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Bhandari M, Jennison AV, Rathnayake IU, Huygens F. Evolution, distribution and genetics of atypical Vibrio cholerae - A review. INFECTION GENETICS AND EVOLUTION 2021; 89:104726. [PMID: 33482361 DOI: 10.1016/j.meegid.2021.104726] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 01/07/2021] [Accepted: 01/15/2021] [Indexed: 12/21/2022]
Abstract
Vibrio cholerae is the etiological agent of cholera, a severe diarrheal disease, which can occur as either an epidemic or sporadic disease. Cholera pandemic-causing V. cholerae O1 and O139 serogroups originated from the Indian subcontinent and spread globally and millions of lives are lost each year, mainly in developing and underdeveloped countries due to this disease. V. cholerae O1 is further classified as classical and El Tor biotype which can produce biotype specific cholera toxin (CT). Since 1961, the current seventh pandemic El Tor strains replaced the sixth pandemic strains resulting in the classical biotype strain that produces classical CT. The ongoing evolution of Atypical El Tor V. cholerae srains encoding classical CT is of global concern. The severity in the pathophysiology of these Atypical El Tor strains is significantly higher than El Tor or classical strains. Pathogenesis of V. cholerae is a complex process that involves coordinated expression of different sets of virulence-associated genes to cause disease. We are yet to understand the complete virulence profile of V. cholerae, including direct and indirect expression of genes involved in its survival and stress adaptation in the host. In recent years, whole genome sequencing has paved the way for better understanding of the evolution and strain distribution, outbreak identification and pathogen surveillance for the implementation of direct infection control measures in the clinic against many infectious pathogens including V. cholerae. This review provides a synopsis of recent studies that have contributed to the understanding of the evolution, distribution and genetics of the seventh pandemic Atypical El Tor V. cholerae strains.
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Affiliation(s)
- Murari Bhandari
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia; Public Health Microbiology, Forensic and Scientific Services, Queensland Department of Health, Brisbane, QLD, Australia
| | - Amy V Jennison
- Public Health Microbiology, Forensic and Scientific Services, Queensland Department of Health, Brisbane, QLD, Australia
| | - Irani U Rathnayake
- Public Health Microbiology, Forensic and Scientific Services, Queensland Department of Health, Brisbane, QLD, Australia
| | - Flavia Huygens
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia.
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Morita M, Okada K, Yamashiro T, Sekizuka T, Roobthaisong A, Wongboot W, Chantaroj S, Tu ND, Xangsayarath P, Sithivong N, Noilath K, Vongdouangchanh A, Kuroda M, Hamada S, Izumiya H, Ohnssishi M. Phylogenetic Analysis Revealed the Dissemination of Closely Related Epidemic Vibrio cholerae O1 Isolates in Laos, Thailand, and Vietnam. Open Forum Infect Dis 2020; 7:ofaa492. [PMID: 33244479 PMCID: PMC7679066 DOI: 10.1093/ofid/ofaa492] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 10/13/2020] [Indexed: 11/24/2022] Open
Abstract
We performed whole-genome sequencing of Vibrio cholerae O1 isolates from Laos, Thailand, and Vietnam, where cholera outbreaks occurred, to determine their genetic lineages. Core genome phylogenetic analysis revealed that the isolates located in same lineage without regional clusters, which suggests that closely related strains circulated in Southeast Asia.
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Affiliation(s)
- Masatomo Morita
- Department of Bacteriology I, National Institute of Infectious Diseases, Tokyo, Japan
| | - Kazuhisa Okada
- Thailand-Japan Research Collaboration Center on Emerging and Re-emerging Infections, Nonthaburi, Thailand.,Research Institute for Microbial Diseases, Osaka University, Osaka, Japan
| | - Tetsu Yamashiro
- Department of Bacteriology, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan.,Nagasaki University, Nagasaki, Japan
| | - Tsuyoshi Sekizuka
- Pathogen Genomics Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Amonrattana Roobthaisong
- Thailand-Japan Research Collaboration Center on Emerging and Re-emerging Infections, Nonthaburi, Thailand
| | - Warawan Wongboot
- Thailand-Japan Research Collaboration Center on Emerging and Re-emerging Infections, Nonthaburi, Thailand.,National Institute of Health, Department of Medical Sciences, Ministry Public Health, Nonthaburi, Thailand
| | - Siriporn Chantaroj
- National Institute of Health, Department of Medical Sciences, Ministry Public Health, Nonthaburi, Thailand
| | - Nguyen Dong Tu
- Bacteriology Department, National Institute of Hygiene and Epidemiology, Hanoi, Vietnam
| | | | - Noikaseumsy Sithivong
