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Rehm C, Kolm C, Pleininger S, Heger F, Indra A, Reischer GH, Farnleitner AAH, Kirschner AKT. Vibrio cholerae-An emerging pathogen in Austrian bathing waters? Wien Klin Wochenschr 2023; 135:597-608. [PMID: 37530997 PMCID: PMC10651712 DOI: 10.1007/s00508-023-02241-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 06/11/2023] [Indexed: 08/03/2023]
Abstract
Vibrio cholerae, an important human pathogen, is naturally occurring in specific aquatic ecosystems. With very few exceptions, only the cholera-toxigenic strains belonging to the serogroups O1 and O139 are responsible for severe cholera outbreaks with epidemic or pandemic potential. All other nontoxigenic, non-O1/non-O139 V. cholerae (NTVC) strains may cause various other diseases, such as mild to severe infections of the ears, of the gastrointestinal and urinary tracts as well as wound and bloodstream infections. Older, immunocompromised people and patients with specific preconditions have an elevated risk. In recent years, worldwide reports demonstrated that NTVC infections are on the rise, caused amongst others by elevated water temperatures due to global warming.The aim of this review is to summarize the knowledge gained during the past two decades on V. cholerae infections and its occurrence in bathing waters in Austria, with a special focus on the lake Neusiedler See. We investigated whether NTVC infections have increased and which specific environmental conditions favor the occurrence of NTVC. We present an overview of state of the art methods that are currently available for clinical and environmental diagnostics. A preliminary public health risk assessment concerning NTVC infections related to the Neusiedler See was established. In order to raise awareness of healthcare professionals for NTVC infections, typical symptoms, possible treatment options and the antibiotic resistance status of Austrian NTVC isolates are discussed.
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Affiliation(s)
- Carmen Rehm
- Division Water Quality and Health, Karl-Landsteiner University of Health Sciences, Krems, Austria
- Institute for Hygiene and Applied Immunology - Water Microbiology, Medical University Vienna, Vienna, Austria
- Interuniversity Cooperation Centre Water & Health
| | - Claudia Kolm
- Division Water Quality and Health, Karl-Landsteiner University of Health Sciences, Krems, Austria
- Interuniversity Cooperation Centre Water & Health
- Institute for Chemical, Environmental and Bioscience Engineering, Research Group Microbiology and Molecular Diagnostics 166/5/3, Technische Universität Wien, Vienna, Austria
| | - Sonja Pleininger
- Institute for Medical Microbiology and Hygiene, National Reference Centre for Vibrio cholerae, Austrian Agency for Health and Food Safety (AGES), Vienna, Austria
| | - Florian Heger
- Institute for Medical Microbiology and Hygiene, National Reference Centre for Vibrio cholerae, Austrian Agency for Health and Food Safety (AGES), Vienna, Austria
| | - Alexander Indra
- Institute for Medical Microbiology and Hygiene, National Reference Centre for Vibrio cholerae, Austrian Agency for Health and Food Safety (AGES), Vienna, Austria
- Paracelsus Medical University Salzburg, Salzburg, Austria
| | - Georg H Reischer
- Interuniversity Cooperation Centre Water & Health
- Institute for Chemical, Environmental and Bioscience Engineering, Research Group Microbiology and Molecular Diagnostics 166/5/3, Technische Universität Wien, Vienna, Austria
| | - Andreas A H Farnleitner
- Division Water Quality and Health, Karl-Landsteiner University of Health Sciences, Krems, Austria
- Interuniversity Cooperation Centre Water & Health
- Institute for Chemical, Environmental and Bioscience Engineering, Research Group Microbiology and Molecular Diagnostics 166/5/3, Technische Universität Wien, Vienna, Austria
| | - Alexander K T Kirschner
- Division Water Quality and Health, Karl-Landsteiner University of Health Sciences, Krems, Austria.
- Institute for Hygiene and Applied Immunology - Water Microbiology, Medical University Vienna, Vienna, Austria.
- Interuniversity Cooperation Centre Water & Health, .
