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Nateghizad H, Sajadi R, Shivaee A, Shirazi O, Sharifian M, Tadi DA, Amini K. Resistance of Vibrio cholera to antibiotics that inhibit cell wall synthesis: A systematic review and meta-analysis. Front Pharmacol 2023; 14:1027277. [PMID: 37021056 PMCID: PMC10069679 DOI: 10.3389/fphar.2023.1027277] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 01/10/2023] [Indexed: 04/07/2023] Open
Abstract
Objective: Cholera is a challenging ancient disease caused by Vibrio cholera (V. cholera). Antibiotics that prevent cell wall synthesis are among the first known antibiotic groups. Due to its high consumption, V. cholera has developed resistance to the majority of antibiotics in this class. Resistance to recommended antibiotics for the treatment of V. cholera has also increased. In light of the decrease in consumption of certain antibiotics in this group that inhibit cell wall synthesis and the implementation of new antibiotics, it is necessary to determine the antibiotic resistance pattern of V. cholera and to employ the most effective treatment antibiotic. Method: An comprehensive systematic search for relevant articles was conducted in PubMed, Web of Science, Scopus, and EMBASE through October 2020. Stata version 17.1 utilized the Metaprop package to execute a Freeman-Tukey double arcsine transformation in order to estimate weighted pooled proportions. Results: A total of 131 articles were included in the meta-analysis. Ampicillin was the most investigated antibiotic. The prevalence of antibiotic resistance was in order aztreonam (0%), cefepime (0%), imipenem (0%), meropenem (3%), fosfomycin (4%), ceftazidime (5%), cephalothin (7%), augmentin (8%), cefalexin (8%), ceftriaxone (9%), cefuroxime (9%), cefotaxime (15%), cefixime (37%), amoxicillin (42%), penicillin (44%), ampicillin (48%), cefoxitin (50%), cefamandole (56%), polymyxin-B (77%), carbenicillin (95%) respectively. Discussion: Aztreonam, cefepime, and imipenem are the most efficient V. cholera cell wall synthesis inhibitors. There has been an increase in resistance to antibiotics such as cephalothin, ceftriaxone, amoxicillin, and meropenem. Over the years, resistance to penicillin, ceftazidime, and cefotaxime, has decreased.
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Affiliation(s)
- Hossein Nateghizad
- Department of Biology, Faculty of Basic Sciences, East of Tehran Branch, Islamic Azad University, Tehran, Iran
| | - Rojina Sajadi
- Department of Biology, Faculty of Basic Sciences, East of Tehran Branch, Islamic Azad University, Tehran, Iran
| | - Ali Shivaee
- Department of Microbiology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Omid Shirazi
- Department of Veterinary medicine, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Mohadeseh Sharifian
- Department of Veterinary medicine, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Danyal Abbasi Tadi
- Department Of Veterinary, Azad University Of Shahr-E Kord, Shahrekord, Iran
| | - Kumarss Amini
- Department of Microbiology, Saveh Branch, Islamic Azad University, Saveh, Iran
- *Correspondence: Kumarss Amini,
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Yuan XH, Li YM, Vaziri AZ, Kaviar VH, Jin Y, Jin Y, Maleki A, Omidi N, Kouhsari E. Global status of antimicrobial resistance among environmental isolates of Vibrio cholerae O1/O139: a systematic review and meta-analysis. Antimicrob Resist Infect Control 2022; 11:62. [PMID: 35468830 PMCID: PMC9036709 DOI: 10.1186/s13756-022-01100-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 04/11/2022] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Vibrio cholerae O1/O139 were the predominant circulating serogroups exhibiting multi-drug resistance (MDR) during the cholera outbreak which led to cholera treatment failures. OBJECTIVE This meta-analysis aimed to evaluate the weighted pooled resistance (WPR) rates in V. cholerae O1/O139 isolates obtained from environmental samples. METHODS We systematically searched the articles in PubMed, Scopus, and Embase (until January 2020). Subgroup analyses were then employed by publication year, geographic areas, and the quality of studies. Statistical analyses were conducted