- National Center for Laboratory and Epidemiology, Vientiane, Lao People's Democratic Republic
| | - Khambai Noilath
- National Center for Laboratory and Epidemiology, Vientiane, Lao People's Democratic Republic
| | | | - Makoto Kuroda
- Pathogen Genomics Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Shigeyuki Hamada
- Research Institute for Microbial Diseases, Osaka University, Osaka, Japan
| | - Hidemasa Izumiya
- Department of Bacteriology I, National Institute of Infectious Diseases, Tokyo, Japan
| | - Makoto Ohnssishi
- Department of Bacteriology I, National Institute of Infectious Diseases, Tokyo, Japan
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Rijal N, Acharya J, Adhikari S, Upadhaya BP, Shakya G, Kansakar P, Rajbhandari P. Changing epidemiology and antimicrobial resistance in Vibrio cholerae: AMR surveillance findings (2006-2016) from Nepal. BMC Infect Dis 2019; 19:801. [PMID: 31510925 PMCID: PMC6739981 DOI: 10.1186/s12879-019-4432-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Accepted: 08/30/2019] [Indexed: 11/24/2022] Open
Abstract
Background In Nepal, cases of Cholera occur annually either as sporadic or as outbreaks claiming the lives of many in rural areas. The present study is a laboratory based surveillance which aims to analyze the changing epidemiology and antimicrobial susceptibility trend of V. cholerae strains isolated or referred to National Public Health Laboratory (NPHL) over a period of 11 years (2006–2016). Methods Specimens of fresh stool /rectal swab either received at sentinel sites or NPHL were processed following standard microbiological techniques. Suspected colonies on selective medium were identified using routine biochemical tests and confirmed by serotyping. Antimicrobial susceptibility testing was performed following Kirby Baeur disc diffusion method. Results Of the 836 confirmed isolates, 87% (728/836) were V.cholerae O1 Ogawa,12% (103/836) were V.cholerae O1 Inaba and only 6 isolates were V.cholerae O1 Hikojima. In 2006 all the Vibrio isolates were of Inaba serotype, followed by all 3 serotypes during 2007.During 2008–2014 only Ogawa serotype was isolated while few cases of Inaba again surfaced in 2015. Resistance to ampicillin decreased from 93% in 2006 to 18% by 2010 and again raised to 100% by 2016.Cotrimoxazole resistance remained at constant range (77–100%).Nalidixic acid resistance was 100% since 2006.Ciprofloxacin and tetracycline resistance emerged in 2007, reached a peak during 2010–2012 and declined to 0 by 2016.Susceptibility to Furazolidone has re-emerged.63.6% of the isolates were Multi drug resistant. Conclusion With changing epidemiology and antibiogram of V.cholerae in Nepal, the present study reflects the importance of continuous monitoring, which could be used by policy makers and health professionals for better management of outbreaks. Decline in tetracycline and ciprofloxacin resistance along with emerging sensitivity to furazolidone shows that these drugs could make an effective comeback in future.
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Affiliation(s)
- Nisha Rijal
- National Public Health Laboratory, Kathmandu, Nepal.
| | | | | | | | - Geeta Shakya
- National Public Health Laboratory, Kathmandu, Nepal
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Roobthaisong A, Okada K, Htun N, Aung WW, Wongboot W, Kamjumphol W, Han AA, Yi Y, Hamada S. Molecular Epidemiology of Cholera Outbreaks during the Rainy Season in Mandalay, Myanmar. Am J Trop Med Hyg 2017; 97:1323-1328. [PMID: 28820711 DOI: 10.4269/ajtmh.17-0296] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Cholera, caused by Vibrio cholerae, remains a global threat to public health. In Myanmar, the availability of published information on the occurrence of the disease is scarce. We report here that cholera incidence in Mandalay generally exhibited a single annual peak, with an annual average of 312 patients with severe dehydration over the past 5 years (since 2011) and was closely associated with the rainy season. We analyzed cholera outbreaks, characterized 67 isolates of V. cholerae serogroup O1 in 2015 from patients from Mandalay, and compared them with 22 V. cholerae O1 isolates (12 from Mandalay and 10 from Yangon) in 2014. The isolates carried the classical cholera toxin B subunit (ctxB), the toxin-coregulated pilus A (tcpA) of Haitian type, and repeat sequence transcriptional regulator (rstR) of El Tor type. Two molecular typing methods, pulsed-field gel electrophoresis and multiple-locus variable-number tandem repeat analysis (MLVA), differentiated the 89 isolates into seven pulsotypes and 15 MLVA profiles. Pulsotype Y15 and one MLVA profile (11, 7, 7, 16, 7) were predominantly found in the isolates from cholera outbreaks in Mandalay, 2015. Pulsotypes Y11, Y12, and Y15 with some MLVA profiles were detected in the isolates from two remote areas, Mandalay and Yangon, with temporal changes. These data suggested that cholera spread from the seaside to the inland area in Myanmar.
