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Mogessie H, Legesse M, Hailu AF, Teklehaymanot T, Alemayehu H, Abubeker R, Ashenafi M. Vibrio cholerae O1 and Escherichia coli O157:H7 from drinking water and wastewater in Addis Ababa, Ethiopia. BMC Microbiol 2024; 24:219. [PMID: 38902619 PMCID: PMC11188251 DOI: 10.1186/s12866-024-03302-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2023] [Accepted: 04/11/2024] [Indexed: 06/22/2024] Open
Abstract
BACKGROUND In Addis Ababa, Ethiopia, open ditches along innner roads in residential areas serve to convey domestic wastewater and rainwater away from residences. Contamination of drinking water by wastewater through faulty distribution lines could expose households to waterborne illnesses. This prompted the study to assess the microbiological safety of wastewater and drinking water in Addis Ababa, identify the pathogens therein, and determine their antibiotic resistance patterns. RESULTS VIBRIO CHOLERAE O1, mainly Hikojima serotype, was isolated from 23 wastewater and 16 drinking water samples. Similarly, 19 wastewater and 10 drinking water samples yielded Escherichia coli O157:H7. V. cholerae O1 were 100% resistant to the penicillins (Amoxacillin and Ampicillin), and 51-82% were resistant to the cephalosporins. About 44% of the V. cholerae O1 isolates in this study were Extended Spectrum Beta-Lactamase (ESBL) producers. Moreover, 26% were resistant to Meropenem. Peperacillin/Tazobactam was the only effective β-lactam antibiotic against V. cholerae O1. V. cholerae O1 isolates showed 37 different patterns of multiple resistance ranging from a minimum of three to a maximum of ten antimicrobials. Of the E. coli O157:H7 isolates, 71% were ESBL producers. About 96% were resistant to Ampicillin. Amikacin and Gentamicin were very effective against E. coli O157:H7 isolates. The isolates from wastewater and drinking water showed multiple antibiotic resistance against three to eight antibiotic drugs. CONCLUSIONS Open ditches for wastewater conveyance along innner roads in residence areas and underground faulty municipal water distribution lines could be possible sources for V. cholerae O1 and E. coli O157:H7 infections to surrounding households and for dissemination of multiple drug resistance in humans and, potentially, the environment.
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Affiliation(s)
- Helina Mogessie
- Microbiology Research Unit, Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia.
| | - Mengistu Legesse
- Microbiology Research Unit, Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Aklilu Feleke Hailu
- Microbiology Research Unit, Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Tilahun Teklehaymanot
- Microbiology Research Unit, Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Haile Alemayehu
- Microbiology Research Unit, Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Rajiha Abubeker
- Ethiopian Public Health Institute, Bacteriology Directorate, Addis Ababa, Ethiopia
| | - Mogessie Ashenafi
- Center for Food Security Studies, College of Development Studies, Addis Ababa University, Addis Ababa, Ethiopia
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Wilinski M, Castro L, Keithley J, Manore C, Campos J, Romero-Severson E, Domman D, Lokhov AY. Congruity of genomic and epidemiological data in modelling of local cholera outbreaks. Proc Biol Sci 2024; 291:20232805. [PMID: 38503333 PMCID: PMC10950457 DOI: 10.1098/rspb.2023.2805] [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: 12/12/2023] [Accepted: 02/19/2024] [Indexed: 03/21/2024] Open
Abstract
Cholera continues to be a global health threat. Understanding how cholera spreads between locations is fundamental to the rational, evidence-based design of intervention and control efforts. Traditionally, cholera transmission models have used cholera case-count data. More recently, whole-genome sequence data have qualitatively described cholera transmission. Integrating these data streams may provide much more accurate models of cholera spread; however, no systematic analyses have been performed so far to compare traditional case-count models to the phylodynamic models from genomic data for cholera transmission. Here, we use high-fidelity case-count and whole-genome sequencing data from the 1991 to 1998 cholera epidemic in Argentina to directly compare the epidemiological model parameters estimated from these two data sources. We find that phylodynamic methods applied to cholera genomics data provide comparable estimates that are in line with established methods. Our methodology represents a critical step in building a framework for integrating case-count and genomic data sources for cholera epidemiology and other bacterial pathogens.