using STATA software (ver. 14.0). RESULTS A total of 20 studies investigating 648 environmental V. cholerae O1/O139 isolates were analysed. The majority of the studies were originated from Asia (n = 9). In addition, a large number of studies (n = 15 i.e. 71.4%) included in the meta-analysis revealed the resistance to cotrimoxazole and ciprofloxacin. The WPR rates were as follows: cotrimoxazole 59%, erythromycin 28%, tetracycline 14%, doxycycline 5%, and ciprofloxacin 0%. There was increased resistance to nalidixic acid, cotrimoxazole, furazolidone, and tetracycline while a decreased resistance to amoxicillin, ciprofloxacin, erythromycin, chloramphenicol, ampicillin, streptomycin, and ceftriaxone was observed during the years 2000-2020. A significant decrease in the doxycycline and ciprofloxacin-resistance rates in V. cholerae O1/O139 isolates was reported over the years 2011-2020 which represents a decrease in 2001-2010 (p < 0.05). CONCLUSIONS Fluoroquinolones, gentamicin, ceftriaxone, doxycycline, kanamycin, and cefotaxime showed the highest effectiveness and the lowest resistance rate. However, the main interest is the rise of antimicrobial resistance in V. cholerae strains especially in low-income countries or endemic areas, and therefore, continuous surveillance, careful appropriate AST, and limitation on improper antibiotic usage are crucial.
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Affiliation(s)
- Xin-Hui Yuan
- The First Hospital of Lanzhou University, Lanzhou, 730000, China
- Nanjing Children's Hospital Affiliated to Nanjing Medical University, Nanjing, 210008, China
| | - Yu-Mei Li
- The First Hospital of Lanzhou University, Lanzhou, 730000, China
| | - Ali Zaman Vaziri
- Department of Genetics, Faculty of Advanced Science and Technology, Tehran Medical Science, Islamic Azad University, Tehran, Iran
| | - Vahab Hassan Kaviar
- Clinical Microbiology Research Center, Ilam University of Medical Sciences, Ilam, Iran
| | - Yang Jin
- Nanjing Children's Hospital Affiliated to Nanjing Medical University, Nanjing, 210008, China
| | - Yu Jin
- Nanjing Children's Hospital Affiliated to Nanjing Medical University, Nanjing, 210008, China.
| | - Abbas Maleki
- Clinical Microbiology Research Center, Ilam University of Medical Sciences, Ilam, Iran
| | - Nazanin Omidi
- Clinical Microbiology Research Center, Ilam University of Medical Sciences, Ilam, Iran
| | - Ebrahim Kouhsari
- Laboratory Sciences Research Center, Faculty of Paramedical Sciences, Golestan University of Medical Sciences, Gorgan, Iran.
- Department of Laboratory Sciences, Faculty of Paramedicine, Golestan University of Medical Sciences, Gorgan, Iran.
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Narendrakumar L, Theresa M, Krishnankutty Chandrika S, Thomas S. Tryptanthrin, a potential biofilm inhibitor against toxigenic Vibrio cholerae, modulating the global quorum sensing regulator, LuxO. BIOFOULING 2019; 35:1093-1103. [PMID: 31825257 DOI: 10.1080/08927014.2019.1696315] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Revised: 11/12/2019] [Accepted: 11/16/2019] [Indexed: 06/10/2023]
Abstract
Cholera caused by the Gram-negative bacterium Vibrio cholerae still remains a major health burden in developing countries due to its high transmissibility and multidrug resistance. Alternative strategies are in quest to curtail the disease focusing on antivirulent approaches, such as biofilm inhibition, which make bacteria more susceptible to antibiotic therapies. The biofilm state is important for V. cholerae pathogenesis and its persistence in the environment. In the present study, tryptanthrin, a phytochemical, has been identified as possessing strong anti-biofilm activity at sub MIC (2 µg ml-1) against V. cholerae. LuxO was identified as the putative target of tryptanthrin by molecular docking and real time analysis. The phytochemical was identified as safe and possessed synergistic action with ciprofloxacin, a commonly used quinolone antibiotic to treat cholera. Collectively, the study establishes the first report on the anti-biofilm property of tryptanthrin by targeting LuxO, which could serve as a potential antivirulent therapy to combat V. cholerae infections.