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Affiliation(s)
- Amonrattana Roobthaisong
- Section of Bacterial Infections, Thailand-Japan Research Collaboration Center on Emerging and Re-emerging Infections, Nonthaburi, Thailand
| | - Kazuhisa Okada
- Section of Bacterial Infections, Thailand-Japan Research Collaboration Center on Emerging and Re-emerging Infections, Nonthaburi, Thailand.,Research Institute for Microbial Diseases, Osaka University, Osaka, Japan
| | - Nilar Htun
- University of Medicine, Mandalay, Myanmar
| | - Wah Wah Aung
- Advanced Molecular Research Centre, Department of Medical Research, Yangon, Myanmar
| | - Warawan Wongboot
- Section of Bacterial Infections, Thailand-Japan Research Collaboration Center on Emerging and Re-emerging Infections, Nonthaburi, Thailand
| | - Watcharaporn Kamjumphol
- Section of Bacterial Infections, Thailand-Japan Research Collaboration Center on Emerging and Re-emerging Infections, Nonthaburi, Thailand
| | | | - Yi Yi
- Public Health Laboratory, Mandalay, Myanmar
| | - Shigeyuki Hamada
- Research Institute for Microbial Diseases, Osaka University, Osaka, Japan
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Nguyen DT, Ngo TC, Le TH, Nguyen HT, Morita M, Arakawa E, Ohnishi M, Nguyen BM, Izumiya H. Molecular epidemiology of Vibrio cholerae O1 in northern Vietnam (2007-2009), using multilocus variable-number tandem repeat analysis. J Med Microbiol 2016; 65:1007-1012. [PMID: 27452304 DOI: 10.1099/jmm.0.000317] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Cholera is an infectious disease of major concern in Vietnam and other Asian countries. In 2009, there was a large outbreak of cholera in northern Vietnam. To investigate relationships among isolates of the causative pathogen Vibrio cholerae in this region since 2007, we carried out a multilocus variable-number tandem repeat analysis (MLVA) of 170 isolates collected between 2007 and 2009. A total of 24 MLVA types were identified using seven loci. Five clones (1-5) were identified using five loci of the large V. cholerae chromosome; clones 1 and 2 were major, and the others were minor. Clone 1 isolates were responsible for the 2009 outbreak. A shift in the predominant clone occurred between 2007 and 2009, with clone 1 likely derived from clone 2. Moreover, the former was less diverse than the latter, suggesting a single source of cholera dissemination. Epidemiological data indicated a wavelet prior to the large outbreak, suggesting that drinking water source or food chain became contaminated during dissemination. Our results reveal the utility of MLVA for analysis of V. cholerae isolates within a relatively short period and broaden our understanding of its transmission and response to cholera.
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Affiliation(s)
- Dong Tu Nguyen
- Department of Bacteriology, National Institute for Hygiene and Epidemiology, Hanoi, Vietnam
| | - Tuan Cuong Ngo
- Department of Bacteriology, National Institute for Hygiene and Epidemiology, Hanoi, Vietnam
| | - Thanh Huong Le
- Department of Bacteriology, National Institute for Hygiene and Epidemiology, Hanoi, Vietnam
| | - Hoai Thu Nguyen
- Department of Bacteriology, National Institute for Hygiene and Epidemiology, Hanoi, Vietnam
| | - Masatomo Morita
- Department of Bacteriology I, National Institute of Infectious Diseases, Tokyo 162-8640, Japan
| | - Eiji Arakawa
- Department of Bacteriology I, National Institute of Infectious Diseases, Tokyo 162-8640, Japan
| | - Makoto Ohnishi
- Department of Bacteriology I, National Institute of Infectious Diseases, Tokyo 162-8640, Japan
| | - Binh Minh Nguyen
- Department of Bacteriology, National Institute for Hygiene and Epidemiology, Hanoi, Vietnam
| | - Hidemasa Izumiya
- Department of Bacteriology I, National Institute of Infectious Diseases, Tokyo 162-8640, Japan
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Vibrio cholerae O1 El Tor from southern Vietnam in 2010 was molecularly distinct from that present from 1999 to 2004. Epidemiol Infect 2015; 144:1241-7. [PMID: 26554547 DOI: 10.1017/s0950268815002617] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
The Vibrio cholerae O1 (VCO1) El Tor biotype appeared during the seventh cholera pandemic starting in 1961, and new variants of this biotype have been identified since the early 1990s. This pandemic has affected Vietnam, and a large outbreak was reported in southern Vietnam in 2010. Pulsed-field gel electrophoresis (PFGE) and multilocus variable-number tandem-repeat analyses (MLVA) were used to screen 34 VCO1 isolates from the southern Vietnam 2010 outbreak (23 patients, five contact persons, and six environmental isolates) to determine if it was genetically distinct from 18 isolates from outbreaks in southern Vietnam from 1999 to 2004, and two isolates from northern Vietnam (2008). Twenty-seven MLVA types and seven PFGE patterns were identified. Both analyses showed that the 2008 and 2010 isolates were distinctly clustered and separated from the 1999-2004 isolates.