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Affiliation(s)
- Mateusz Wilinski
- Theoretical Division, Los Alamos National Laboratory, Los Alamos, NM, USA
| | - Lauren Castro
- Analytics, Intelligence and Technology Division, Los Alamos National Laboratory, Los Alamos, NM, USA
| | - Jeffrey Keithley
- Analytics, Intelligence and Technology Division, Los Alamos National Laboratory, Los Alamos, NM, USA
- Department of Computer Science, University of Iowa, Iowa City, IA, USA
| | - Carrie Manore
- Theoretical Division, Los Alamos National Laboratory, Los Alamos, NM, USA
| | - Josefina Campos
- UO Centro Nacional de Genómica y Bioinformtica, ANLIS ‘Dr. Carlos G. Malbrán, Buenos Aires, Argentina
| | | | - Daryl Domman
- Center for Global Health, Department of Internal Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM, USA
| | - Andrey Y. Lokhov
- Theoretical Division, Los Alamos National Laboratory, Los Alamos, NM, USA
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Monira S, Barman I, Jubyda FT, Ali SI, Islam A, Rahman KMZ, Rashid MU, Johura FT, Sultana M, Zohura F, Bhuyian SI, Parvin T, Sack D, Ahmed T, Saif-Ur-Rahman KM, Hossain M, Watanabe H, George CM, Alam M. Gut microbiota shifts favorably with delivery of handwashing with soap and water treatment intervention in a prospective cohort (CHoBI7 trial). JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2023; 42:146. [PMID: 38129922 PMCID: PMC10740293 DOI: 10.1186/s41043-023-00477-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 11/21/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND Cholera can result in the expulsion of important microbiota from the gut and result in death if left untreated. The disease transmits mainly via drinking water carrying Vibrio cholerae; and household contacts (HHC) of cholera patients are at elevated risk during the first week of infection. The gut microbiota profiles of HHC-children of cholera patients at Dhaka city slums were investigated before (day 0) and after (day 8) delivery of chlorinated water as part of the major study 'CHoBI7 trial (cholera-hospital-based intervention for 7 days)'. RESULT Results of sequencing and analysis of bacterial community DNA revealed the predominance of two bacterial phyla: Bacteroidetes and Firmicutes at day 0 with a relative abundance of 62 ± 6 (mean ± SEM%) and 32 ± 7, respectively. The pattern reversed at day 8 with a decreased relative abundance of Bacteroidetes (39 ± 12; p = 0.034) and an increased abundance of Firmicutes (49 ± 12; p = 0.057). Of 65 bacterial families confirmed at day 0, six belonging to Proteobacteria including Vibrionaceae disappeared at day 8. Interestingly, the relative abundance of four Firmicutes families-Lachnospiraceae, Bifidobacteriaceae, Clostridiaceae, and Ruminococcaceae was increased in all five study children at day 8. CONCLUSION The observed exclusion of pathogenic Proteobacteria and enhancement of beneficial Firmicutes in the gut of children delivered with chlorinated water as part of WASH intervention reflect a great promise of the CHoBI7 program in preventing cholera and improving child health.
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Affiliation(s)
- Shirajum Monira
- Molecular Ecology and Metagenomics Laboratory, Infectious Diseases Division, icddr,b, (International Centre for Diarrhoeal Diseases Research Bangladesh), Dhaka, Bangladesh
| | - Indrajeet Barman
- Molecular Ecology and Metagenomics Laboratory, Infectious Diseases Division, icddr,b, (International Centre for Diarrhoeal Diseases Research Bangladesh), Dhaka, Bangladesh
| | - Fatema Tuz Jubyda
- Molecular Ecology and Metagenomics Laboratory, Infectious Diseases Division, icddr,b, (International Centre for Diarrhoeal Diseases Research Bangladesh), Dhaka, Bangladesh
| | - Sk Imran Ali
- Molecular Ecology and Metagenomics Laboratory, Infectious Diseases Division, icddr,b, (International Centre for Diarrhoeal Diseases Research Bangladesh), Dhaka, Bangladesh
| | - Aminul Islam
- Molecular Ecology and Metagenomics Laboratory, Infectious Diseases Division, icddr,b, (International Centre for Diarrhoeal Diseases Research Bangladesh), Dhaka, Bangladesh
| | - Kazi Mohammad Zillur Rahman
- Molecular Ecology and Metagenomics Laboratory, Infectious Diseases Division, icddr,b, (International Centre for Diarrhoeal Diseases Research Bangladesh), Dhaka, Bangladesh
| | - Mahamud-Ur Rashid
- Molecular Ecology and Metagenomics Laboratory, Infectious Diseases Division, icddr,b, (International Centre for Diarrhoeal Diseases Research Bangladesh), Dhaka, Bangladesh
| | - Fatema-Tuz Johura
- Molecular Ecology and Metagenomics Laboratory, Infectious Diseases Division, icddr,b, (International Centre for Diarrhoeal Diseases Research Bangladesh), Dhaka, Bangladesh
| | - Marzia Sultana
- Molecular Ecology and Metagenomics Laboratory, Infectious Diseases Division, icddr,b, (International Centre for Diarrhoeal Diseases Research Bangladesh), Dhaka, Bangladesh
| | - Fatema Zohura
- Molecular Ecology and Metagenomics Laboratory, Infectious Diseases Division, icddr,b, (International Centre for Diarrhoeal Diseases Research Bangladesh), Dhaka, Bangladesh
| | - Sazzadul Islam Bhuyian
- Molecular Ecology and Metagenomics Laboratory, Infectious Diseases Division, icddr,b, (International Centre for Diarrhoeal Diseases Research Bangladesh), Dhaka, Bangladesh
| | - Tahmina Parvin
- Molecular Ecology and Metagenomics Laboratory, Infectious Diseases Division, icddr,b, (International Centre for Diarrhoeal Diseases Research Bangladesh), Dhaka, Bangladesh
| | - David Sack
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Tahmeed Ahmed
- Molecular Ecology and Metagenomics Laboratory, Infectious Diseases Division, icddr,b, (International Centre for Diarrhoeal Diseases Research Bangladesh), Dhaka, Bangladesh
| | - K M Saif-Ur-Rahman
- Molecular Ecology and Metagenomics Laboratory, Infectious Diseases Division, icddr,b, (International Centre for Diarrhoeal Diseases Research Bangladesh), Dhaka, Bangladesh
- Evidence Synthesis Ireland and Cochrane Ireland, College of Medicine, Nursing, and Health Sciences, University of Galway, Galway, Ireland
| | - Maqsud Hossain
- NSU Genome Research Institute, North South University, Dhaka, Bangladesh
| | - Haruo Watanabe
- National Institutes of Infectious Diseases (NIID), Tokyo, Japan
| | - Christine Marie George
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Munirul Alam
- Molecular Ecology and Metagenomics Laboratory, Infectious Diseases Division, icddr,b, (International Centre for Diarrhoeal Diseases Research Bangladesh), Dhaka, Bangladesh.