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Awasthi SP, Chowdhury N, Hatanaka N, Hinenoya A, Ramamurthy T, Asakura M, Yamasaki S. Quantification of Vibrio cholerae cholix exotoxin by sandwich bead-ELISA. J Med Microbiol 2021; 70. [PMID: 33830907 DOI: 10.1099/jmm.0.001311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Introduction. Cholix toxin (ChxA) is an ADP-ribosylating exotoxin produced by Vibrio cholerae. However, to date, there is no quantitative assay available for ChxA, which makes it difficult to detect and estimate the level of ChxA produced by V. cholerae.Hypothesis/Gap Statement. It is important to develop a reliable and specific quantitative assay to measure the production level of ChxA, which will help us to understand the role of ChxA in V. cholerae pathogenesis.Aim. The aim of this study was to develop a bead-based sandwich ELISA (bead-ELISA) for the quantification of ChxA and to evaluate the importance of ChxA in the pathogenesis of V. cholerae infection.Methodology. Anti-rChxA was raised in New Zealand white rabbits, and Fab-horse radish peroxidase conjugate was prepared by the maleimide method to use in the bead-ELISA. This anti-ChxA bead-ELISA was applied to quantify the ChxA produced by various V. cholerae strains. The production of ChxA was examined in different growth media such as alkaline peptone water (APW), Luria-Bertani broth and AKI. Finally, the assay was evaluated using a mouse lethality assay with representative V. cholerae strains categorized as low to high ChxA-producers based on anti-ChxA bead-ELISA.Results. A sensitive bead-ELISA assay, which can quantify from 0.6 to 60 ng ml-1 of ChxA, was developed. ChxA was mostly detected in the extracellular cell-free supernatant and its production level varied from 1.2 ng ml-1 to 1.6 µg ml-1. The highest ChxA production was observed when V. cholerae strains were cultured in LB broth, but not in APW or AKI medium. The ChxA-producer V. cholerae strains showed 20-80 % lethality and only the high ChxA II-producer was statistically more lethal than a non-ChxA-producer, in the mice model assay. ChxA I and II production levels were not well correlated with mice lethality, and this could be due to the heterogeneity of the strains tested.Conclusion. ChxA I to III was produced mostly extracellularly at various levels depending on strains and culture conditions. The bead-ELISA developed in this study is useful for the detection and quantification of ChxA in V. cholerae strains.
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Affiliation(s)
- Sharda Prasad Awasthi
- Graduate School of Life and Environmental Sciences, Osaka Prefecture University, Osaka, Japan
| | - Nityananda Chowdhury
- Present address: Medical University of South Carolina, 173 Ashley Ave., BSB 246, Charleston, SC, USA.,Graduate School of Life and Environmental Sciences, Osaka Prefecture University, Osaka, Japan
| | - Noritoshi Hatanaka
- Graduate School of Life and Environmental Sciences, Osaka Prefecture University, Osaka, Japan
| | - Atsushi Hinenoya
- Graduate School of Life and Environmental Sciences, Osaka Prefecture University, Osaka, Japan
| | | | - Masahiro Asakura
- Graduate School of Life and Environmental Sciences, Osaka Prefecture University, Osaka, Japan
| | - Shinji Yamasaki
- Graduate School of Life and Environmental Sciences, Osaka Prefecture University, Osaka, Japan
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Perepelov AV, Li X, Xu C, Filatov AV, Shashkov AS, Senchenkova SN, Liu B. Structure elucidation and gene cluster characterization of the O-antigen of Vibrio cholerae O14. Carbohydr Res 2019; 474:67-71. [DOI: 10.1016/j.carres.2019.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Revised: 12/31/2018] [Accepted: 01/14/2019] [Indexed: 10/27/2022]
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Awasthi SP, Chowdhury N, Neogi SB, Hinenoya A, Hatanaka N, Chowdhury G, Ramamurthy T, Yamasaki S. Development of a multiplex PCR assay for the detection of major virulence genes in Vibrio cholerae including non-O1 and non-O139 serogroups. J Microbiol Methods 2019; 157:54-58. [DOI: 10.1016/j.mimet.2018.12.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Revised: 12/09/2018] [Accepted: 12/13/2018] [Indexed: 01/29/2023]
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Vibrio cholerae embraces two major evolutionary traits as revealed by targeted gene sequencing. Sci Rep 2018; 8:1631. [PMID: 29374205 PMCID: PMC5785995 DOI: 10.1038/s41598-018-19995-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Accepted: 01/11/2018] [Indexed: 01/27/2023] Open
Abstract