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Affiliation(s)
- Lekshmi Narendrakumar
- Cholera and Biofilm Research Laboratory, Rajiv Gandhi Centre for Biotechnology, Thiruvananthapuram, Kerala, India
- Department of Biotechnology, University of Kerala, Thiruvananthapuram, Kerala, India
| | - Mary Theresa
- Cholera and Biofilm Research Laboratory, Rajiv Gandhi Centre for Biotechnology, Thiruvananthapuram, Kerala, India
| | | | - Sabu Thomas
- Cholera and Biofilm Research Laboratory, Rajiv Gandhi Centre for Biotechnology, Thiruvananthapuram, Kerala, India
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Lekshmi N, Joseph I, Ramamurthy T, Thomas S. Changing facades of Vibrio cholerae: An enigma in the epidemiology of cholera. Indian J Med Res 2018; 147:133-141. [PMID: 29806601 PMCID: PMC5991131 DOI: 10.4103/ijmr.ijmr_280_17] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Indexed: 11/06/2022] Open
Abstract
Cholera, caused by the Gram-negative bacterium Vibrio cholerae, has ravaged humanity from time immemorial. Although the disease can be treated using antibiotics along with administration of oral rehydration salts and controlled by good sanitation, cholera is known to have produced mayhems in ancient times when little was known about the pathogen. By the 21st century, ample information about the pathogen, its epidemiology, genetics, treatment and control strategies was revealed. However, there is still fear of cholera outbreaks in developing countries, especially in the wake of natural calamities. Studies have proved that the bacterium is mutating and evolving, out-competing all our efforts to treat the disease with previously used antibiotics and control with existing vaccines. In this review, the major scientific insights of cholera research are discussed. Considering the important role of biofilm formation in the V. cholerae life cycle, the vast availability of next-generation sequencing data of the pathogen and multi-omic approach, the review thrusts on the identification of suitable biofilm-inhibiting targets and the discovery of anti-biofilm drugs from nature to control the disease.
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Affiliation(s)
- N. Lekshmi
- Cholera & Biofilm Research Laboratory, Rajiv Gandhi Centre for Biotechnology, Thiruvananthapuram, India
| | - Iype Joseph
- Cholera & Biofilm Research Laboratory, Rajiv Gandhi Centre for Biotechnology, Thiruvananthapuram, India
| | - T. Ramamurthy
- Center for Human Microbial Ecology, Translational Health Science & Technology Institute, Faridabad, India
| | - Sabu Thomas
- Cholera & Biofilm Research Laboratory, Rajiv Gandhi Centre for Biotechnology, Thiruvananthapuram, India
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Thapa Shrestha U, Adhikari N, Maharjan R, Banjara MR, Rijal KR, Basnyat SR, Agrawal VP. Multidrug resistant Vibrio cholerae O1 from clinical and environmental samples in Kathmandu city. BMC Infect Dis 2015; 15:104. [PMID: 25888391 PMCID: PMC4350293 DOI: 10.1186/s12879-015-0844-9] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2014] [Accepted: 02/19/2015] [Indexed: 11/21/2022] Open
Abstract
Background Cholera, an infectious disease caused by Vibrio cholerae, is a major public health problem and is a particularly burden in developing countries including Nepal. Although the recent worldwide outbreaks of cholera have been due to V. cholerae El Tor, the classical biotypes are still predominant in Nepal. Serogroup O1 of the V. cholerae classical biotype was the primary cause of a cholera outbreak in Kathmandu in 2012. Thus, this study was designed to know serotypes and biotypes of V. cholerae strains causing recent outbreak with reference to drug resistant patterns. Moreover, we also report the toxigenic strains of V. cholerae from both environmental and clinical specimens by detecting the ctx gene. Methods Twenty four V. cholerae (n = 22 from stool samples and n = 2 from water samples) isolated in this study were subjected to Serotyping and biotyping following the standard protocols as described previously. All of the isolates were tested for antimicrobial susceptibility patterns using the modified Kirby-Bauer disk diffusion method as recommended by CLSI guidelines. The screening of the ctx genes (ctxA2-B gene) were performed by PCR method using a pair of primers; C2F (5′-AGGTGTAAAATTCCTTGACGA-3′) and C2R (5′-TCCTCAGGGTATCCTTCATC-3′) to identify the toxigenic strains of V. cholerae. Results Among twenty four V. cholerae isolates, 91.7% were clinical and 8.3% were from water samples. Higher rate of V. cholerae infection was found among adults of aged group 20–30 years. All isolates were serogroups O1 of the V. cholerae classical biotype and sub serotype, Ogawa. All isolates were resistant to ampicillin, nalidixic acid and cotrimoxazole. 90.9% were resistant to erythromycin however, tetracycline was found to be the most effective drug for the isolates. All isolates were multidrug resistant (MDR) and possessed a ctx gene of approximately 400 base pairs indicating the toxigenic strains. Conclusion Hundred percent strains of V. cholerae were MDR possessing a ctx gene. It suggests that toxigenic strains be identified and proper antibiotic susceptibility testing be conducted. This will allow effective empirical therapy to be used to treat and control cholera.