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Pal BB, Samal D, Nayak SR, Pany S. Spectrum of ctxB genotypes, antibiogram profiles and virulence genes of Vibrio cholerae serogroups isolated from environmental water sources from Odisha, India. BMC Microbiol 2023; 23:75. [PMID: 36927368 PMCID: PMC10018994 DOI: 10.1186/s12866-023-02811-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 03/04/2023] [Indexed: 03/18/2023] Open
Abstract
BACKGROUND The present study reports on the comprehensive analysis of Vibrio cholerae O1 and non-O1/non-O139 serogroups isolated from environmental water sources during cholera outbreaks, epidemics and surveillance studies between years 2007 to 2019 from different districts of Odisha, India. METHODS A total of 85 stocked cultures of V. cholerae O1 and non-O1/non-O139 strains were analyzed for different ctxB genotypes, toxic genes, antibiogram profiles through PCR assays and pulsotyped by pulsed-field gel electrophoresis (PFGE). RESULTS From all V. cholerae strains tested, 51 isolates were O1 Ogawa and the rest 34 strains were non-O1/non-O139. All the V. cholerae O1 strains were altered El Tor variants carrying ctxB1, ctxB3 and ctxB7 genotypes. However, only ctxB1 genotypes were present in V. cholerae non-O1/non-O139. Though non-O1/non-O139 strains were negative by O1 antisera, 20% strains were positive for rfbO1 gene by PCR assay. All the V. cholerae isolates possessed a variety of virulence genes including ace, ctxAB, toxR, zot, hlyA which were in higher percentage in the case of V. cholerae O1. The Vibrio cholerae O1 and non-O1-/non-O139 strains showed multiple antibiotic resistances in 2007 and 2012. The PCR detection of four resistance associated genes (strB, dfrA1, sulll, SXT) confirmed higher prevalence in V. cholerae non-O1/non-O139 strains. The PFGE analysis revealed 3 pulsotypes having 93% similarity among V. cholerae O1 strains. CONCLUSION This study indicates the changing epidemiology, antibiogram patterns and continuous genetic variation in environmental V. cholerae strains of Odisha over the years. So continuous surveillance is necessary to understand the changing patterns of V. cholerae different serogroups isolated from stool and water samples from Odisha.
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Affiliation(s)
- Bibhuti Bhusan Pal
- Microbiology Division, ICMR-Regional Medical Research Centre, 751023, Chandrasekharpur, Bhubaneswar, Odisha, India.
| | - Debasish Samal
- Microbiology Division, ICMR-Regional Medical Research Centre, 751023, Chandrasekharpur, Bhubaneswar, Odisha, India
| | - Smruti Ranjan Nayak
- Microbiology Division, ICMR-Regional Medical Research Centre, 751023, Chandrasekharpur, Bhubaneswar, Odisha, India
| | - Swatishree Pany
- Microbiology Division, ICMR-Regional Medical Research Centre, 751023, Chandrasekharpur, Bhubaneswar, Odisha, India
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Lu P, Chen J, Li Z, Li Z, Zhang J, Kan B, Pang B. Visual Identification and Serotyping of Toxigenic Vibrio cholerae Serogroups O1 and O139 With CARID. Front Cell Infect Microbiol 2022; 12:863435. [PMID: 35433512 PMCID: PMC9008587 DOI: 10.3389/fcimb.2022.863435] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 03/07/2022] [Indexed: 12/26/2022] Open
Abstract
There is a growing demand for rapid, sensitive, field-deployable nucleic acid tests for cholera, which usually occurs in rural areas. In this study, we developed a Cas12a-assisted rapid isothermal detection (CARID) system for the detection of toxigenic V. cholerae serogroups O1 and O139 by combining recombinase-aided amplification and CRISPR-Cas (clustered regularly interspaced short palindromic repeats and CRISPR-associated proteins). The results can be determined by fluorescence signal and visualized by lateral flow dipstick. We identified 154 V. cholerae strains and 129 strains of other intestinal diarrheagenic bacteria with a 100% coincidence rate. The limit of detection of CARID was 20 copies/reaction of V. cholerae genomic DNA, which is comparable to that of polymerase chain reaction (PCR) and qPCR. Multiple-CARID was also established for efficiency and economic considerations with an acceptable decrease in sensitivity. Simulated sample tests showed that CARID is suitable for complex samples. In conclusion, CARID is a rapid, sensitive, economically efficient, and portable method for the detection of V. cholerae, which makes it suitable for field responses to cholera.
