discharged into receiving surface waters.

Virulence and Antibiotic Resistance Characteristics of Vibrio Isolates From Rustic Environmental Freshwaters

The study investigated the occurrence of antimicrobial resistance genes and virulence determinants in Vibrio species recovered from different freshwater sheds in rustic milieu. A total of 118 Vibrio isolates comprising Vibrio fluvialis (n=41), Vibrio mimicus (n=40) and V. vulnificus (n=37) was identified by amplification of ToxR, vmh and hsp60 genes. The amplification of virulence genes indicated that V. mimicus (toxR, zot, ctx, VPI, and ompU) genes were detected in 12.5%, 32.5%, 45%, 37.5% and 10% respectively. V. fluvialis genes (stn, hupO and vfh) were harboured in 48.8%, 14.6% and 19.5% isolates congruently. The other virulence genes that include vcgC and vcgE were observed in 63.1% and 29% of isolates belonging to V. vulnificus. With the exceptions of imipenem, meropenem and ciprofloxacin, most isolates exhibited more than 50% resistance to antibiotics. The antimicrobial resistance was more prevalent for polymyxin B (100%), azithromycin (100%) and least in ciprofloxacin (16.1%). Multiple antibiotic resistance index range was 0.3 and 0.8 with most isolates showing MARI of 0.8. The blaTEM, AmpC, blaGES, blaIMP, blaOXA-48 and blaKPC genes were detected in 53.3%, 42%, 29.6%, 16.6%, 15%, 11.3% and 5.6% of the isolates. Non-beta lactamases such as streptomycin resistance (aadA and strA), gentamicin resistance (aphA1) and quinolone resistance gene (qnrVC) were found in 5.2%, 44.3%, 26% and 2.8%. Chloramphenicol resistance genes (cmlA1 and catII) were found in 5.2% and 44.3% among the isolates. Our findings reveal the presence of antimicrobial resistance genes and virulent Vibrio species in aquatic environment which can have potential risk to human and animal's health.

Microbial Quality of Treated Wastewater and Borehole Water Used for Irrigation in a Semi-Arid Area

The current study investigated the distribution of microbial populations and diversity in treated wastewater used for irrigation at the University of Limpopo Experimental Farm (ULEF), from different stages of post treatment disposal at Mankweng Wastewater Treatment Plant (MWTP) in Limpopo Province, South Africa. The study was arranged in a 4 × 5 factorial experiment, which studied the interactive effects of four collection points and five months of sampling, with borehole water used as a reference point. Water samples were analyzed for bacteria, helminths, and protozoa. All data were transformed and subjected to factorial analysis of variance. The site-time interactions were significant for Salmonella spp. and Ascaris lumbricoides, whereas collection point was significant for all variables. In conclusion, movement and storage of water post treatment at MWTP were able to improve the microbial quality of the treated wastewater disposed for irrigation at ULEF.

Non-toxigenic Vibrio cholerae non-O1/non-O139 pseudo-bacteraemia in a neonate: A case report

Toxigenic Vibrio cholerae O1/O139 is causative of cholera, which is a well characterised potentially epidemic gastrointestinal disease. Less is known about the pathogenesis and clinical presentation of non-toxigenic V. cholerae non-O1/non-O139, although they are increasingly implicated in human disease globally, have been isolated from various South African water sources and can contaminate the environment. The authors describe a case of pseudo-bacteraemia with non-toxigenic V. cholerae non-O1/non-O139 in a neonate.

Coupled DNA-labeling and sequencing approach enables the detection of viable-but-non-culturable Vibrio spp. in irrigation water sources in the Chesapeake Bay watershed

Nontraditional irrigation water sources (e.g., recycled water, brackish water) may harbor human pathogens, including Vibrio spp., that could be present in a viable-but-nonculturable (VBNC) state, stymieing current culture-based detection methods. To overcome this challenge, we coupled 5-bromo-2'-deoxyuridine (BrdU) labeling, enrichment techniques, and 16S rRNA sequencing to identify metabolically-active Vibrio spp. in nontraditional irrigation water (recycled water, pond water, non-tidal freshwater, and tidal brackish water). Our coupled BrdU-labeling and sequencing approach revealed the presence of metabolically-active Vibrio spp. at all sampling sites. Whereas, the culture-based method only detected vibrios at three of the four sites. We observed the presence of V. cholerae, V. vulnificus, and V. parahaemolyticus using both methods, while V. aesturianus and V. shilonii were detected only through our labeling/sequencing approach. Multiple other pathogens of concern to human health were also identified through our labeling/sequencing approach including P. shigelloides, B. cereus and E. cloacae. Most importantly, 16S rRNA sequencing of BrdU-labeled samples resulted in Vibrio spp. detection even when our culture-based methods resulted in negative detection. This suggests that our novel approach can effectively detect metabolically-active Vibrio spp. that may have been present in a VBNC state, refining our understanding of the prevalence of vibrios in nontraditional irrigation waters.