Vibrio cholerae inhabits aquatic environments worldwide and has over 200 recognized serogroups classified by O-polysaccharide specificity. Here, we report that V. cholerae selects either of two genetic traits during their evolution. Sequencing of the specific gene locus MS6_A0927 revealed that 339 of 341 strains of V. cholerae and closely related Vibrio species originating from 34 countries over a century carried either metY (M) (~1,269 bp) or luxR-hchA (LH) (~1,600 bp) genes, and consequently those vibrios were separated into two clusters, M (45.4%) and LH (54.6%). Only two strains contained both M and LH in the same locus. Moreover, extensive polymorphisms in those genes were detected in M and LH with 79 and 46 sequence variations, respectively. V. cholerae O1 strains isolated from cholera outbreaks worldwide, and some non-O1 strains evolving from O1 via exchange of genes encoding cell surface polysaccharides possessed LH alleles. Analysis of polymorphisms in the gene locus implicated a high degree of genetic diversity and identical subpopulations among the V. cholerae species.
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Awasthi SP, Asakura M, Neogi SB, Hinenoya A, Ramamurthy T, Yamasaki S. Development of a PCR-restriction fragment length polymorphism assay for detection and subtyping of cholix toxin variant genes of Vibrio cholerae. J Med Microbiol 2014; 63:667-673. [DOI: 10.1099/jmm.0.070797-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Cholix toxin (ChxA) is an exotoxin reported in Vibrio cholerae non-O1/non-O139. Apart from its prototype (ChxA I) we have recently identified two novel variants of this toxin, ChxA II and ChxA III. Our previous investigations indicated that the first two variants may instigate extra-intestinal infections and ChxA II can be more lethal than ChxA I in mice. However, all three cholix toxins (ChxA I to III) failed to show any enterotoxicity in rabbit ileal loops. In this study we developed a PCR-restriction fragment length polymorphism (RFLP) assay to differentiate all three chxA variants to further understand the importance of each subtype. By using 53 V. cholerae non-O1/non-O139 strains harbouring chxA genes, which were previously categorized by sequencing, and various other strains as negative controls, the PCR-RFLP assay showed 100 % typability and specificity. Furthermore, when applied to differentiate additional V. cholerae strains, which were also screened for the chxA gene by colony hybridization, this assay identified chxA I and chxA II genes among 18.5 % and 4.5 % of non-O1/non-O139 strains (n = 178), respectively. One non-O1/non-O139 strain was untypable due to the insertion of an IS911-like element. Interestingly, the chxA I gene was detected in 10 out of 137 cholera toxin gene-negative V. cholerae O1 strains. These results suggest that the PCR-RFLP assay developed in this study can be a rapid and simple method to differentiate the chxA subtypes.
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Affiliation(s)
- Sharda Prasad Awasthi
- International Prevention of Epidemics, Graduate School of Life and Environmental Sciences, Osaka Prefecture University, Osaka, Japan
| | - Masahiro Asakura
- International Prevention of Epidemics, Graduate School of Life and Environmental Sciences, Osaka Prefecture University, Osaka, Japan
| | - Sucharit Basu Neogi
- Diarrhoeal Disease Epidemiology and Ecology Department, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
- International Prevention of Epidemics, Graduate School of Life and Environmental Sciences, Osaka Prefecture University, Osaka, Japan
| | - Atsushi Hinenoya
- International Prevention of Epidemics, Graduate School of Life and Environmental Sciences, Osaka Prefecture University, Osaka, Japan
| | - T. Ramamurthy
- National Institute of Cholera and Enteric Diseases, Kolkata, India
| | - Shinji Yamasaki
- International Prevention of Epidemics, Graduate School of Life and Environmental Sciences, Osaka Prefecture University, Osaka, Japan
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Distribution of virulence genes in clinical and environmental Vibrio cholerae strains in Bangladesh. Appl Environ Microbiol 2013; 79:5782-5. [PMID: 23872570 DOI: 10.1128/aem.01113-13] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
Vibrio cholerae, an environmental organism, is a facultative human pathogen. Here, we report the virulence profiles, comprising 18 genetic markers, of 102 clinical and 692 environmental V. cholerae strains isolated in Bangladesh between March 2004 and January 2006, showing the variability of virulence determinants within the context of public health.