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Yilmaz T, Goluch ED. A comprehensive review of conventional techniques and biosensor systems developed for in situ detection of vibrio cholerae. Trends Analyt Chem 2021. [DOI: 10.1016/j.trac.2021.116416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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7
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Islam MT, Nasreen T, Kirchberger PC, Liang KYH, Orata FD, Johura FT, Hussain NAS, Im MS, Tarr CL, Alam M, Boucher YF. Population Analysis of Vibrio cholerae in Aquatic Reservoirs Reveals a Novel Sister Species ( Vibrio paracholerae sp. nov.) with a History of Association with Humans. Appl Environ Microbiol 2021; 87:e0042221. [PMID: 34132593 PMCID: PMC8357300 DOI: 10.1128/aem.00422-21] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 06/04/2021] [Indexed: 12/12/2022] Open
Abstract
Most efforts to understand the biology of Vibrio cholerae have focused on a single group, the pandemic-generating lineage harboring the strains responsible for all known cholera pandemics. Consequently, little is known about the diversity of this species in its native aquatic environment. To understand the differences in the V. cholerae populations inhabiting regions with a history of cholera cases and those lacking such a history, a comparative analysis of population composition was performed. Little overlap was found in lineage compositions between those in Dhaka, Bangladesh (where cholera is endemic), located in the Ganges Delta, and those in Falmouth, MA (no known history of cholera), a small coastal town on the United States east coast. The most striking difference was the presence of a group of related lineages at high abundance in Dhaka, which was completely absent from Falmouth. Phylogenomic analysis revealed that these lineages form a cluster at the base of the phylogeny for the V. cholerae species and were sufficiently differentiated genetically and phenotypically to form a novel species. A retrospective search revealed that strains from this species have been anecdotally found from around the world and were isolated as early as 1916 from a British soldier in Egypt suffering from choleraic diarrhea. In 1935, Gardner and Venkatraman unofficially referred to a member of this group as Vibrio paracholerae. In recognition of this earlier designation, we propose the name Vibrio paracholerae sp. nov. for this bacterium. Genomic analysis suggests a link with human populations for this novel species and substantial interaction with its better-known sister species. IMPORTANCE Cholera continues to remain a major public health threat around the globe. Understanding the ecology, evolution, and environmental adaptation of the causative agent (Vibrio cholerae) and tracking the emergence of novel lineages with pathogenic potential are essential to combat the problem. In this study, we investigated the population dynamics of Vibrio cholerae in an inland locality, which is known as endemic for cholera, and compared them with those of a cholera-free coastal location. We found the consistent presence of the pandemic-generating lineage of V. cholerae in Dhaka, where cholera is endemic, and an exclusive presence of a lineage phylogenetically distinct from other V. cholerae lineages. Our study suggests that this lineage represents a novel species that has pathogenic potential and a human link to its environmental abundance. The possible association with human populations and coexistence and interaction with toxigenic V. cholerae in the natural environment make this potential human pathogen an important subject for future studies.
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Affiliation(s)
| | - Tania Nasreen
- Department of Biological Sciences, University of Alberta, Edmonton, Alberta, Canada
| | - Paul C. Kirchberger
- Department of Integrative Biology, University of Texas at Austin, Austin, Texas, USA
| | - Kevin Y. H. Liang
- Department of Biological Sciences, University of Alberta, Edmonton, Alberta, Canada
| | - Fabini D. Orata
- Department of Biological Sciences, University of Alberta, Edmonton, Alberta, Canada
| | - Fatema-Tuz Johura
- Infectious Diseases Division, International Centre for Diarrheal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Nora A. S. Hussain
- Department of Biological Sciences, University of Alberta, Edmonton, Alberta, Canada
| | - Monica S. Im
- National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Cheryl L. Tarr
- National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Munirul Alam
- Infectious Diseases Division, International Centre for Diarrheal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Yann F. Boucher
- Department of Biological Sciences, University of Alberta, Edmonton, Alberta, Canada
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
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Investigation of the Domestic Reservoirs of Diarrheagenic Escherichia coli in Diarrhea Case Households of Urban Bangladesh. Curr Microbiol 2021; 78:2534-2547. [PMID: 33956228 DOI: 10.1007/s00284-021-02506-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Accepted: 04/25/2021] [Indexed: 10/21/2022]
Abstract
This study collected rectal swabs from diarrheal patients and in-house environmental samples from low-income households in Dhaka City, Bangladesh, over a 4-month period and investigated these to determine the domestic transmission pathways of Escherichia coli-associated diarrhea. The environmental samples included swabs from four frequently touched surfaces, drinking water and food. Both the rectal swabs and environmental samples were examined for virulence genes characteristic of diarrheagenic E. coli pathotypes by PCR. In addition, each sample was cultured for E. coli, and the strains were analyzed for virulence profile and subjected to multilocus sequence typing (MLST). The results showed that 31% (73 of 233) of all samples including rectal swabs and household samples were positive for one or more of the diarrheagenic E. coli virulence factors. PCR analyses showed that 28% (10/36) of the rectal swabs, 43% (58/136) of household swabs, 9% (3/32) of the food, and 7% (2/29) of the water samples were positive for various virulence genes. 6 Out of the 36 rectal swab samples and associated household samples were shown to have similar E. coli pathotypic genes, and the drinking vessel surface was identified as the major source of contamination. EAEC and CTEC were the most commonly identified pathotypes in the cultured isolates. The phylogenetic tree constructed by MLST data showed that the diarrheagenic isolates were clustered in several diversified lineages. This study supports the hypothesis that there are high-risk hotspots, particularly those surfaces associated with food consumption, for diarrheagenic E. coli contamination within the household environments of Bangladesh.