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Affiliation(s)
- Upendra Thapa Shrestha
- Research Laboratory for Biotechnology and Biochemistry (RLABB), Sanepa, Lalitpur, Nepal. .,Department of Microbiology, Kantipur College of Medical Science (KCMS), Sitapaila, KTM, Nepal.
| | - Nabaraj Adhikari
- Department of Microbiology, Kantipur College of Medical Science (KCMS), Sitapaila, KTM, Nepal.
| | - Rojina Maharjan
- Department of Microbiology, Kantipur College of Medical Science (KCMS), Sitapaila, KTM, Nepal.
| | - Megha R Banjara
- Central Department of Microbiology, Tribhuvan University, Kirtipur, KTM, Nepal.
| | - Komal R Rijal
- Central Department of Microbiology, Tribhuvan University, Kirtipur, KTM, Nepal.
| | - Shital R Basnyat
- Department of Microbiology, Kantipur College of Medical Science (KCMS), Sitapaila, KTM, Nepal.
| | - Vishwanath P Agrawal
- Research Laboratory for Biotechnology and Biochemistry (RLABB), Sanepa, Lalitpur, Nepal.
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Bhattacharya MK, Kanungo S, Ramamurthy T, Rajendran K, Sinha A, Bhattacharya A, Sarkar BS. Comparison between Single Dose Azithromycin and Six Doses, 3 Day Norfloxacin for Treatment of Cholera in Adult. INTERNATIONAL JOURNAL OF BIOMEDICAL SCIENCE : IJBS 2014; 10:248-51. [PMID: 25598755 PMCID: PMC4289698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/30/2014] [Accepted: 11/03/2014] [Indexed: 11/04/2022]
Abstract
AIM To evaluate the efficacy of single dose Azithromycin (1 gram) in treatment of cholera in adults. A randomized, controlled clinical trial on 120 adults with acute watery diarrhoea and moderate to severe dehydration compared the efficacy of azithromycin (1 gram) single dose and Norfloxacin (400 mg) twice daily for three days in treating cholera. Data were analysed for 64 patients who were stool culture positive for Vibrio cholerae. In conjunction with rehydration therapy, 32 patients received Azithromycin and 32 patients received Norfloxacin. Patients in the two treatment groups had comparable clinical characteristics on admission. CONCLUSIONS Result shows Azithromycin and Norfloxacin has got almost similar efficacy in reducing stool output, duration of diarrhoea and fluid requirement in cholera positive cases.