Molecular Detection and Distribution of Six Medically Important Vibrio spp. in Selected Freshwater and Brackish Water Resources in Eastern Cape Province, South Africa

Water resources contaminated with pathogenic Vibrio species are usually a source of devastating infection outbreaks that have been a public health concern in both developed and developing countries over the decades. The present study assessed the prevalence of six medically significant Vibrio species in some water resources in Eastern Cape Province, South Africa for 12 months. We detected vibrios in all the 194 water samples analyzed using polymerase chain reaction (PCR). The prevalence of Vibrio cholerae, Vibrio mimicus, Vibrio fluvialis, Vibrio vulnificus, Vibrio alginolyticus, and Vibrio parahaemolyticus in freshwater samples was 34, 19, 9, 2, 3, and 2%, and that in brackish water samples was 44, 28, 10, 7, 46, and 51%, respectively. The population of the presumptive Vibrio spp. isolated from freshwater (628) and brackish water (342) samples that were confirmed by PCR was 79% (497/628) and 85% (291/342), respectively. Twenty-two percent of the PCR-confirmed Vibrio isolates from freshwater (n = 497) samples and 41% of the PCR-confirmed Vibrio isolates from brackish water samples (n = 291) fall among the Vibrio species of interest. The incidences of V. cholerae, V. mimicus, V. fluvialis, V. vulnificus, V. alginolyticus, and V. parahaemolyticus amidst these Vibrio spp. of interest that were recovered from freshwater samples were 75, 14, 4, 6, 1, and 1%, whereas those from brackish water samples were 24, 7, 3, 3, 47, and 18%, respectively. Our observation during the study suggests pollution as the reason for the unusual isolation of medically important vibrios in winter. Correlation analysis revealed that temperature drives the frequency of isolation, whereas salinity drives the composition of the targeted Vibrio species at our sampling sites. The finding of the study is of public health importance going by the usefulness of the water resources investigated. Although controlling and preventing most of the factors that contribute to the prevalence of medically important bacteria, such as Vibrio species, at the sampling points might be difficult, regular monitoring for creating health risk awareness will go a long way to prevent possible Vibrio-related infection outbreaks at the sampling sites and their immediate environment.

Nanotechnology as a viable alternative for the removal of antimicrobial resistance determinants from discharged municipal effluents and associated watersheds: A review

Effective and efficient utilization of antimicrobial drugs has been one of the important cornerstone of modern medicine. However, since antibiotics were first discovered by Alexander Fleming about a century ago, the time clock of antimicrobial resistance (AMR) started ticking somewhat leading to a global fear of a possible "post-antimicrobial era". Antibiotic resistance (AR) remains a serious challenge causing global outcry in both the clinical setting and the environment. The huge influence of municipal wastewater effluent discharges on the aquatic environment has made the niche a hotspot of research interest in the study of emergence and spread of AMR microbes and their resistance determinants/genes. The current review adopted a holistic approach in studying the proliferation of antibiotic resistance determinants (ARDs) as well as their impacts and fate in municipal wastewater effluents and the receiving aquatic environments. The various strategies deployed hitherto for the removal of resistance determinants in municipal effluents were carefully reviewed, while the potential for the use of nanotechnology as a viable alternative is explicitly explored. Also, highlighted in this review are the knowledge gaps to be filled in order to curtail the spread of AMR in aquatic environment and lastly, suggestions on the applicability of nanotechnology in eliminating AMR determinants in municipal wastewater treatment facilities are proffered.