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Dinede G, Abagero A, Tolosa T. Cholera outbreak in Addis Ababa, Ethiopia: A case-control study. PLoS One 2020; 15:e0235440. [PMID: 32614915 PMCID: PMC7332024 DOI: 10.1371/journal.pone.0235440] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 06/15/2020] [Indexed: 11/18/2022] Open
Abstract
Background Cholera remains a significant public health problem in more than one-third of the countries of the world. Cholera outbreak has become more common in Addis Ababa particularly in the rainy seasons; however, there is a paucity of data on risk factors associated with cholera outbreaks rendering interventions difficult. We investigated the outbreak to identify its etiology, source, risk factors and in order to control the outbreak. Methods We compared cases with health center-based unmatched controls (1:2). Cases were patients aged ≥5 years with acute watery diarrhea, with or without vomiting while controls were persons aged ≥5 years without history of acute watery diarrhea. We interviewed our study participants using structured questionnaire to collect demographic and cholera risk factors data. We described the outbreak over time, and then tested our hypotheses using unconditional logistic regression. Results The outbreak began on 7 September, 2017 reaching its peak on 23 September, 2017 and ended on 01 October, 2017. We identified a total of 25 cases (Median age: 38 years; IQR: 20 years) and recruited 50 controls (Median age: 35 years; IQR: 29 years). All case-patients had acute watery diarrhea and dehydration requiring intravenous fluids. All cases were admitted to cholera treatment center but there were no deaths. Stool and water samples yielded isolates of Vibrio cholerae O1 of serological subtype Ogawa. Consumption of contaminated holy water (AOR: 20.5, 95%CI: 3.50, 119.61) and raw vegetables (AOR: 15.3, 95%CI: 3, 81.51) were independent risk factors whereas washing hands with soap after visiting latrine (AOR: 0.04, 95%CI: 0.01, 0.25) was independent protective factor. Conclusion Our findings demonstrated cholera foodborne transmission via consumption of raw vegetables, and its waterborne transmission via consumption of contaminated holy water. Washing hands with soap after visiting latrine was protective. We recommended cooking of vegetables and promoting hand washing.
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Affiliation(s)
- Getachew Dinede
- Epidemiology Directorate, Ministry of Agriculture, Addis Ababa, Ethiopia
- * E-mail:
| | - Abdulnasir Abagero
- Field Epidemiology Training Program, School of Public Health, Addis Ababa University, Ethiopia
| | - Tadele Tolosa
- Microbiology and Dairy Heard Health Management, School of Veterinary Medicine, College of Agriculture and Veterinary Medicine, Jimma University, Jimma, Ethiopia
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Meszaros VA, Miller-Dickson MD, Baffour-Awuah F, Almagro-Moreno S, Ogbunugafor CB. Direct transmission via households informs models of disease and intervention dynamics in cholera. PLoS One 2020; 15:e0229837. [PMID: 32163436 PMCID: PMC7067450 DOI: 10.1371/journal.pone.0229837] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Accepted: 02/14/2020] [Indexed: 02/07/2023] Open
Abstract
While several basic properties of cholera outbreaks are common to most settings-the pathophysiology of the disease, the waterborne nature of transmission, and others-recent findings suggest that transmission within households may play a larger role in cholera outbreaks than previously appreciated. Important features of cholera outbreaks have long been effectively modeled with mathematical and computational approaches, but little is known about how variation in direct transmission via households may influence epidemic dynamics. In this study, we construct a mathematical model of cholera that incorporates transmission within and between households. We observe that variation in the magnitude of household transmission changes multiple features of disease dynamics, including the severity and duration of outbreaks. Strikingly, we observe that household transmission influences the effectiveness of possible public health interventions (e.g. water treatment, antibiotics, vaccines). We find that vaccine interventions are more effective than water treatment or antibiotic administration when direct household transmission is present. Summarizing, we position these results within the landscape of existing models of cholera, and speculate on its implications for epidemiology and public health.
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Affiliation(s)
- Victor A. Meszaros
- Department of Ecology and Evolutionary Biology, Brown University, Providence, RI, United States of America
| | - Miles D. Miller-Dickson
- Department of Ecology and Evolutionary Biology, Brown University, Providence, RI, United States of America
| | - Francis Baffour-Awuah
- Department of Mathematics, Florida State University, Tallahassee, FL, United States of America
| | - Salvador Almagro-Moreno
- Burnett School of Biomedical Sciences, University of Central Florida, Orlando, FL, United States of America
- National Center for Integrated Coastal Research, University of Central Florida, Orlando, FL, United States of America
| | - C. Brandon Ogbunugafor
- Department of Ecology and Evolutionary Biology, Brown University, Providence, RI, United States of America
- * E-mail:
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D’Mello-Guyett L, Gallandat K, Van den Bergh R, Taylor D, Bulit G, Legros D, Maes P, Checchi F, Cumming O. Prevention and control of cholera with household and community water, sanitation and hygiene (WASH) interventions: A scoping review of current international guidelines. PLoS One 2020; 15:e0226549. [PMID: 31914164 PMCID: PMC6948749 DOI: 10.1371/journal.pone.0226549] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Accepted: 12/03/2019] [Indexed: 12/13/2022] Open
Abstract
INTRODUCTION Cholera remains a frequent cause of outbreaks globally, particularly in areas with inadequate water, sanitation and hygiene (WASH) services. Cholera is spread through faecal-oral routes, and studies demonstrate that ingestion of Vibrio cholerae occurs from consuming contaminated food and water, contact with cholera cases and transmission from contaminated environmental point sources. WASH guidelines recommending interventions for the prevention and control of cholera are numerous and vary considerably in their recommendations. To date, there has been no review of practice guidelines used in cholera prevention and control programmes. METHODS We systematically searched international agency websites to identify WASH intervention guidelines used in cholera programmes in endemic and epidemic settings. Recommendations listed in the guidelines were extracted, categorised and analysed. Analysis was based on consistency, concordance and recommendations were classified on the basis of whether the interventions targeted within-household or community-level transmission. RESULTS Eight international guidelines were included in this review: three by non-governmental organisations (NGOs), one from a non-profit organisation (NPO), three from multilateral organisations and one from a research institution. There were 95 distinct recommendations identified, and concordance among guidelines was poor to fair. All categories of WASH interventions were featured in the guidelines. The majority of recommendations targeted community-level transmission (45%), 35% targeted within-household transmission and 20% both. CONCLUSIONS Recent evidence suggests that interventions for effective cholera control and response to epidemics should focus on case-centred approaches and within-household transmission. Guidelines did consistently propose interventions targeting transmission within households. However, the majority of recommendations listed in guidelines targeted community-level transmission and tended to be more focused on preventing contamination of the environment by cases or recurrent outbreaks, and the level of service required to interrupt community-level transmission was often not specified. The guidelines in current use were varied and interpretation may be difficult when conflicting recommendations are provided. Future editions of guidelines should reflect on the inclusion of evidence-based approaches, cholera transmission models and resource-efficient strategies.
