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Agyei FK, Scharf B, Duodu S. Vibrio cholerae Bacteremia: An Enigma in Cholera-Endemic African Countries. Trop Med Infect Dis 2024; 9:103. [PMID: 38787036 PMCID: PMC11125774 DOI: 10.3390/tropicalmed9050103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Revised: 03/06/2024] [Accepted: 03/08/2024] [Indexed: 05/25/2024] Open
Abstract
Cholera is highly endemic in many sub-Saharan African countries. The bacterium Vibrio cholerae is responsible for this severe dehydrating diarrheal disease that accounts for over 100,000 deaths each year globally. In recent years, the pathogen has been found to invade intestinal layers and translocate into the bloodstream of humans. The non-toxigenic strains of V. cholerae (non-O1/O139), also known as NOVC, which do not cause epidemic or pandemic cases of cholera, are the major culprits of V. cholerae bacteremia. In non-cholera-endemic regions, clinical reports on NOVC infection have been noted over the past few decades, particularly in Europe and America. Although low-middle-income countries are most susceptible to cholera infections because of challenges with access to clean water and inappropriate sanitation issues, just a few cases of V. cholerae bloodstream infections have been reported. The lack of evidence-based research and surveillance of V. cholerae bacteremia in Africa may have significant clinical implications. This commentary summarizes the existing knowledge on the host risk factors, pathogenesis, and diagnostics of NOVC bacteremia.
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Affiliation(s)
- Foster K. Agyei
- West African Centre for Cell Biology of Infectious Pathogens, University of Ghana, Accra LG54, Ghana;
- Department of Biological Sciences, Virginia Polytechnic Institute and State University, Blacksburg, VA 24061, USA;
| | - Birgit Scharf
- Department of Biological Sciences, Virginia Polytechnic Institute and State University, Blacksburg, VA 24061, USA;
| | - Samuel Duodu
- West African Centre for Cell Biology of Infectious Pathogens, University of Ghana, Accra LG54, Ghana;
- Department of Biochemistry, Cell and Molecular Biology, University of Ghana, Accra LG54, Ghana
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Dorman MJ, Thomson NR. Vibrio cholerae O37: one of the exceptions that prove the rule. Microb Genom 2023; 9:mgen000980. [PMID: 37043377 PMCID: PMC10210954 DOI: 10.1099/mgen.0.000980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 02/10/2023] [Indexed: 04/13/2023] Open
Abstract
Between 1965 and 1968, outbreaks of cholera in Sudan and former Czechoslovakia provoked considerable public health concern. These still represent important historical events that need to be linked to the growing genomic evidence describing the aetiological agent of cholera, Vibrio cholerae. Whilst O1 serogroup V. cholerae are canonically associated with epidemic and pandemic cholera, these events were caused by a clone of toxigenic V. cholerae O37 that may be more globally distributed than just to Europe and North Africa. Understanding the biology of these non-O1 strains of V. cholerae is key to understanding how diseases like cholera continue to be globally important. In this article, we consolidate epidemiological, molecular and genomic descriptions of the bacteria responsible for these outbreaks. We attempt to resolve discrepancies in order to summarize the history and provenance of as many commonly used serogroup O37 strains as possible. Finally, we highlight the potential for whole-genome sequencing of V. cholerae O37 isolates from strain collections to shed light on the open questions that we identify.
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Affiliation(s)
- Matthew J. Dorman
- Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, CB10 1SA, UK
- Churchill College, University of Cambridge, Storey’s Way, Cambridge, CB3 0DS, UK
| | - Nicholas R. Thomson
- Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, CB10 1SA, UK
- London School of Hygiene and Tropical Medicine, Keppel St, Bloomsbury, London, WC1E 7HT, UK
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Igere BE, Okoh AI, Nwodo UU. Non-serogroup O1/O139 agglutinable Vibrio cholerae: a phylogenetically and genealogically neglected yet emerging potential pathogen of clinical relevance. Arch Microbiol 2022; 204:323. [PMID: 35567650 PMCID: PMC9107296 DOI: 10.1007/s00203-022-02866-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 03/17/2022] [Accepted: 03/20/2022] [Indexed: 12/19/2022]
Abstract
Somatic antigen agglutinable type-1/139 Vibrio cholerae (SAAT-1/139-Vc) members or O1/O139 V. cholerae have been described by various investigators as pathogenic due to their increasing virulence potential and production of choleragen. Reported cholera outbreak cases around the world have been associated with these choleragenic V. cholerae with high case fatality affecting various human and animals. These virulent Vibrio members have shown genealogical and phylogenetic relationship with the avirulent somatic antigen non-agglutinable strains of 1/139 V. cholerae (SANAS-1/139- Vc) or O1/O139 non-agglutinating V. cholerae (O1/O139-NAG-Vc). Reports on implication of O1/O139-NAGVc members in most sporadic cholera/cholera-like cases of diarrhea, production of cholera toxin and transmission via consumption and/or contact with contaminated water/seafood are currently on the rise. Some reported sporadic cases of cholera outbreaks and observed change in nature has also been tracable to these non-agglutinable Vibrio members (O1/O139-NAGVc) yet there is a sustained paucity of research interest on the non-agglutinable V. cholerae members. The emergence of fulminating extraintestinal and systemic vibriosis is another aspect of SANAS-1/139- Vc implication which has received low attention in terms of research driven interest. This review addresses the need to appraise and continually expand research based studies on the somatic antigen non-serogroup agglutinable type-1/139 V. cholerae members which are currently prevalent in studies of water bodies, fruits/vegetables, foods and terrestrial environment. Our opinion is amassed from interest in integrated surveillance studies, management/control of cholera outbreaks as well as diarrhea and other disease-related cases both in the rural, suburban and urban metropolis.