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Kim EJ, Lee CH, Nair GB, Kim DW. Whole-genome sequence comparisons reveal the evolution of Vibrio cholerae O1. Trends Microbiol 2015; 23:479-89. [DOI: 10.1016/j.tim.2015.03.010] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2015] [Revised: 03/23/2015] [Accepted: 03/31/2015] [Indexed: 12/20/2022]
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Ratanasuwan W, Kim YH, Sah BK, Suwanagool S, Kim DR, Anekthananon A, Lopez AL, Techasathit W, Grahek SL, Clemens JD, Wierzba TF. Peru-15 (Choleragarde(®)), a live attenuated oral cholera vaccine, is safe and immunogenic in human immunodeficiency virus (HIV)-seropositive adults in Thailand. Vaccine 2015; 33:4820-6. [PMID: 26241948 DOI: 10.1016/j.vaccine.2015.07.073] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2015] [Revised: 07/21/2015] [Accepted: 07/23/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND Many areas with endemic and epidemic cholera report significant levels of HIV transmission. According to the World Health Organization (WHO), over 95% of reported cholera cases occur in Africa, which also accounts for nearly 70% of people living with HIV/AIDS globally. Peru-15, a promising single dose live attenuated oral cholera vaccine (LA-OCV), was previously found to be safe and immunogenic in cholera endemic areas. However, no data on the vaccine's safety among HIV-seropositive adults had been collected. METHODS This study was a double-blinded, individually randomized, placebo-controlled trial enrolling HIV-seropositive adults, 18-45 years of age, conducted in Bangkok, Thailand, to assess the safety of Peru-15 in a HIV-seropositive cohort. RESULTS 32 HIV infected subjects were randomized to receive either a single oral dose of the Peru-15 vaccine with a buffer or a placebo (buffer only). No serious adverse events were reported during the follow-up period in either group. The geometric mean fold (GMF) rise in V. cholerae O1 El Tor specific antibody titers between baseline and 7 days after dosing was 32.0 (p<0.001) in the vaccine group compared to 1.6 (p<0.14) in the placebo group. Among the 16 vaccinees,14 vaccinees (87.5%) had seroconversion compared to 1 of 16 placebo recipients (6.3%). V. cholerae was isolated from the stool of one vaccinee, and found to be genetically identical to the Peru-15 vaccine strain. There were no significant changes in HIV viral load or CD4 T-cell counts between vaccine and placebo groups. CONCLUSION Peru-15 was shown to be safe and immunogenic in HIV-seropositive Thai adults.
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Affiliation(s)
- W Ratanasuwan
- Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Y H Kim
- International Vaccine Institute, Seoul, Republic of Korea.
| | - B K Sah
- International Vaccine Institute, Seoul, Republic of Korea
| | - S Suwanagool
- Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - D R Kim
- International Vaccine Institute, Seoul, Republic of Korea
| | | | - A L Lopez
- University of the Philippines Manila - National Institutes of Health, Manila, Philippines
| | - W Techasathit
- Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - S L Grahek
- The George Washington University School of Medicine and Health Sciences, Washington, DC, United States; Sabin Vaccine Institute, Washington, DC, United States
| | - J D Clemens
- International Center for Diarrheal Disease Research, Dhaka, Bangladesh
| | - T F Wierzba
- International Vaccine Institute, Seoul, Republic of Korea
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Dixit SM, Johura FT, Manandhar S, Sadique A, Rajbhandari RM, Mannan SB, Rashid MU, Islam S, Karmacharya D, Watanabe H, Sack RB, Cravioto A, Alam M. Cholera outbreaks (2012) in three districts of Nepal reveal clonal transmission of multi-drug resistant Vibrio cholerae O1. BMC Infect Dis 2014; 14:392. [PMID: 25022982 PMCID: PMC4223374 DOI: 10.1186/1471-2334-14-392] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2013] [Accepted: 07/11/2014] [Indexed: 11/23/2022] Open
Abstract