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Affiliation(s)
- Lauren D’Mello-Guyett
- Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Environmental Health Unit, Médecins Sans Frontières, Brussels, Belgium
| | - Karin Gallandat
- Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Rafael Van den Bergh
- LuxOR, Luxembourg Operational Research Unit, Médecins Sans Frontières, Luxembourg
| | - Dawn Taylor
- Public Health Unit, Médecins Sans Frontières, Amsterdam, Netherlands
| | - Gregory Bulit
- Water, Sanitation and Hygiene, UNICEF, New York, New York, United States of America
| | - Dominique Legros
- Global Task Force on Cholera Control, World Health Organization, Geneva, Switzerland
| | - Peter Maes
- Environmental Health Unit, Médecins Sans Frontières, Brussels, Belgium
| | - Francesco Checchi
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Oliver Cumming
- Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
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12
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Zereen F, Akter S, Sobur MA, Hossain MT, Rahman MT. Molecular detection of Vibrio cholerae from human stool collected from SK Hospital, Mymensingh, and their antibiogram. J Adv Vet Anim Res 2019; 6:451-455. [PMID: 31819871 PMCID: PMC6882716 DOI: 10.5455/javar.2019.f367] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 09/08/2019] [Accepted: 09/09/2019] [Indexed: 11/17/2022] Open
Abstract
Objective: Vibrio spp., particularly, Vibrio cholerae is a major etiology of diarrhea in humans worldwide. In this study, we isolated and identified V. cholerae from the human stool of suspected cases along with antibiogram. Materials and Methods: In total, 25 stool samples from cholera suspected patients were analyzed. Isolation and molecular detection of Vibrio species were performed based on staining, motility, cultural and biochemical characteristics followed by polymerase chain reaction (PCR) using groEL gene-specific primers. Results: Among the 25 samples, seven showed growth of yellow color colonies on Thiosulfate-Citrate-Bile salts-Sucrose agar plates. The isolates were Gram-negative, curved shaped, and motile. Biochemically, they were found positive for indole and Methyl Red tests and negative for Voges–Proskauer test. Out of the seven positive samples, only three isolates were confirmed as Vibrio spp. using genus-specific primers. Subsequently, these three isolates were confirmed as V. cholerae by PCR using V. cholerae groEL gene-specific primers. Antibiotic sensitivity test revealed these three isolates as highly sensitive to azithromycin, chloramphenicol, gentamicin, and norfloxacillin while resistant to streptomycin, tetracycline, and oxacillin. Conclusion: Vibrio cholerae were isolated from the stool of diarrheic human patients and confirmed by PCR targeting the groEL gene. The isolates were found resistant to streptomycin, tetracycline and oxacillin, and need further characterization to reveal the molecular basis of their origin and resistance.
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Affiliation(s)
- Farah Zereen
- Department of Microbiology and Hygiene, Faculty of Veterinary Science, Bangladesh Agricultural University, Mymensingh 2202, Bangladesh
| | - Soudiya Akter
- Department of Microbiology and Hygiene, Faculty of Veterinary Science, Bangladesh Agricultural University, Mymensingh 2202, Bangladesh
| | - Md Abdus Sobur
- Department of Microbiology and Hygiene, Faculty of Veterinary Science, Bangladesh Agricultural University, Mymensingh 2202, Bangladesh
| | - Muhammad Tofazzal Hossain
- Department of Microbiology and Hygiene, Faculty of Veterinary Science, Bangladesh Agricultural University, Mymensingh 2202, Bangladesh
| | - Md Tanvir Rahman
- Department of Microbiology and Hygiene, Faculty of Veterinary Science, Bangladesh Agricultural University, Mymensingh 2202, Bangladesh
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13
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Foysal MJ, Momtaz F, Robiul Kawser AQM, Chaklader MR, Siddik MAB, Lamichhane B, Tay ACY, Rahman MM, Fotedar R. Microbiome patterns reveal the transmission of pathogenic bacteria in hilsa fish (Tenualosa ilisha) marketed for human consumption in Bangladesh. J Appl Microbiol 2019; 126:1879-1890. [PMID: 30888695 DOI: 10.1111/jam.14257] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 01/22/2019] [Accepted: 03/10/2019] [Indexed: 12/11/2022]
Abstract
AIMS This study conducted bacterial community, virulence and antibiogram profiling inside the hindgut and skin of freshly caught hilsa fish and those sold at markets. METHODS AND RESULTS The results of 16S rRNA-based high-throughput sequencing showed a higher number of bacterial genera in marketed fish samples than in fresh fish samples. The total operational taxonomic units, genus counts and diversity index were significantly higher (P > 0·05) in marketed fish, which also had abundant pathogenic bacterial groups. Skin samples had a lower profusion of pathogenic bacteria than gut samples. A total of 52 bacterial isolates from nine species were identified in this study, of which 25 were from a Chittagong market and 22 were from a Dhaka market, whereas only five were from fresh hilsa. The polymerase chain reaction amplification of 12 species-specific virulence genes in the 52 isolates, namely, aer, hly, chxA, toxB, rtxC, sfa, uge, norB, trx, toxA, ipaH, sigA and coa, indicated a high number of positive samples containing Vibrio cholerae, Aeromonas spp., Klebsiella pneumoniae, Escherichia coli and Staphylococcus aureus. Antibiogram profiling of these bacteria against 10 commercial antibiotics showed high-resistance patterns of the isolates against sulfamethoxazole, kanamycin, neomycin, ampicillin and tetracycline. CONCLUSION The results reveal the spread of multidrug-resistant bacteria in hilsa fish marketed for human consumption in Bangladesh. SIGNIFICANCE AND IMPACT OF THE STUDY This study highlights the risk of spreading environmentally and clinically pathogenic bacteria in fish sold for human consumption in Bangladesh. Such bacteria come from aquatic pollution and poor handling, storage and transportation practices that may predispose fish to major outbreaks of infectious and waterborne diseases.