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Affiliation(s)
- Bright E Igere
- Department of Microbiology and Biotechnology, Western Delta University, Oghara, Delta State, Nigeria.
- Applied and Environmental Microbiology Research Group, Department of Biochemistry and Microbiology, University of Fort Hare, Alice, 5700, South Africa.
- SAMRC Microbial Water Quality Monitoring Centre, University of Fort Hare, Alice, 5700, South Africa.
| | - Anthony I Okoh
- Applied and Environmental Microbiology Research Group, Department of Biochemistry and Microbiology, University of Fort Hare, Alice, 5700, South Africa
- SAMRC Microbial Water Quality Monitoring Centre, University of Fort Hare, Alice, 5700, South Africa
- Department of Environmental Health Sciences, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Uchechukwu U Nwodo
- Applied and Environmental Microbiology Research Group, Department of Biochemistry and Microbiology, University of Fort Hare, Alice, 5700, South Africa
- SAMRC Microbial Water Quality Monitoring Centre, University of Fort Hare, Alice, 5700, South Africa
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Ottaviani D, Medici L, Talevi G, Napoleoni M, Serratore P, Zavatta E, Bignami G, Masini L, Chierichetti S, Fisichella S, Leoni F. Molecular characterization and drug susceptibility of non-O1/O139 V. cholerae strains of seafood, environmental and clinical origin, Italy. Food Microbiol 2017; 72:82-88. [PMID: 29407408 DOI: 10.1016/j.fm.2017.11.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Revised: 11/06/2017] [Accepted: 11/21/2017] [Indexed: 11/26/2022]
Abstract
Toxigenic and antimicrobial susceptibility patterns and genetic relatedness of 42 non-O1/O139 V. cholerae strains, the majority of them isolated from seafood and marine water of the Adriatic sea, Italy, and 9 clinical strains, two of which with seawater of the Adriatic as the source of infection, were studied. All strains had hlyA El Tor gene but lacked ctxA gene. Four and two isolates, respectively, also had stn/sto and tcpA Class genes. More than 90% of strains showed susceptibility to cefotaxime, ciprofloxacin, cloramphenicol, tetracycline, trimethoprim + sulfamethoxazole and intermediate or full resistance to tetracycline and erythromycin. Six strains of seafood and clinical source were multi-drug resistant. PFGE analysis allowed to type all the strains with 50 banding patterns. Twenty-one strains, 11 and 8 from seafood and seawater, respectively, and 2 of clinical origin, were grouped into 9 different clusters. We report the presence of toxigenic and multidrug resistant non-O1/O139 V. cholerae strains in Adriatic, some of which genetically related, and support that they represent a potential reservoir of toxin and antibiotic resistance genes.
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Affiliation(s)
- Donatella Ottaviani
- Istituto Zooprofilattico Sperimentale dell'Umbria e delle Marche, Sezione di Ancona, Laboratorio Nazionale di Riferimento (LNR) Contaminazioni Batteriologiche Molluschi Bivalvi Vivi, Via Cupa di Posatora 3, 60126 Ancona, Italy.