Background Although endemic cholera causes significant morbidity and mortality each year in Nepal, lack of information about the causal bacterium often hinders cholera intervention and prevention. In 2012, diarrheal outbreaks affected three districts of Nepal with confirmed cases of mortality. This study was designed to understand the drug response patterns, source, and transmission of Vibrio cholerae associated with 2012 cholera outbreaks in Nepal. Methods V. cholerae (n = 28) isolated from 2012 diarrhea outbreaks {n = 22; Kathmandu (n = 12), Doti (n = 9), Bajhang (n = 1)}, and surface water (n = 6; Kathmandu) were tested for antimicrobial response. Virulence properties and DNA fingerprinting of the strains were determined by multi-locus genetic screening employing polymerase chain reaction, DNA sequencing, and pulsed-field gel electrophoresis (PFGE). Results All V. cholerae strains isolated from patients and surface water were confirmed to be toxigenic, belonging to serogroup O1, Ogawa serotype, biotype El Tor, and possessed classical biotype cholera toxin (CTX). Double-mismatch amplification mutation assay (DMAMA)-PCR revealed the V. cholerae strains to possess the B-7 allele of ctx subunit B. DNA sequencing of tcpA revealed a point mutation at amino acid position 64 (N → S) while the ctxAB promoter revealed four copies of the tandem heptamer repeat sequence 5'-TTTTGAT-3'. V. cholerae possessed all the ORFs of the Vibrio seventh pandemic island (VSP)-I but lacked the ORFs 498–511 of VSP-II. All strains were multidrug resistant with resistance to trimethoprim-sulfamethoxazole (SXT), nalidixic acid (NA), and streptomycin (S); all carried the SXT genetic element. DNA sequencing and deduced amino acid sequence of gyrA and parC of the NAR strains (n = 4) revealed point mutations at amino acid positions 83 (S → I), and 85 (S → L), respectively. Similar PFGE (NotI) pattern revealed the Nepalese V. cholerae to be clonal, and related closely with V. cholerae associated with cholera in Bangladesh and Haiti. Conclusions In 2012, diarrhea outbreaks in three districts of Nepal were due to transmission of multidrug resistant V. cholerae El Tor possessing cholera toxin (ctx) B-7 allele, which is clonal and related closely with V. cholerae associated with cholera in Bangladesh and Haiti.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | - Munirul Alam
- International Centre for Diarrheal Disease Research, GPO Box 128, 1000 Dhaka, Bangladesh.
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Okada K, Na-Ubol M, Natakuathung W, Roobthaisong A, Maruyama F, Nakagawa I, Chantaroj S, Hamada S. Comparative genomic characterization of a Thailand-Myanmar isolate, MS6, of Vibrio cholerae O1 El Tor, which is phylogenetically related to a "US Gulf Coast" clone. PLoS One 2014; 9:e98120. [PMID: 24887199 PMCID: PMC4045137 DOI: 10.1371/journal.pone.0098120] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2014] [Accepted: 04/29/2014] [Indexed: 12/17/2022] Open
Abstract
Background The cholera outbreaks in Thailand during 2007–2010 were exclusively caused by the Vibrio cholerae O1 El Tor variant carrying the cholera toxin gene of the classical biotype. We previously isolated a V. cholerae O1 El Tor strain from a patient with diarrhea and designated it MS6. Multilocus sequence-typing analysis revealed that MS6 is most closely related to the U. S. Gulf Coast clone with the exception of two novel housekeeping genes. Methodology/Principal Findings The nucleotide sequence of the genome of MS6 was determined and compared with those of 26 V. cholerae strains isolated from clinical and environmental sources worldwide. We show here that the MS6 isolate is distantly related to the ongoing seventh pandemic V. cholerae O1 El Tor strains. These strains differ with respect to polymorphisms in housekeeping genes, seventh pandemic group-specific markers, CTX phages, two genes encoding predicted transmembrane proteins, the presence of metY (MS6_A0927) or hchA/luxR in a highly conserved region of the V. cholerae O1 serogroup, and a superintegron (SI). We found that V. cholerae species carry either hchA/luxR or metY and that the V. cholerae O1 clade commonly possesses hchA/luxR, except for MS6 and U. S. Gulf Coast strains. These findings illuminate the evolutionary relationships among V. cholerae O1 strains. Moreover, the MS6 SI carries a quinolone-resistance gene cassette, which was closely related with those present in plasmid-borne integrons of other gram-negative bacteria. Conclusions/Significance Phylogenetic analysis reveals that MS6 is most closely related to a U. S. Gulf Coast clone, indicating their divergence before that of the El Tor biotype strains from a common V. cholerae O1 ancestor. We propose that MS6 serves as an environmental aquatic reservoir of V. cholerae O1.