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Affiliation(s)
- M J Foysal
- School of Molecular and Life Sciences, Curtin University, Bentley, WA, Australia.,Department of Genetic Engineering and Biotechnology, Shahjalal University of Science and Technology, Sylhet, Bangladesh
| | - F Momtaz
- Department of Microbiology, Chittagong University, Chittagong, Bangladesh
| | - A Q M Robiul Kawser
- Department of Aquaculture, Bangabandhu Sheikh Mujibur Rahman Agricultural University, Gazipur, Bangladesh
| | - M R Chaklader
- School of Molecular and Life Sciences, Curtin University, Bentley, WA, Australia
| | - M A B Siddik
- School of Molecular and Life Sciences, Curtin University, Bentley, WA, Australia.,Department of Fisheries Biology and Genetics, Patuakhali Science and Technology University, Patuakhali, Bangladesh
| | - B Lamichhane
- Helicobacter Research Laboratory, Marshall Centre for Infectious Disease Research and Training, School of Biomedical Sciences, University of Western Australia, Perth, WA, Australia
| | - A C Y Tay
- Helicobacter Research Laboratory, Marshall Centre for Infectious Disease Research and Training, School of Biomedical Sciences, University of Western Australia, Perth, WA, Australia
| | - M M Rahman
- Department of Biotechnology, Bangabandhu Sheikh Mujibur Rahman Agricultural University, Gazipur, Bangladesh
| | - R Fotedar
- School of Molecular and Life Sciences, Curtin University, Bentley, WA, Australia
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14
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Levade I, Terrat Y, Leducq JB, Weil AA, Mayo-Smith LM, Chowdhury F, Khan AI, Boncy J, Buteau J, Ivers LC, Ryan ET, Charles RC, Calderwood SB, Qadri F, Harris JB, LaRocque RC, Shapiro BJ. Vibrio cholerae genomic diversity within and between patients. Microb Genom 2019; 3. [PMID: 29306353 PMCID: PMC5761273 DOI: 10.1099/mgen.0.000142] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Cholera is a severe, water-borne diarrhoeal disease caused by toxin-producing strains of the bacterium Vibrio cholerae. Comparative genomics has revealed 'waves' of cholera transmission and evolution, in which clones are successively replaced over decades and centuries. However, the extent of V. cholerae genetic diversity within an epidemic or even within an individual patient is poorly understood. Here, we characterized V. cholerae genomic diversity at a micro-epidemiological level within and between individual patients from Bangladesh and Haiti. To capture within-patient diversity, we isolated multiple (8 to 20) V. cholerae colonies from each of eight patients, sequenced their genomes and identified point mutations and gene gain/loss events. We found limited but detectable diversity at the level of point mutations within hosts (zero to three single nucleotide variants within each patient), and comparatively higher gene content variation within hosts (at least one gain/loss event per patient, and up to 103 events in one patient). Much of the gene content variation appeared to be due to gain and loss of phage and plasmids within the V. cholerae population, with occasional exchanges between V. cholerae and other members of the gut microbiota. We also show that certain intra-host variants have phenotypic consequences. For example, the acquisition of a Bacteroides plasmid and non-synonymous mutations in a sensor histidine kinase gene both reduced biofilm formation, an important trait for environmental survival. Together, our results show that V. cholerae is measurably evolving within patients, with possible implications for disease outcomes and transmission dynamics.