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Affiliation(s)
| | - S Kanungo
- National Institute of Cholera & Enteric Disease, Kolkata, India
| | - T Ramamurthy
- National Institute of Cholera & Enteric Disease, Kolkata, India
| | - K Rajendran
- National Institute of Cholera & Enteric Disease, Kolkata, India
| | - A Sinha
- ID & BG Hospital, Kolkata, India
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Abstract
Cholera is a global health problem as several thousands of cases and deaths occur each year. The unique epidemiologic attribute of the disease is its propensity to occur as outbreaks that may flare-up into epidemics, if not controlled. The causative bacterial pathogen Vibrio cholerae prevails in the environment and infects humans whenever there is a breakdown in the public health component. The Indian subcontinent is vulnerable to this disease due its vast coastlines with areas of poor sanitation, unsafe drinking water, and overcrowding. Recently, it was shown that climatic conditions also play a major role in the persistence and spread of cholera. Constant change in the biotypes and serotypes of V. cholerae are also important aspects that changes virulence and survival of the pathogen. Such continuous changes increase the infection ability of the pathogen affecting the susceptible population including the children. The short-term carrier status of V. cholerae has been studied well at community level and this facet significantly contributes to the recurrence of cholera. Several molecular tools recognized altering clonality of V. cholerae in relation with the advent of a serogroup or serotype. Rapid identification systems were formulated for the timely detection of the pathogen so as to identify and control the outbreak and institute proper treatment of the patients. The antimicrobials used in the past are no longer useful in the treatment of cholera as V. cholerae has acquired several mechanisms for multiple antimicrobial resistance. This upsurge in antimicrobial resistance directly influences the management of the disease. This chapter provides an overview of cholera prevalence in India, possible sources of infection, and molecular epidemiology along with antimicrobial resistance of V. cholerae.
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Das S, Goyal R, Ramachandran VJ, Gupta S. Fluoroquinolone resistance inVibrio choleraeO1: emergence of El Tor Inaba. ACTA ACUST UNITED AC 2013; 25:211-2. [PMID: 16156987 DOI: 10.1179/146532805x58157] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Affiliation(s)
- Shukia Das
- Department of Microbiology, University College of Medical Sciences GTB Hospital, Delhi, India
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Mandal J, Dinoop KP, Parija SC. Increasing antimicrobial resistance of Vibrio cholerae OI biotype E1 tor strains isolated in a tertiary-care centre in India. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2012; 30:12-16. [PMID: 22524114 PMCID: PMC3312354 DOI: 10.3329/jhpn.v30i1.11270] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
The antimicrobial susceptibility patterns are on constant change with the recent emergence of multidrug-resistant strains of most bacteria. Results of recent studies in India showed that most isolates of Vibrio cholerae O1 were resistant to the commonly-used antibiotics. The study was conducted to determine the antibiotic susceptibility patterns of V. cholerae O1 isolated during 2008-2010 at the hospital of the Jawaharlal Nehru Institute of Post Graduate Medical Education and Research, Puducherry, India. In total, 154 strains of V. cholerae O1 from 2,658 stool specimens were reported during January 2008-December 2010--34 in 2008, 2 in 2009, and 118 in 2010. The isolates of V. cholerae O1 were subjected to antimicrobial susceptibility testing using the Kirby-Bauer method. The antibiotic disks tested were tetracycline (30 microg), furazolidone (100 microg), ampicillin (10 microg), ceftriaxone (30 microg), and ciprofloxacin (5 microg). Escherichia coli ATCC 25922 was used as the control organism. The minimum inhibitory concentrations (MICs) of ceftriaxone, ciprofloxacin, and tetracycline were determined using the agar dilution method for all the strains. The E-test method was used for the strains which had either intermediate resistance or were resistant to the antibiotics by the agar dilution method. The results of the agar dilution corroborated the results of the E-test. The MIC of ceftriaxone in 151 strains was <2 microg/mL while it was 16 microg/mL in three strains; the latter three strains were resistant to ceftriaxone by the disc-diffusion test. The MIC of ciprofloxacin in 150 strains was <0.5 microg/mL while the MIC of tetracycline was <1 microg/mL. In the remaining four strains, the MIC of tetracycline was >32 microg/mL, and the MIC of ciprofloxacin was >8 microg/mL. These four strains were resistant to both tetracycline and ciprofloxacin by the disc-diffusion test and were exclusive of the three ceftriaxone-resistant strains. The majority of the isolates were obtained from children aged 0-5 year(s)-70.3% (83 of 118) and 41.2% (14 of 34) were reported in 2010 and 2008 respectively. Since treating severe cases of cholera with antibiotics is important, the continuing spread of resistance in V. cholerae to the most important agents of therapy is a matter of concern. Also, chemoprophylaxis with antimicrobial agents is likely to become even more difficult.