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Affiliation(s)
- Kazuhisa Okada
- Thailand–Japan Research Collaboration Center on Emerging and Re-emerging Infections (RCC-ERI), Nonthaburi, Thailand
- Research Institute for Microbial Diseases, Osaka University, Suita, Osaka, Japan
- * E-mail:
| | - Mathukorn Na-Ubol
- Thailand–Japan Research Collaboration Center on Emerging and Re-emerging Infections (RCC-ERI), Nonthaburi, Thailand
| | - Wirongrong Natakuathung
- Thailand–Japan Research Collaboration Center on Emerging and Re-emerging Infections (RCC-ERI), Nonthaburi, Thailand
| | - Amonrattana Roobthaisong
- Thailand–Japan Research Collaboration Center on Emerging and Re-emerging Infections (RCC-ERI), Nonthaburi, Thailand
| | - Fumito Maruyama
- Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Ichiro Nakagawa
- Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Siriporn Chantaroj
- National Institute of Health, Department of Medical Sciences (DMSc), Ministry of Public Health, Nonthaburi, Thailand
| | - Shigeyuki Hamada
- Thailand–Japan Research Collaboration Center on Emerging and Re-emerging Infections (RCC-ERI), Nonthaburi, Thailand
- Research Institute for Microbial Diseases, Osaka University, Suita, Osaka, Japan
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Saidi SM, Chowdhury N, Awasthi SP, Asakura M, Hinenoya A, Iijima Y, Yamasaki S. Prevalence of Vibrio cholerae O1 El Tor variant in a cholera-endemic zone of Kenya. J Med Microbiol 2014; 63:415-420. [PMID: 24396087 DOI: 10.1099/jmm.0.068999-0] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Since 2007, Kenya has experienced an increase in cholera outbreaks characterized by a high fatality rate. In this study, we characterized 81 Vibrio cholerae isolates from diarrhoeal stool samples in Nyanza, a cholera-endemic lake region of Kenya, for virulence properties, clonality and antibiotic susceptibility. Eighty of these isolates were V. cholerae O1 El Tor variants carrying the classical ctxB gene sequence, while one isolate was V. cholerae non-O1/O139. All of the El Tor variants were of clonal origin, as revealed by PFGE, and were susceptible to ampicillin, tetracycline, ciprofloxacin, fosfomycin, kanamycin and norfloxacin. However, the isolates showed resistance to sulfamethoxazole/trimethoprim and streptomycin, and intermediate resistance to nalidixic acid, chloramphenicol and imipenem. The non-O1/O139 isolate carried the cholix toxin II gene (chxA II) and was susceptible to all antimicrobials tested except ampicillin. We propose that an El Tor variant clone caused the Nyanza cholera outbreak of 2007-2008.
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Affiliation(s)
- Suleiman M Saidi
- Medical Sciences Department, Technical University of Mombasa, Mombasa, Kenya.,International Prevention of Epidemics, Graduate School of Life and Environmental Sciences, Osaka Prefecture University, Osaka, Japan
| | - Nityananda Chowdhury
- International Prevention of Epidemics, Graduate School of Life and Environmental Sciences, Osaka Prefecture University, Osaka, Japan
| | - Sharda P 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
| | - Atsushi Hinenoya
- International Prevention of Epidemics, Graduate School of Life and Environmental Sciences, Osaka Prefecture University, Osaka, Japan
| | | | - Shinji Yamasaki
- International Prevention of Epidemics, Graduate School of Life and Environmental Sciences, Osaka Prefecture University, Osaka, Japan
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Abstract
This chapter highlights the cholera situation in South Asia and the Bay of Bengal region, the original 'homeland' of cholera. A detailed discussion of cholera outbreaks in individual countries in South-East Asia follows. The countries of the World Health Organization (WHO) SEARO (South-East Asia Region) region are discussed first, followed by discussions about the other countries in South-East Asia that do not fall within the purview of the WHO SEARO classification of the member countries of the region. Therefore, the chapter attempts to provide a comprehensive yet precise outline of the major cholera outbreaks that have occurred in the region over the years.
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Chomvarin C, Johura FT, Mannan SB, Jumroenjit W, Kanoktippornchai B, Tangkanakul W, Tantisuwichwong N, Huttayananont S, Watanabe H, Hasan NA, Huq A, Cravioto A, Colwell RR, Alam M. Drug response and genetic properties of Vibrio cholerae associated with endemic cholera in north-eastern Thailand, 2003-2011. J Med Microbiol 2013; 62:599-609. [PMID: 23319310 DOI: 10.1099/jmm.0.053801-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Cholera, caused by Vibrio cholerae, results in significant morbidity and mortality worldwide, including Thailand. Representative V. cholerae strains associated with endemic cholera (n = 32), including strains (n = 3) from surface water sources, in Khon Kaen, Thailand (2003-2011), were subjected to microbiological, molecular and phylogenetic analyses. According to phenotypic and related genetic data, all tested V. cholerae strains belonged to serogroup O1, biotype El Tor (ET), Inaba (IN) or Ogawa (OG). All of the strains were sensitive to gentamicin and ciprofloxacin, while multidrug-resistant (MDR) strains showing resistance to erythromycin, tetracycline, trimethoprim/sulfamethoxazole and ampicillin were predominant in 2007. V. cholerae strains isolated before and after 2007 were non-MDR. All except six diarrhoeal strains possessed ctxA and ctxB genes and were toxigenic altered ET, confirmed by MAMA-PCR and DNA sequencing. Year-wise data revealed that V. cholerae INET strains isolated between 2003 and 2004, plus one strain isolated in 2007, lacked the RS1 sequence (rstC) and toxin-linked cryptic plasmid (TLC)-specific genetic marker, but possessed CTX(CL) prophage genes ctxB(CL) and rstR(CL). A sharp genetic transition was noted, namely the majority of V. cholerae strains in 2007 and all in 2010 and 2011 were not repressor genotype rstR(CL) but instead were rstR(ET), and all ctx(+) strains possessed RS1 and TLC-specific genetic markers. DNA sequencing data revealed that strains isolated since 2007 had a mutation in the tcpA gene at amino acid position 64 (N→S). Four clonal types, mostly of environmental origin, including subtypes, reflected genetic diversity, while distinct signatures were observed for clonally related, altered ET from Thailand, Vietnam and Bangladesh, confirmed by distinct subclustering patterns observed in the PFGE (NotI)-based dendrogram, suggesting that endemic cholera is caused by V. cholerae indigenous to Khon Kaen.