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Morita M, Yamamoto S, Hiyoshi H, Kodama T, Okura M, Arakawa E, Alam M, Ohnishi M, Izumiya H, Watanabe H. Horizontal gene transfer of a genetic island encoding a type III secretion system distributed inVibrio cholerae. Microbiol Immunol 2013; 57:334-9. [DOI: 10.1111/1348-0421.12039] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2012] [Revised: 12/04/2012] [Accepted: 02/03/2013] [Indexed: 11/29/2022]
Affiliation(s)
- Masatomo Morita
- Department of Bacteriology I; National Institute of Infectious Diseases; Tokyo
| | - Shouji Yamamoto
- Department of Bacteriology I; National Institute of Infectious Diseases; Tokyo
| | - Hirotaka Hiyoshi
- Research Institute for Microbial Diseases; Osaka University; Osaka
| | - Toshio Kodama
- Research Institute for Microbial Diseases; Osaka University; Osaka
| | | | - Eiji Arakawa
- Department of Bacteriology I; National Institute of Infectious Diseases; Tokyo
| | - Munirul Alam
- International Center for Diarrhoeal Disease Research; Bangladesh; Dhaka; Bangladesh
| | - Makoto Ohnishi
- Department of Bacteriology I; National Institute of Infectious Diseases; Tokyo
| | - Hidemasa Izumiya
- Department of Bacteriology I; National Institute of Infectious Diseases; Tokyo
| | - Haruo Watanabe
- Department of Bacteriology I; National Institute of Infectious Diseases; Tokyo
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Novel cholix toxin variants, ADP-ribosylating toxins in Vibrio cholerae non-O1/non-O139 strains, and their pathogenicity. Infect Immun 2012; 81:531-41. [PMID: 23230295 DOI: 10.1128/iai.00982-12] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Cholix toxin (ChxA) is a recently discovered exotoxin in Vibrio cholerae which has been characterized as a third member of the eukaryotic elongation factor 2-specific ADP-ribosyltransferase toxins, in addition to exotoxin A of Pseudomonas aeruginosa and diphtheria toxin of Corynebacterium diphtheriae. These toxins consist of three characteristic domains for receptor binding, translocation, and catalysis. However, there is little information about the prevalence of chxA and its genetic variations and pathogenic mechanisms. In this study, we screened the chxA gene in a large number (n = 765) of V. cholerae strains and observed its presence exclusively in non-O1/non-O139 strains (27.0%; 53 of 196) and not in O1 (n = 485) or O139 (n = 84). Sequencing of these 53 chxA genes generated 29 subtypes which were grouped into three clusters designated chxA I, chxA II, and chxA III. chxA I belongs to the prototype, while chxA II and chxA III are newly discovered variants. ChxA II and ChxA III had unique receptor binding and catalytic domains, respectively, in comparison to ChxA I. Recombinant ChxA I (rChxA I) and rChxA II but not rChxA III showed variable cytotoxic effects on different eukaryotic cells. Although rChxA II was more lethal to mice than rChxA I when injected intravenously, no enterotoxicity of any rChxA was observed in a rabbit ileal loop test. Hepatocytes showed coagulation necrosis in rChxA I- or rChxA II-treated mice, seemingly the major target for ChxA. The present study illustrates the potential of ChxA as an important virulence factor in non-O1/non-O139 V. cholerae, which may be associated with extraintestinal infections rather than enterotoxicity.