| | - Laura Medici
- Istituto Zooprofilattico Sperimentale dell'Umbria e delle Marche, Sezione di Ancona, Laboratorio Nazionale di Riferimento (LNR) Contaminazioni Batteriologiche Molluschi Bivalvi Vivi, Via Cupa di Posatora 3, 60126 Ancona, Italy
| | - Giulia Talevi
- Istituto Zooprofilattico Sperimentale dell'Umbria e delle Marche, Sezione di Ancona, Laboratorio Nazionale di Riferimento (LNR) Contaminazioni Batteriologiche Molluschi Bivalvi Vivi, Via Cupa di Posatora 3, 60126 Ancona, Italy
| | - Maira Napoleoni
- Istituto Zooprofilattico Sperimentale dell'Umbria e delle Marche, Sezione di Ancona, Laboratorio Nazionale di Riferimento (LNR) Contaminazioni Batteriologiche Molluschi Bivalvi Vivi, Via Cupa di Posatora 3, 60126 Ancona, Italy
| | - Patrizia Serratore
- Dipartimento di Scienze Mediche Veterinarie, Unità Operativa Speciale Cesenatico, Università degli Studi di Bologna, Viale A.Vespucci 2, 47042 Cesentatico, FC, Italy
| | - Emanuele Zavatta
- Dipartimento di Scienze Mediche Veterinarie, Unità Operativa Speciale Cesenatico, Università degli Studi di Bologna, Viale A.Vespucci 2, 47042 Cesentatico, FC, Italy
| | - Giorgia Bignami
- Dipartimento di Scienze Mediche Veterinarie, Unità Operativa Speciale Cesenatico, Università degli Studi di Bologna, Viale A.Vespucci 2, 47042 Cesentatico, FC, Italy
| | - Laura Masini
- Istituto Zooprofilattico Sperimentale dell'Umbria e delle Marche, Sezione di Ancona, Laboratorio Nazionale di Riferimento (LNR) Contaminazioni Batteriologiche Molluschi Bivalvi Vivi, Via Cupa di Posatora 3, 60126 Ancona, Italy
| | - Serena Chierichetti
- Istituto Zooprofilattico Sperimentale dell'Umbria e delle Marche, Sezione di Ancona, Laboratorio Nazionale di Riferimento (LNR) Contaminazioni Batteriologiche Molluschi Bivalvi Vivi, Via Cupa di Posatora 3, 60126 Ancona, Italy
| | - Stefano Fisichella
- Istituto Zooprofilattico Sperimentale dell'Umbria e delle Marche, Sezione di Ancona, Laboratorio Nazionale di Riferimento (LNR) Contaminazioni Batteriologiche Molluschi Bivalvi Vivi, Via Cupa di Posatora 3, 60126 Ancona, Italy
| | - Francesca Leoni
- Istituto Zooprofilattico Sperimentale dell'Umbria e delle Marche, Sezione di Ancona, Laboratorio Nazionale di Riferimento (LNR) Contaminazioni Batteriologiche Molluschi Bivalvi Vivi, Via Cupa di Posatora 3, 60126 Ancona, Italy
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Practical Guidance for Clinical Microbiology Laboratories: Diagnosis of Bacterial Gastroenteritis. Clin Microbiol Rev 2015; 28:3-31. [PMID: 25567220 DOI: 10.1128/cmr.00073-14] [Citation(s) in RCA: 140] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Bacterial gastroenteritis is a disease that is pervasive in both the developing and developed worlds. While for the most part bacterial gastroenteritis is self-limiting, identification of an etiological agent by bacterial stool culture is required for the management of patients with severe or prolonged diarrhea, symptoms consistent with invasive disease, or a history that may predict a complicated course of disease. Importantly, characterization of bacterial enteropathogens from stool cultures in clinical laboratories is one of the primary means by which public health officials identify and track outbreaks of bacterial gastroenteritis. This article provides guidance for clinical microbiology laboratories that perform stool cultures. The general characteristics, epidemiology, and clinical manifestations of key bacterial enteropathogens are summarized. Information regarding optimal specimen collection, transport, and processing and current diagnostic tests and testing algorithms is provided. This article is an update of Cumitech 12A (P. H. Gilligan, J. M. Janda, M. A. Karmali, and J. M. Miller, Cumitech 12A, Laboratory diagnosis of bacterial diarrhea, 1992).
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Abstract
Vibriosis is a group of intestinal and extraintestinal infections caused by marine-dwelling bacteria of the genus Vibrio. Infections range from indolent illnesses to fulminant diseases, including cholera and necrotizing fasciitis. Most illnesses result from direct contact with the marine environment or consumption of shellfish, especially oysters. In the United States vibrio infections are increasing but are underreported because of lack of clinical recognition and appropriate detection in the microbiology laboratory. Recent advances to aid in the detection and identification of vibrio illnesses in the laboratory include rapid identification tests, new media, and molecular identification systems.
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Affiliation(s)
- J Michael Janda
- Department of Public Health, Alameda County Public Health Laboratory, 1000 Broadway, Suite 500, Oakland, CA 94607, USA
| | - Anna E Newton
- Enteric Diseases Epidemiology Branch, Division of Foodborne, Waterborne and Environmental Diseases, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30333, USA
| | - Cheryl A Bopp
- Enteric Diseases Laboratory Branch, Division of Foodborne, Waterborne and Environmental Diseases, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30333, USA.
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