Profiles of antibiotic resistance genes and virulence genes and their temporal interactions in the membrane bioreactor and oxidation ditch

Antibiotic resistance genes (ARGs) and virulence genes (VGs) in wastewater treatment plants (WWTPs) may pose a potential threat to public health if without proper treatment. In this study, GeoChip was used to reveal the differences in ARG/VG diversity between a membrane bioreactor (MBR) and an oxidation ditch (OD) and the temporal co-occurrence patterns between ARGs and VGs. Results showed that the diversity of ARGs and VGs was lower in MBR than that in OD in the short term due to the better disinfection capability of MBR. However, the differences in diversity between two reactors disappeared in the long term because of the great variation of temperature. Instead, time-decay relationship was observed and overall turnover rate was -0.0105. Co-occurrence patterns indicate that direct connections between ARGs and VGs reduced sharply with time increasing due to the different responses of ARGs and VGs to environmental variation.

Limpet (Scutellastra cochlear) Recovered From Some Estuaries in the Eastern Cape Province, South Africa Act as Reservoirs of Pathogenic Vibrio Species

Limpet (Scutellastra cochlear) serves as seafood recipe and an important member of the aquatic food chain. It is an abundant mollusc in some aquatic environment in South Africa. In this study, we investigated the potential of the molluscs harvested from the Buffalo, Swartkops, and Kowie estuaries in the Eastern Cape Province, South Africa to serve as transient or maintenance reservoir of Vibrio species. The mollusc and source water samples were collected monthly from the rivers between December 2016 and November 2017. The reservoir category of the limpet samples recovered was determined by employing the combination of MPN-PCR method and statistical analysis (comparison of mean and proportion tests). The densities of Vibrio spp. in limpet and their source water samples were determined using MPN-PCR methods. Presumptive isolates were recovered by processing the samples with thiosulfate-citrate-bile salts-sucrose agar and where necessary, samples were enriched with alkaline peptone water. The presumptive isolates were identified using PCR methods with emphasis on six Vibrio species of public health importance. Vibrio spp. were detected in all the limpet samples but not in all the water samples. The densities of Vibrio spp. in the limpet samples were more than the densities of Vibrio species in their source water and these were significant at P < 0.05. In like manner, five out of the six key Vibrio pathogens targeted in this study were more prevalent in limpet samples than in source water samples. Based on our findings, we concluded that our method though could be improved on, is efficient for the determination of reservoir types of bacterial-carrying organisms. We also concluded that the limpet found in the estuaries are not just a transient but a maintenance reservoir of Vibrio spp. which could cause vibrio-related infections.

Vibrio Species in Wastewater Final Effluents and Receiving Watershed in South Africa: Implications for Public Health

Wastewater treatment facilities in South Africa are obliged to make provision for wastewater effluent quality management, with the aim of securing the integrity of the surrounding watersheds and environments. The Department of Water Affairs has documented regulatory parameters that have, over the years, served as a guideline for quality monitoring/management purposes. However, these guidelines have not been regularly updated and this may have contributed to some of the water quality anomalies. Studies have shown that promoting the monitoring of the current routinely monitored parameters (both microbial and physicochemical) may not be sufficient. Organisms causing illnesses or even outbreaks, such as Vibrio pathogens with their characteristic environmental resilience, are not included in the guidelines. In South Africa, studies that have been conducted on the occurrence of Vibrio pathogens in domestic and wastewater effluent have made it apparent that these pathogens should also be monitored. The importance of effective wastewater management as one of the key aspects towards protecting surrounding environments and receiving watersheds, as well as protecting public health, is highlighted in this review. Emphasis on the significance of the Vibrio pathogen in wastewater is a particular focus.

Antibiotic Susceptibility of Non-Cholera Vibrios Isolated from Farmed and Wild Marine Fish (Argyrosomus japonicus), Implications for Public Health

