Cholera outbreaks in Nigeria are associated with multidrug resistant atypical El Tor and non-O1/non-O139 Vibrio cholerae.
Cholera outbreaks in Nigeria are associated with multidrug resistant atypical El Tor and non-O1/non-O139 Vibrio cholerae.
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DOI：
10.1371/journal.pntd.0002049
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发表时间：
2013
影响因子：
3.8
通讯作者：
Vicente AC
中科院分区：
文献类型：
--
作者：
Marin MA;Thompson CC;Freitas FS;Fonseca EL;Aboderin AO;Zailani SB;Quartey NK;Okeke IN;Vicente AC
在本千年，许多非洲国家霍乱爆发的数量、规模和死亡病例急剧增加。2010年，尼日利亚报告了4万多例霍乱病例。霍乱弧菌O 1 El Tor生物型的变体已经出现，但对西非霍乱暴发的菌株知之甚少，这对实施控制流行性霍乱的干预措施至关重要。 通过标准培养方法鉴定2009年12月至2010年10月尼日利亚急性水样腹泻暴发中的霍乱弧菌分离株。对15株O 1和5株非O 1/非O 139菌株进行了分析;对与毒力、耐药性和生物型相关的靶向区域进行了PCR和测序。我们还研究了多位点序列分析和脉冲场凝胶电泳菌株之间的遗传相关性。药敏试验采用纸片扩散法和E-test。我们发现，多药耐药的非典型El Tor菌株，降低了对环丙沙星和氯霉素的敏感性，其特征在于存在SXT元件，和gyrA Ser 83 Ile/parC Ser 85 Leu等位基因以及CTX噬菌体和TCP簇，其特征在于rstR El Tor，ctxB-7和tcpA CIRS等位基因，分别是2009年和2010年霍乱暴发的主要原因。我们还从尼日利亚的霍乱样腹泻病例中鉴定并表征了霍乱弧菌非O 1/非O 139谱系。最近的尼日利亚暴发是由多药耐药的非典型El Tor和非O 1/非O 139霍乱弧菌菌株确定的，从第七次霍乱大流行开始，典型的El Tor似乎在该国不再流行/地方病。这种情况与东非、亚洲和加勒比国家类似。在尼日利亚检测到一种高毒力、抗微生物药物耐药谱系令人担忧，并指出需要以疫苗为基础控制该疾病。这项研究还揭示了非O 1/非O 139霍乱弧菌在尼日利亚霍乱中的假定重要性。霍乱是一种急性水样腹泻，严重脱水，由霍乱弧菌，一种在水生环境中普遍存在的细菌引起。霍乱是一种全球性威胁，特别是在缺乏饮用水和污水等卫生条件的地区。发生了七次霍乱大流行，都起源于亚洲。目前正在进行的第七次大流行是由霍乱弧菌El Tor生物型引起的。最近，El Tor经历了基因变化，被称为“非典型”El Tor的菌株正在许多地区迅速取代原来的El Tor。非典型El Tor的特点是多抗生素耐药性和主要毒力决定因素的变化。由非典型菌株引起的霍乱在临床上可能更严重。在非洲，霍乱爆发的频率和严重程度都在增加，最近在尼日利亚、安哥拉、莫桑比克和津巴布韦发生的重大疫情就证明了这一点。在此，我们对从尼日利亚最近不同疫情中分离的霍乱弧菌进行了全面的表征。我们的研究结果表明，尼日利亚的霍乱疫情是由非典型的埃尔托菌株驱动的，就像世界各地一样。
The current millennium has seen a steep rise in the number, size and case-fatalities of cholera outbreaks in many African countries. Over 40,000 cases of cholera were reported from Nigeria in 2010. Variants of Vibrio cholerae O1 El Tor biotype have emerged but very little is known about strains causing cholera outbreaks in West Africa, which is crucial for the implementation of interventions to control epidemic cholera. V. cholerae isolates from outbreaks of acute watery diarrhea in Nigeria from December, 2009 to October, 2010 were identified by standard culture methods. Fifteen O1 and five non-O1/non-O139 strains were analyzed; PCR and sequencing targeted regions associated with virulence, resistance and biotype were performed. We also studied genetic interrelatedness among the strains by multilocus sequence analysis and pulsed-field gel electrophoresis. The antibiotic susceptibility was tested by the disk diffusion method and E-test. We found that multidrug resistant atypical El Tor strains, with reduced susceptibility to ciprofloxacin and chloramphenicol, characterized by the presence of the SXT element, and gyrA Ser83Ile/parC Ser85Leu alleles as well CTX phage and TCP cluster characterized by rstR ElTor, ctxB-7 and tcpA CIRS alleles, respectively, were largely responsible for cholera outbreaks in 2009 and 2010. We also identified and characterized a V. cholerae non-O1/non-O139 lineage from cholera-like diarrhea cases in Nigeria. The recent Nigeria outbreaks have been determined by multidrug resistant atypical El Tor and non-O1/non-O139 V. cholerae strains, and it seems that the typical El Tor, from the beginning of seventh cholera pandemic, is no longer epidemic/endemic in this country. This scenario is similar to the East Africa, Asia and Caribbean countries. The detection of a highly virulent, antimicrobial resistant lineage in Nigeria is worrisome and points to a need for vaccine-based control of the disease. This study has also revealed the putative importance of non-O1/non-O139 V. cholerae in diarrheal disease in Nigeria. Cholera is acute watery diarrhoea, severely dehydrating, caused by Vibrio cholerae, a bacterium ubiquitous in aquatic environments. Cholera is a global threat, particularly, in areas where sanitary conditions, such as drinking water and sewage, are not available. Seven cholera pandemics, all originating in Asia, occurred. The ongoing pandemic, the 7th, has been caused by V. cholerae El Tor biotype. Recently, El Tor has undergone genetic changes and the strains being referred to as “atypical” El Tor are rapidly replacing the original El Tor in many areas. The atypical El Tor is characterized by multi-antibiotic resistance and changes in the major virulence determinants. Cholera caused by atypical strains may be more clinically severe. In Africa, cholera outbreaks are occurring with increasing frequency and severity, as demonstrated by the recent major outbreaks in Nigeria, Angola, Mozambique and Zimbabwe. Here, we performed a comprehensive characterization of V. cholerae isolated from different recent outbreaks in Nigeria. Our results show that cholera outbreaks in Nigeria are driven by atypical El Tor strains, as worldwide.
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影响因子：
9.4
作者：
DALSGAARD, A;ALBERT, MJ;ECHEVERRIA, P
通讯作者：
ECHEVERRIA, P
DOI：
10.1111/j.1574-695x.1998.tb01128.x
发表时间：
1998-03-01
影响因子：
--
作者：
Hoshino, K;Yamasaki, S;Takeda, Y
通讯作者：
Takeda, Y
影响因子：
9.4
作者：
Ghosh-Banerjee, J.;Senoh, M.;Takeda, Y.
通讯作者：
Takeda, Y.
DOI：
10.1073/pnas.95.6.3134
发表时间：
1998-03-17
影响因子：
11.1
作者：
Karaolis, DKR;Johnson, JA;Reeves, PR
通讯作者：
Reeves, PR
影响因子：
4.9
作者：
Baranwal, S;Dey, K;Kundu, M
通讯作者：
Kundu, M