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Affiliation(s)
- Chariya Chomvarin
- Department of Microbiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Fatema-Tuz Johura
- Center for Food and Waterborne Disease, International Center for Diarrheal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Shahnewaj B Mannan
- Center for Food and Waterborne Disease, International Center for Diarrheal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Warin Jumroenjit
- Department of Microbiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | | | - Waraluk Tangkanakul
- Bureau of General Communicable Diseases, Department of Disease Control, Ministry of Public Health, Nonthaburi, Thailand
| | | | - Sriwanna Huttayananont
- National Institute of Health, Department of Medical Sciences, Ministry of Public Health, Thailand
| | - Haruo Watanabe
- National Institute of Infectious Diseases, Shinjuku-ku, Tokyo, Japan
| | - Nur A Hasan
- Maryland Pathogen Research Institute, University of Maryland, College Park, Maryland, USA
| | - Anwar Huq
- Maryland Pathogen Research Institute, University of Maryland, College Park, Maryland, USA
| | - Alejandro Cravioto
- Center for Food and Waterborne Disease, International Center for Diarrheal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Rita R Colwell
- University of Maryland Institute for Advanced Computer Studies, College Park, MD, USA.,Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.,Maryland Pathogen Research Institute, University of Maryland, College Park, Maryland, USA
| | - Munirul Alam
- Center for Food and Waterborne Disease, International Center for Diarrheal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
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14
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Okada K, Roobthaisong A, Nakagawa I, Hamada S, Chantaroj S. Genotypic and PFGE/MLVA analyses of Vibrio cholerae O1: geographical spread and temporal changes during the 2007-2010 cholera outbreaks in Thailand. PLoS One 2012; 7:e30863. [PMID: 22292065 PMCID: PMC3265523 DOI: 10.1371/journal.pone.0030863] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2011] [Accepted: 12/22/2011] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Vibrio cholerae O1 El Tor dominated the seventh cholera pandemic which occurred in the 1960s. For two decades, variants of V. cholerae O1 El Tor that produce classical cholera toxin have emerged and spread globally, replacing the prototypic El Tor biotype. This study aims to characterize V. cholerae O1 isolates from outbreaks in Thailand with special reference to genotypic variations over time. METHODS/FINDINGS A total of 343 isolates of V. cholerae O1 from cholera outbreaks from 2007 to 2010 were investigated, and 99.4% were found to carry the classical cholera toxin B subunit (ctxB) and El Tor rstR genes. Pulsed-field gel electrophoresis (PFGE) differentiated the isolates into 10 distinct pulsotypes, clustered into two major groups, A and B, with an overall similarity of 88%. Ribotyping, multiple-locus variable-number tandem-repeat analysis (MLVA), and PCR to detect Vibrio seventh pandemic island II (VSP-II) related genes of randomly selected isolates from each pulsotype corresponded to the results obtained by PFGE. Epidemiological investigations revealed that MLVA type 2 was strongly associated with a cholera outbreak in northeastern Thailand in 2007, while MLVA type 7 dominated the outbreaks of the southern Gulf areas in 2009 and MLVA type 4 dominated the outbreaks of the central Gulf areas during 2009-2010. Only MLVA type 16 isolates were found in a Thai-Myanmar border area in 2010, whereas those of MLVA types 26, 39, and 41 predominated this border area in 2008. Type 39 then disappeared 1-2 years later as MLVA type 41 became prevalent. Type 41 was also found to infect an outbreak area. CONCLUSIONS MLVA provided a high-throughput genetic typing tool for understanding the in-depth epidemiology of cholera outbreaks. Our epidemiological surveys suggest that some clones of V. cholerae O1 with similar but distinctive genetic traits circulate in outbreak sites, while others disappear over time.