This study aimed to evaluate the antibiogram and antibiotic resistance genes (ARGs) of Vibrio isolates recovered from a marine fish (Argyrosomus japonicus) and water samples from two commercial dusky kob aquaculture farms and the Kariega estuary, South Africa, and to evaluate these findings for their public health implications. A total of 277 molecularly confirmed Vibrio isolates consisting of 126 Vibrio fluvialis, 45 Vibrio vulnificus, 30 Vibrio Parahaemolyticus, and 76 vibrios belonging to species of the genus other than Vibrio cholerae were subjected to susceptibility testing to 15 antibiotics by the disc diffusion method. Multiple antibiotic resistance index (MARI) was used to determine the antibiotic resistance-associated health risk, while polymerase chain reaction was used to evaluate the presence of 14 ARGs for nonsusceptible strains. Highest resistances were recorded to amoxicillin (76.2%), ampicillin (67.5%), erythromycin (38.3%), and doxycycline (35.0%), while susceptibilities were highest to gentamicin (100%), followed by norfloxacin (97.8%), florfenicol (90.3%), tetracycline (87.7%), and chloramphenicol (87.4%). We recorded a 58.5% multidrug resistance (resistance to ≥2 antimicrobial classes). MARI did not vary significantly between sites (p > 0.05); however, values of >0.2 were recorded in 40% (108/277) of all strains tested. ARG markers, ampC, blaOXA, tetA, tetM, dfr1, sul1, sul2, ermB, nptII, strA, and SXT integrase, were detected in one or more strains with ermB (82.5%), sul2 (53.8%), strA (44%), dfr1 (42.3%), and tetM (38.3%) being the most abundant. Healthy marine finfish (dusky kob) and their environment can serve as reservoirs for antibiotic resistant vibrios and ARGs, which could be disseminated to humans and other susceptible bacteria and this therefore becomes a public health concern.

Occurrence of Virulence Genes Associated with Human Pathogenic Vibrios Isolated from Two Commercial Dusky Kob (Argyrosmus japonicus) Farms and Kareiga Estuary in the Eastern Cape Province, South Africa

Background: Seafood-borne Vibrio infections, often linked to contaminated seafood and water, are of increasing global public health concern. The aim of this study was to evaluate the prevalence of human pathogenic vibrios and their associated virulence genes isolated from fish and water samples from 2 commercial dusky kob farms and Kareiga estuary, South Africa. Methods: A total of 200 samples including dusky kob fish (n = 120) and seawater (n = 80) were subjected to Vibrio screening on thiosulfate-citrate-bile salts-sucrose agar (TCBS). Presumptive isolates were confirmed and delineated to V. cholerae, V. parahaemolyticus, V. vulnificus, and V. fluvialis by PCR. Various pathogenic gene markers were screened: V. parahaemolyticus (trh and tdh), V. vulnificus (vcgE and vcgC) and V. fluvialis (stn, vfh,hupO, vfpA). Restriction Fragment Length Polymorphism (RFLP) of the vvhA gene of V. vulnificus strains was performed to determine the associated biotypes. Results: Total Vibrio prevalence was 59.4% (606/1020) of which V. fluvialis was the most predominant 193 (31.85%), followed by Vibrio vulnificus 74 (12.21%) and V. parahaemolyticus 33 (5.45%). No V. cholerae strain was detected. One of the V. parahaemolyticus strains possessed the trh gene 7 (9.46%) while most (91.9%; 68/74) V. vulnificus isolates were of the E-type genotype. V. fluvialis virulence genes detected were stn (13.5%), hupO (10.4%) and vfpA (1.0%). 12.16% (9/74) of V. vulnificus strains exhibited a biotype 3 RFLP pattern. Conclusions: This is the first report of potentially pathogenic vibrios from healthy marine fish in the study area, and therefore a public health concern.

Antimicrobial Susceptibility among Urban Wastewater and Wild Shellfish Isolates of Non-O1/Non-O139 Vibrio cholerae from La Rance Estuary (Brittany, France)

The early 2000s marked the end of the Golden age of the antibiotics and the beginning of the awareness on the potential threat to human health due to the dissemination of antimicrobial resistance. As a base-line study, we investigated the antimicrobial susceptibility of 99 strains of non-O1/non-O139 Vibrio cholerae isolated from wastewater and shellfish in 2000/2001 within La Rance estuary (Brittany, France). All isolates were susceptible to amoxicillin-clavulanic acid, cefotaxime, imipenem, chloramphenicol, nalidixic acid, ciprofloxacin, norfloxacin, amikacin, gentamicin, tetracycline, doxycycline, trimethoprim-sulfamethoxazole, and erythromycin. The only resistances were to streptomycin, sulfonamides and ampicillin: 54.6% of the isolates had acquired resistance to at least one antimicrobial agent among them and only six isolates from cockles were multidrug resistant. On the basis of the distribution of a limited selection of resistance associated genes, our study shows that V. cholerae can constitute an environmental reservoir for these genes. However, none of our isolates harbored integron. This result casts doubt on the capacity of non-O1/non-O139 V. cholerae to acquire resistance-associated genes in such context, and on its potential role of indicator of the dissemination of antimicrobial resistance in the aquatic environment.

