The Transmission and Antibiotic Resistance Variation in a Multiple Drug Resistance Clade of Vibrio cholerae Circulating in Multiple Countries in Asia.

Bo Pang,Zhigang Cui,Baowei Diao,Biao Kan,Pengcheng Du,Haijian Zhou,Zhemin Zhou,Dongsheng Zhou

doi:10.1371/journal.pone.0149742

Abstract

Vibrio cholerae has caused massive outbreaks and even trans-continental epidemics. In 2008 and 2010, at least 3 remarkable cholera outbreaks occurred in Hainan, Anhui and Jiangsu provinces of China. To address the possible transmissions and the relationships to the 7th pandemic strains of those 3 outbreaks, we sequenced the whole genomes of the outbreak isolates and compared with the global isolates from the 7th pandemic. The three outbreaks in this study were caused by a cluster of V. cholerae in clade 3.B which is parallel to the clade 3.C that was transmitted from Nepal to Haiti and caused an outbreak in 2010. Pan-genome analysis provided additional evolution information on the mobile element and acquired multiple antibiotic resistance genes. We suggested that clade 3.B should be monitored because the multiple antibiotic resistant characteristics of this clade and the ‘amplifier’ function of China in the global transmission of current Cholera pandemic. We also show that dedicated whole genome sequencing analysis provided more information than the previous techniques and should be applied in the disease surveillance networks.

Highlights

Seven cholera pandemics have been acknowledged since 1817[1]
To analyze the genomic characteristics and possible origins of the three outbreaks in 2008 and 2010, here we sequenced the genomes of 3 isolates that were isolated during the outbreaks, and compared them with our widest possible global collection of 7th pandemic V. cholerae genomes, which have been reported recently[6]. From views of both core genome and Horizontal gene transfer (HGT) elements, these three outbreaks were triggered by the transmissions from South Asia, where cholera is endemic, in an existing epidemic clade 3.B, which co-exist in the same area with a genetically independent clade 3.C, which has caused Haiti outbreak
By using whole genome re-sequencing, the strains from the O1 El Tor cholera outbreaks in recent years in China were analyzed for their genomic characteristics and evolutionary relationships with the 7th pandemic strains

Summary

Introduction

Seven cholera pandemics have been acknowledged since 1817[1]. The 7th pandemic erupted in Indonesia at 1961 and reached South Asia at 1963[2], where the pathogen circulated for half a century and spread over the world in multiple transmissions[3]. In 1970s the 7th pandemic reached Africa and become one of the severe health problems there; in 1990s it reached South-America and triggered large outbreaks[1]. The most recent notable event should be the 2010 Haitian cholera outbreak, which has caused more than 700,000 cases and more than 8700. Circulating of a Multiple Drug Resistance Clade of V. cholerae design, data collection and analysis, decision to publish, or preparation of the manuscript

Methods

Results

Conclusion