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Affiliation(s)
- Jharna Mandal
- Department of Microbiology, Jawaharlal Nehru Institute of Post Graduate Medical Education and Research, Puducherry, India
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Chandralekha C, Veligandla G, Vanaja R. Emergence of Vibrio cholerae Serotype Hikojima in Northern Tamil Nadu. Indian J Community Med 2011; 36:165-6. [PMID: 21976808 PMCID: PMC3180948 DOI: 10.4103/0970-0218.84142] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2010] [Accepted: 05/24/2011] [Indexed: 11/15/2022] Open
Affiliation(s)
- C Chandralekha
- Department of Microbiology, Government Vellore Medical College, Tamil Nadu, India E-mail:
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Genetic determinants of virulence, antibiogram and altered biotype among the Vibrio cholerae O1 isolates from different cholera outbreaks in India. INFECTION GENETICS AND EVOLUTION 2010; 10:815-9. [DOI: 10.1016/j.meegid.2009.06.022] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2009] [Revised: 06/22/2009] [Accepted: 06/26/2009] [Indexed: 11/19/2022]
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Goel AK, Jain M, Kumar P, Jiang SC. Molecular characterization of Vibrio cholerae outbreak strains with altered El Tor biotype from southern India. World J Microbiol Biotechnol 2010; 26:281-287. [DOI: doi 10.1007/s11274-009-0171-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2023]
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Molecular characterization of Vibrio cholerae outbreak strains with altered El Tor biotype from southern India. World J Microbiol Biotechnol 2009; 26:281-287. [PMID: 20495624 PMCID: PMC2872801 DOI: 10.1007/s11274-009-0171-7] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2009] [Accepted: 08/26/2009] [Indexed: 11/03/2022]
Abstract
Forty-four Vibrio cholerae isolates collected over a 7-month period in Chennai, India in 2004 were characterized for gene traits, antimicrobial susceptibility and genomic fingerprints. All 44 isolates were identified as O1 El Tor Ogawa, positive for various toxigenic and pathogenic genes viz. ace, ctxB, hlyA, ompU, ompW, rfbO1, rtx, tcpA, toxR and zot. Nucleotide sequencing revealed the presence of cholera toxin B of classical biotype in all the El Tor isolates, suggesting infection of isolates by classical CTXPhi. Antibiogram analysis showed a broad-spectrum antibiotic resistance that was also confirmed by the presence of resistant genes in the genomes. All isolates contained a class 1 integron and an SXT constin. However, isolates were sensitive to chloramphenicol and tested negative for the chloramphenicol resistant gene suggesting a deletion in SXT constin. Fingerprinting analysis of isolates by ERIC- and Box PCR revealed similar DNA patterns indicating the clonal dissemination of a single predominant V. cholerae O1 strain throughout the 2004 outbreak in Chennai. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1007/s11274-009-0171-7) contains supplementary material, which is available to authorized users.
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Okuda J, Ramamurthy T, Yamasaki S. Antibacterial activity of ciprofloxacin against clinical strains of Vibrio cholerae O139 recently isolated from India. YAKUGAKU ZASSHI 2007; 127:903-4. [PMID: 17473533 DOI: 10.1248/yakushi.127.903] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
We determined the in vitro antibacterial activity of ciprofloxacin against Vibrio cholerae O139 recently isolated from cholera patients in India. Ciprofloxacin showed excellent antibacterial activity against the O139 strains, and ciprofloxacin-resistant O139 strains were not observed. The lack of incidence of ciprofloxacin resistance in O139 strains may be because O139 strains appeared comparatively recently and have not been extensively treated with antibacterial agents including fluoroquinolones.
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Affiliation(s)
- Jun Okuda
- New Product Research Laboratories I, Daiichi Pharmaceutical Co. Ltd., Tokyo, Japan.