Vibrio Parahaemolyticus: A Review on Distribution, Pathogenesis, Virulence Determinants and Epidemiology

Vibrio parahaemolyticus is a Gram-negative, halophilic bacterium isolated from marine environments globally. After the consumption of contaminated seafood, V. parahaemolyticus causes acute gastroenteritis. To initiate infection, a wide range of virulence factors are required. A complex group of genes is known to participate in the pathogenicity of V. parahaemolyticus; however, to understand the full mechanism of infection, extensive research is yet required. V. parahaemolyticus has become the leading cause of seafood-related gastroenteritis in Japan, the United States and several other parts of the world. In addition, outbreaks caused by the pandemic clone of this organism are escalating and spreading universally. To minimize the risk of V. parahaemolyticus infection and warrant the safety of seafood, collaboration between governments and scientists is required. We herein provide an updated review of the pathogenicity determinants and distribution of V. parahaemolyticus to deliver a better understanding of the significance of V. parahaemolyticus and its host-pathogen interactions.

Assessment of chlorine tolerance profile of Citrobacter species recovered from wastewater treatment plants in Eastern Cape, South Africa

This present study assessed the chlorine tolerance of some Citrobacter species recovered from secondary effluents from the clarifiers of two wastewater treatment plants in the Eastern Cape, South Africa. The bacterial survival, chlorine lethal dose and inactivation kinetics at lethal doses were examined. Inactivation of the test bacteria (n = 20) at the recommended dose of 0.5 mg/l for 30 min exposure showed a progressive reduction in bacterial population from 4 to 5 log reduction and residuals ranged between 0.12 and 0.46 mg/l. The bactericidal activity of chlorine increased at higher dosages with a substantial reduction in viability of the bacteria and complete inactivation of the bacterial population at a lethal dose of 0.75 and 1.0 mg/l in 30 min. For the inactivation kinetics, bactericidal activity of chlorine increased with time showing a 3.67-5.4 log reduction in 10 min, 4.0-5.6 log reduction in 20 min and above 6.3 log reductions to complete sterilization of bacterial population over 30 min for all the entire test Citrobacter isolates used in this study. Furthermore, there was a strong correlation (R ² > 0.84) between bacteria inactivation and increase in contact time. This study appears to have provided support for laboratory evidence of bacterial tolerance to chlorine disinfection at current recommended dose (0.5 mg/l for 30 min), and chlorine concentration between 0.75 and 1.0 mg/l was found to have a better disinfecting capacity to check tolerance of Citrobacter species.

Development of a PCR-free DNA-based assay for the specific detection of Vibrio species in environmental samples by targeting the 16S rRNA

A novel PCR-free DNA-based assay was developed for the detection of Vibrio spp. A sandwich hybridization format using an immobilized capture probe and a labeled signal probe was selected and combined with chemiluminescent method for the detection of the RNA target. In a first step, probes were validated using positive controls (PCs). A linearity was observed between 0.1 and 2.5 nM of PC, and detection limit was determined as 0.1 nM. In a second step, specificity was checked by using RNA extracted from a panel of 31 environmental bacterial strains. Detection limit of 5 ng μL^-1 of total fragmented RNA was obtained, and the assay allowed a good discrimination between the 21 Vibrio and the 10 non-Vibrio strains tested. Finally, the DNA-based assay was successfully applied to analysis of spiked and natural environmental samples. Stability and analysis time of the DNA-based assay were also investigated to optimize working conditions. We demonstrated that microplates can be coated beforehand with capture probe and stored at 4 °C without any buffer in wells for at least 30 days. The use of the pre-made plates enables the assay to be completed in 2 h. The developed assay appeared as an interesting tool to determine the presence of bacteria in environmental samples.