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Purdy AE, Balch D, Lizárraga-Partida ML, Islam MS, Martinez-Urtaza J, Huq A, Colwell RR, Bartlett DH. Diversity and distribution of cholix toxin, a novel ADP-ribosylating factor from Vibrio cholerae. ENVIRONMENTAL MICROBIOLOGY REPORTS 2010; 2:198-207. [PMID: 23766017 DOI: 10.1111/j.1758-2229.2010.00139.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Non-toxigenic non-O1, non-O139 Vibrio cholerae strains isolated from both environmental and clinical settings carry a suite of virulence factors aside from cholera toxin. Among V. cholerae strains isolated from coastal waters of southern California, this includes cholix toxin, an ADP-ribosylating factor that is capable of halting protein synthesis in eukaryotic cells. The prevalence of the gene encoding cholix toxin, chxA, was assessed among a collection of 155 diverse V. cholerae strains originating from both clinical and environmental settings in Bangladesh and Mexico and other countries around the globe. The chxA gene was present in 47% of 83 non-O1, non-O139 strains and 16% of 72 O1/O139 strains screened as part of this study. A total of 86 chxA gene sequences were obtained, and phylogenetic analysis revealed that they fall into two distinct clades. These two clades were also observed in the phylogenies of several housekeeping genes, suggesting that the divergence observed in chxA extends to other regions of the V. cholerae genome, and most likely has arisen from vertical descent rather than horizontal transfer. Our results clearly indicate that ChxA is a major toxin of V. cholerae with a worldwide distribution that is preferentially associated with non-pandemic strains.
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Affiliation(s)
- Alexandra E Purdy
- Marine Biology Research Division and Center for Marine Biotechnology and Biomedicine, Scripps Institution of Oceanography, University of California, San Diego, 8750 Biological Grade, La Jolla, CA 92093-0202, USA. Centro de Investigación Científica y de Educación Superior de Ensenada (CICESE), km. 107 Carr, Tijuana-Ensenada, 22860 B.C. México. International Center for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh. Instituto de Acuicultura, Universidad de Santiago de Compostela, Santiago de Compostela, Spain. Maryland Pathogen Research Institute and 7Center for Bioinformatics and Computational Biology, University of Maryland, College Park, MD 20742, USA
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Tobin‐D’Angelo M, Smith A, Bulens S, Thomas S, Hodel M, Izumiya H, Arakawa E, Morita M, Watanabe H, Marin C, Parsons M, Greene K, Cooper K, Haydel D, Bopp C, Yu P, Mintz E. Severe Diarrhea Caused by Cholera Toxin–ProducingVibrio choleraeSerogroup O75 Infections Acquired in the Southeastern United States. Clin Infect Dis 2008; 47:1035-40. [DOI: 10.1086/591973] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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Jørgensen R, Purdy AE, Fieldhouse RJ, Kimber MS, Bartlett DH, Merrill AR. Cholix toxin, a novel ADP-ribosylating factor from Vibrio cholerae. J Biol Chem 2008; 283:10671-8. [PMID: 18276581 DOI: 10.1074/jbc.m710008200] [Citation(s) in RCA: 106] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
The ADP-ribosyltransferases are a class of enzymes that display activity in a variety of bacterial pathogens responsible for causing diseases in plants and animals, including those affecting mankind, such as diphtheria, cholera, and whooping cough. We report the characterization of a novel toxin from Vibrio cholerae, which we call cholix toxin. The toxin is active against mammalian cells (IC(50) = 4.6 +/- 0.4 ng/ml) and crustaceans (Artemia nauplii LD(50) = 10 +/- 2 mug/ml). Here we show that this toxin is the third member of the diphthamide-specific class of ADP-ribose transferases and that it possesses specific ADP-ribose transferase activity against ribosomal eukaryotic elongation factor 2. We also describe the high resolution crystal structures of the multidomain toxin and its catalytic domain at 2.1- and 1.25-A resolution, respectively. The new structural data show that cholix toxin possesses the necessary molecular features required for infection of eukaryotes by receptor-mediated endocytosis, translocation to the host cytoplasm, and inhibition of protein synthesis by specific modification of elongation factor 2. The crystal structures also provide important insight into the structural basis for activation of toxin ADP-ribosyltransferase activity. These results indicate that cholix toxin may be an important virulence factor of Vibrio cholerae that likely plays a significant role in the survival of the organism in an aquatic environment.
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Affiliation(s)
- René Jørgensen
- Department of Molecular and Cellular Biology, University of Guelph, Guelph, Ontario N1G 2W1, Canada
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