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Okuda J, Ramamurthy T, Yamasaki S. The potent antibacterial activity of Sitafloxacin against fluoroquinolone-resistant clinical isolates of Vibrio cholerae O1. Microbiol Immunol 2007; 51:467-9. [PMID: 17446687 DOI: 10.1111/j.1348-0421.2007.tb03921.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The in vitro antibacterial activity of sitafloxacin using clinical isolates of Vibrio cholerae O1 was compared to other fluoroquinolones: ciprofloxacin, ofloxacin, sparfloxacin and levofloxacin. Against fluoroquinolone-resistant O1 strains, sitafloxacin was 4- to 16-fold more effective than other fluoroquinolones at MIC(90*). Against fluoroquinolone-susceptible O1 strains, the MIC(90) of sitafloxacin was 2- to 4-fold lower than other fluoroquinolones. This suggests sitafloxacin can be used in the treatment of infections caused by V. cholerae O1 strains including the fluoroquinolone-resistant strains.
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Affiliation(s)
- Jun Okuda
- New Product Research Laboratories I, Daiichi Pharmaceutical Co Ltd, Tokyo, Japan.
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Abstract
Intestinal infection with Vibrio cholerae results in the loss of large volumes of watery stool, leading to severe and rapidly progressing dehydration and shock. Without adequate and appropriate rehydration therapy, severe cholera kills about half of affected individuals. Cholera toxin, a potent stimulator of adenylate cyclase, causes the intestine to secrete watery fluid rich in sodium, bicarbonate, and potassium, in volumes far exceeding the intestinal absorptive capacity. Cholera has spread from the Indian subcontinent where it is endemic to involve nearly the whole world seven times during the past 185 years. V cholerae serogroup O1, biotype El Tor, has moved from Asia to cause pandemic disease in Africa and South America during the past 35 years. A new serogroup, O139, appeared in south Asia in 1992, has become endemic there, and threatens to start the next pandemic. Research on case management of cholera led to the development of rehydration therapy for dehydrating diarrhoea in general, including the proper use of intravenous and oral rehydration solutions. Appropriate case management has reduced deaths from diarrhoeal disease by an estimated 3 million per year compared with 20 years ago. Vaccination was thought to have no role for cholera, but new oral vaccines are showing great promise.
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Affiliation(s)
- David A Sack
- International Centre for Diarrhoeal Disease Research, Bangladesh, Centre for Health and Population Research, Dhaka, Bangladesh.
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Oldfield EC, Wallace MR. The role of antibiotics in the treatment of infectious diarrhea. Gastroenterol Clin North Am 2001; 30:817-36. [PMID: 11586559 DOI: 10.1016/s0889-8553(05)70212-0] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Abstract
Infectious diarrhea is a significant cause of morbidity and mortality and a common complaint in clinical practice. Routine empirical use of antibiotics for infectious diarrhea should be avoided because of the self-limited nature of most cases, the cost of antibiotics, and the potential to worsen the already significant problem of antibiotic resistance of enteric pathogens. For patients with severe invasive or prolonged diarrhea or who are at high risk of complications, such as the elderly, diabetics, cirrhotics, and immunocompromised patients, empirical treatment with a quinolone antibiotic for 3 to 5 days can be considered. Antibiotic treatment can be highly effective for Shigella, ETEC, and V. cholerae infections, and metronidazole is indicated for C. difficile colitis. The impact of antibiotics for other specific pathogens is modest, and antibiotic therapy should be reserved for the same group of patients who would be considered for empirical treatment. The most significant problem in the antibiotic treatment of infectious diarrhea is the progressive increase in resistance among enteric pathogens; only the prudent use of antimicrobials in all areas of daily practice can limit or delay the impact of this serious problem.
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Affiliation(s)
- E C Oldfield
- Infectious Disease Division, Department of Medicine, Eastern Virginia Medical School, Norfolk, Virginia, USA
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Garg P, Sinha S, Chakraborty R, Bhattacharya SK, Nair GB, Ramamurthy T, Takeda Y. Emergence of fluoroquinolone-resistant strains of Vibrio cholerae O1 biotype El Tor among hospitalized patients with cholera in Calcutta, India. Antimicrob Agents Chemother 2001; 45:1605-6. [PMID: 11372642 PMCID: PMC90520 DOI: 10.1128/aac.45.5.1605-1606.2001] [Citation(s) in RCA: 57] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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