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Affiliation(s)
- Kazuhisa Okada
- Thailand-Japan Research Collaboration Center on Emerging and Re-emerging Infections, Nonthaburi, Thailand.
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15
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Tran HD, Alam M, Trung NV, Van Kinh N, Nguyen HH, Pham VC, Ansaruzzaman M, Rashed SM, Bhuiyan NA, Dao TT, Endtz HP, Wertheim HFL. Multi-drug resistant Vibrio cholerae O1 variant El Tor isolated in northern Vietnam between 2007 and 2010. J Med Microbiol 2011; 61:431-437. [PMID: 22016560 PMCID: PMC3347965 DOI: 10.1099/jmm.0.034744-0] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Since 2007, there has been a re-emergence of cholera outbreaks in northern Vietnam. To understand the molecular epidemiological relatedness and determine the antibiotic susceptibility profiles of responsible V. cholerae O1 outbreak strains, a representative collection of 100 V. cholerae O1 strains was characterized. V. cholerae O1 strains isolated from diarrhoeal patients in northern Vietnam between 2007 and 2010 were investigated for antibiotic susceptibility and characterized by using phenotypic and genotypic tests, including PFGE analysis. Ten clinical V. cholerae O1 isolates from Bangladesh and Zimbabwe were included for comparison. The results revealed that all isolates were resistant to co-trimoxazole and nalidixic acid, 29 % were resistant to tetracycline and 1 % were resistant to azithromycin. All strains were susceptible to ampicillin–sulbactam, doxycycline, chloramphenicol and ciprofloxacin and 95 % were susceptible to azithromycin. MIC values did show reduced susceptibility to fluoroquinolones and 63 % of the strains were intermediately resistant to tetracycline. The isolates expressed phenotypic traits of both serogroup O1 Ogawa and El Tor and harboured an rstR El Tor and ctxB classical biotype. Among the outbreak isolates, only a single PFGE pattern was observed throughout the study period. This study shows that multi-drug resistant V. cholerae altered El Tor producing classical CT strains are now predominant in northern Vietnam.
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Affiliation(s)
- Huu Dat Tran
- Department of Medical Microbiology, Hanoi Medical University, 1 Ton That Tung Street, Hanoi, Vietnam.,National Hospital of Tropical Diseases, 78 Giai Phong Street, Hanoi, Vietnam
| | - Munirul Alam
- Enteric & Food Microbiology Laboratory, ICDDR,B: International Centre for Diarrhoeal Disease Research, Bangladesh GPO Box 128, Dhaka 1000, Bangladesh
| | - Nguyen Vu Trung
- Department of Medical Microbiology, Hanoi Medical University, 1 Ton That Tung Street, Hanoi, Vietnam.,National Hospital of Tropical Diseases, 78 Giai Phong Street, Hanoi, Vietnam
| | - Nguyen Van Kinh
- Department of Infectious Diseases, Hanoi Medical University, 1 Ton That Tung Street, Hanoi, Vietnam.,National Hospital of Tropical Diseases, 78 Giai Phong Street, Hanoi, Vietnam
| | - Hong Ha Nguyen
- National Hospital of Tropical Diseases, 78 Giai Phong Street, Hanoi, Vietnam
| | - Van Ca Pham
- National Hospital of Tropical Diseases, 78 Giai Phong Street, Hanoi, Vietnam
| | - Mohammad Ansaruzzaman
- Enteric & Food Microbiology Laboratory, ICDDR,B: International Centre for Diarrhoeal Disease Research, Bangladesh GPO Box 128, Dhaka 1000, Bangladesh
| | - Shah Manzur Rashed
- Enteric & Food Microbiology Laboratory, ICDDR,B: International Centre for Diarrhoeal Disease Research, Bangladesh GPO Box 128, Dhaka 1000, Bangladesh
| | - Nurul A Bhuiyan
- Enteric & Food Microbiology Laboratory, ICDDR,B: International Centre for Diarrhoeal Disease Research, Bangladesh GPO Box 128, Dhaka 1000, Bangladesh
| | - Tuyet Trinh Dao
- National Hospital of Tropical Diseases, 78 Giai Phong Street, Hanoi, Vietnam
| | - Hubert P Endtz
- Department of Medical Microbiology & Infectious Diseases, Erasmus MC, University Medical Centre Rotterdam, The Netherlands.,Enteric & Food Microbiology Laboratory, ICDDR,B: International Centre for Diarrhoeal Disease Research, Bangladesh GPO Box 128, Dhaka 1000, Bangladesh
| | - Heiman F L Wertheim
- Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, University of Oxford, Churchill Hospital, Old Road, Oxford OX3 7LJ, UK.,Oxford University Clinical Research Unit Vietnam, Wellcome Trust Major Overseas Program, National Hospital of Tropical Diseases, 78 Giai Phong Road, Dong Da, Hanoi, Vietnam
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