Abstract

In September 2010, a cholera outbreak was reported from Odisha, Eastern India. V. cholerae isolated from the clinical samples were biochemically and serologically confirmed as serogroup O1, biotype El Tor, and serotype Ogawa. Multiplex PCR screening revealed the presence of various genes, namely, ompW, ctxB, zot, rfbO1, tcp, ace, hlyA, ompU, rtx, and toxR, in all of the isolates. The isolates were resistant to co-trimoxazole, nalidixic acid, polymyxin B, spectinomycin, streptomycin, sulfamethoxazole, tetracycline, trimethoprim, and vibriostatic agent 2,4-diamino-6,7-diisopropylpteridine (O/129). Minimum inhibitory concentration of tetracycline decreased in the presence of carbonyl cyanide m-chlorophenylhydrazone (CCCP), suggesting the involvement of efflux pumps. PCR analysis confirmed the presence of class I integrons as well as SXT elements harbouring antibiotic resistance genes in all isolates. Sequencing revealed the presence of ctxB gene of classical biotype in all the isolates. The isolates harboured an RS1-CTX prophage array with El Tor type rstR and classical ctxB on the large chromosome. The study indicated that the V. cholerae El Tor variants are evolving in the area with better antibiotic resistance and virulence potential.

Highlights

  • IntroductionTetracycline is an important broad spectrum antibiotic used for the prophylaxis and treatment of variety of bacterial infections including listed biothreat agents Bacillus anthracis, Francisella tularensis, and Yersinia pestis [5]

  • Cholera is still a major health problem of global importance as evidenced by the recent outbreaks in Haiti and Zimbabwe

  • A total of 27 clinical strains of V. cholerae were isolated from the affected patients during cholera outbreak in Odisha, Eastern India

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Summary

Introduction

Tetracycline is an important broad spectrum antibiotic used for the prophylaxis and treatment of variety of bacterial infections including listed biothreat agents Bacillus anthracis, Francisella tularensis, and Yersinia pestis [5]. It has been a preferred choice for control of cholera as recommended by WHO [6]. We reported a novel mutation in ctxB gene of outbreak isolates in 2007 from Rayagada (19.09∘N 83.27∘E), Odisha, and later on the same allelic variation was observed in the Haitian outbreak isolates [7, 8] These isolates were multidrug resistant but sensitive to tetracycline [8]. We report the emergence of tetracycline resistant V. cholerae from this outbreak of Eastern India

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