Urban effluent discharges as causes of public and environmental health concerns in South Africa's aquatic milieu

The water quality in South Africa's river systems is rapidly deteriorating as a consequence of increased discharge of wastewater effluents. The natural ability of rivers and reservoirs to trap toxic chemicals and nutrients in their sediments enables these systems to accumulate contaminants, altering the natural balance in environmental water quality, thereby raising a plethora of public and environmental health concerns. Impaired water quality has been linked to an array of problems in South Africa including massive fish mortalities, altered habitat template leading to the thinning of riverine macroinvertebrate diversity, shifts in microbial community structures with drastic ecological consequences and evolvement of antibiotic resistance genes that, under natural conditions, can be transferred to waterborne pathogens. Urban wastewater discharge has also been implicated in increased bioaccumulation of metals in edible plant parts, elevated concentrations of endocrine-disrupting compounds (EDCs), which are blamed for reduced fertility and increased cancer risk, excessive growth of toxic cyanobacteria and an increase in concentrations of pathogenic microorganisms which constitute a potential health threat to humans. However, despite the ecotoxicological hazards posed by wastewater effluents, ecotoxicological studies are currently underutilised in South African aquatic ecosystem assessments, and where they have been done, the observation is that ecotoxicological studies are mostly experimental and restricted to small study areas. More research is still needed to fully assess especially the ecotoxicological consequences of surface water pollution by urban wastewater effluents in South Africa. A review of the effects of urban effluent discharges that include domestic effluent mixed with industrial effluent and/or urban stormwater run-off is hereby presented.

pH level as a marker for predicting death among patients with Vibrio vulnificus infection, South Korea, 2000-2011

Initial pH level at hospital admission was the most accurate and simple predictor of death.

Vibrio vulnificus infection can progress to necrotizing fasciitis and death. To improve the likelihood of patient survival, an early prognosis of patient outcome is clinically important for emergency/trauma department doctors. To identify an accurate and simple predictor for death among V. vulnificus–infected persons, we reviewed clinical data for 34 patients at a hospital in South Korea during 2000–2011; of the patients, 16 (47%) died and 18 (53%) survived. For nonsurvivors, median time from hospital admission to death was 15 h (range 4–70). For predicting death, the areas under the receiver operating characteristic curves of the Acute Physiology and Chronic Health Evaluation (APACHE) II score and initial pH were 0.746 and 0.972, respectively (p = 0.005). An optimal cutoff pH of <7.35 had a sensitivity of 100% and specificity of 83%. Compared with the APACHE II score, the initial arterial blood pH level in V. vulnificus-infected patients was a more accurate predictive marker for death.

Non-O1/non-O139 Vibrio cholerae carrying multiple virulence factors and V. cholerae O1 in the Chesapeake Bay, Maryland

Non-O1/non-O139 Vibrio cholerae inhabits estuarine and coastal waters globally, but its clinical significance has not been sufficiently investigated, despite the fact that it has been associated with septicemia and gastroenteritis. The emergence of virulent non-O1/non-O139 V. cholerae is consistent with the recognition of new pathogenic variants worldwide. Oyster, sediment, and water samples were collected during a vibrio surveillance program carried out from 2009 to 2012 in the Chesapeake Bay, Maryland. V. cholerae O1 was detected by a direct fluorescent-antibody (DFA) assay but was not successfully cultured, whereas 395 isolates of non-O1/non-O139 V. cholerae were confirmed by multiplex PCR and serology. Only a few of the non-O1/non-O139 V. cholerae isolates were resistant to ampicillin and/or penicillin. Most of the isolates were sensitive to all antibiotics tested, and 77 to 90% carried the El Tor variant hemolysin gene hlyAET, the actin cross-linking repeats in toxin gene rtxA, the hemagglutinin protease gene hap, and the type 6 secretion system. About 19 to 21% of the isolates carried the neuraminidase-encoding gene nanH and/or the heat-stable toxin (NAG-ST), and only 5% contained a type 3 secretion system. None of the non-O1/non-O139 V. cholerae isolates contained Vibrio pathogenicity island-associated genes. However, ctxA, ace, or zot was present in nine isolates. Fifty-five different genotypes showed up to 12 virulence factors, independent of the source of isolation, and represent the first report of both antibiotic susceptibility and virulence associated with non-O1/non-O139 V. cholerae from the Chesapeake Bay. Since these results confirm the presence of potentially pathogenic non-O1/non-O139 V. cholerae, monitoring for total V. cholerae, regardless of serotype, should be done within the context of public health.