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Affiliation(s)
- Inès Levade
- 1Department of Biological Sciences, University of Montreal, Montreal, Quebec, Canada
| | - Yves Terrat
- 1Department of Biological Sciences, University of Montreal, Montreal, Quebec, Canada
| | - Jean-Baptiste Leducq
- 1Department of Biological Sciences, University of Montreal, Montreal, Quebec, Canada
| | - Ana A Weil
- 2Division of Infectious Diseases, Massachusetts General Hospital, Boston, MA, USA.,3Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Leslie M Mayo-Smith
- 2Division of Infectious Diseases, Massachusetts General Hospital, Boston, MA, USA
| | - Fahima Chowdhury
- 4Center for Vaccine Sciences, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Ashraful I Khan
- 4Center for Vaccine Sciences, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Jacques Boncy
- 5National Public Health Laboratory, Ministry of Public Health and Population, Port-au-Prince, Haiti
| | - Josiane Buteau
- 5National Public Health Laboratory, Ministry of Public Health and Population, Port-au-Prince, Haiti
| | - Louise C Ivers
- 3Department of Medicine, Harvard Medical School, Boston, MA, USA.,6Division of Global Health Equity, Brigham and Women's Hospital, Boston, MA, USA.,7Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
| | - Edward T Ryan
- 2Division of Infectious Diseases, Massachusetts General Hospital, Boston, MA, USA.,3Department of Medicine, Harvard Medical School, Boston, MA, USA.,8Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, MA, USA
| | - Richelle C Charles
- 2Division of Infectious Diseases, Massachusetts General Hospital, Boston, MA, USA.,3Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Stephen B Calderwood
- 2Division of Infectious Diseases, Massachusetts General Hospital, Boston, MA, USA.,3Department of Medicine, Harvard Medical School, Boston, MA, USA.,9Department of Microbiology and Immunobiology, Harvard Medical School, Boston, MA, USA
| | - Firdausi Qadri
- 4Center for Vaccine Sciences, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Jason B Harris
- 2Division of Infectious Diseases, Massachusetts General Hospital, Boston, MA, USA.,10Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Regina C LaRocque
- 2Division of Infectious Diseases, Massachusetts General Hospital, Boston, MA, USA.,3Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - B Jesse Shapiro
- 1Department of Biological Sciences, University of Montreal, Montreal, Quebec, Canada
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15
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Rahman Z, Rahman MA, Rashid MU, Monira S, Johura FT, Mustafiz M, Bhuyian SI, Zohura F, Parvin T, Hasan K, Saif-Ur-Rahman KM, Islam NN, Sack DA, George CM, Alam M. Vibrio cholerae Transmits Through Water Among the Household Contacts of Cholera Patients in Cholera Endemic Coastal Villages of Bangladesh, 2015-2016 (CHoBI7 Trial). Front Public Health 2018; 6:238. [PMID: 30214899 PMCID: PMC6125298 DOI: 10.3389/fpubh.2018.00238] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2018] [Accepted: 08/08/2018] [Indexed: 12/15/2022] Open
Abstract
Recurrent cholera causes significant morbidity and mortality in cholera endemic estuarine areas of Bangladesh. There have been limited studies to investigate the transmission patterns of V. cholerae associated with cholera in Bangladesh. In this study, we characterized V. cholerae serogroup O1 isolated from 30 cholera patients, 76 household contacts, 119 stored drinking water samples, and 119 water source samples in Bakerganj and Mathbaria, two cholera endemic coastal regions in Bangladesh. Results of phenotypic and molecular characterization of V. cholerae isolates (n = 56) confirmed them to be toxigenic belonging to serogroup O1 biotype El Tor (ET), and possessing cholera toxin of the classical biotype (altered ET). Molecular fingerprinting of the V. cholerae O1 of clinical and water origins determined by PFGE of Not-I- digested genomic DNA showed them to be closely related, as the PFGE banding patterns were highly homogenous. Phylogenetic analysis using dendrogram of cholera patients, household contacts, and household groundwater sources showed isolates within households to be clonally linked, suggesting water as an important vehicle of transmission of cholera in the coastal villages of Bangladesh. Transmission of toxigenic V. cholerae O1 through drinking water in cholera endemic rural settings underscores the urgent need for evidence based water, sanitation, and hygiene interventions promoting safe drinking water to prevent morbidity and mortality related to cholera and other enteric infections in Bangladesh.
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Affiliation(s)
- Zillur Rahman
- Infectious Diseases Division, International Center for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Md. Anisur Rahman
- Department of Biotechnology and Genetic Engineering, Noakhali Science and Technology University, Noakhali, Bangladesh
| | - Mahamud-ur Rashid
- Infectious Diseases Division, International Center for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Shirajum Monira
- Infectious Diseases Division, International Center for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Fatema-Tuz Johura
- Infectious Diseases Division, International Center for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Munshi Mustafiz
- Infectious Diseases Division, International Center for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Sazzadul I. Bhuyian
- Infectious Diseases Division, International Center for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Fatema Zohura
- Infectious Diseases Division, International Center for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Tahmina Parvin
- Infectious Diseases Division, International Center for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Khaled Hasan
- Department of International Health, Johns Hopkins Bloomberg School of Public Health Baltimore, Baltimore, MD, United States
| | - K. M. Saif-Ur-Rahman
- Infectious Diseases Division, International Center for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Nazneen N. Islam
- Department of Genetic Engineering and Biotechnology, University of Chittagong, Chittagong, Bangladesh
| | - David A. Sack
- Department of International Health, Johns Hopkins Bloomberg School of Public Health Baltimore, Baltimore, MD, United States
| | - Christine M. George
- Department of International Health, Johns Hopkins Bloomberg School of Public Health Baltimore, Baltimore, MD, United States
| | - Munirul Alam
- Infectious Diseases Division, International Center for Diarrhoeal Disease Research, Dhaka, Bangladesh
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16
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Ferdous J, Sultana R, Rashid RB, Tasnimuzzaman M, Nordland A, Begum A, Jensen PKM. A Comparative Analysis of Vibrio cholerae Contamination in Point-of-Drinking and Source Water in a Low-Income Urban Community, Bangladesh. Front Microbiol 2018; 9:489. [PMID: 29616005 PMCID: PMC5867346 DOI: 10.3389/fmicb.2018.00489] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Accepted: 03/02/2018] [Indexed: 11/13/2022] Open
Abstract
Bangladesh is a cholera endemic country with a population at high risk of cholera. Toxigenic and non-toxigenic Vibrio cholerae (V. cholerae) can cause cholera and cholera-like diarrheal illness and outbreaks. Drinking water is one of the primary routes of cholera transmission in Bangladesh. The aim of this study was to conduct a comparative assessment of the presence of V. cholerae between point-of-drinking water and source water, and to investigate the variability of virulence profile using molecular methods of a densely populated low-income settlement of Dhaka, Bangladesh. Water samples were collected and tested for V. cholerae from "point-of-drinking" and "source" in 477 study households in routine visits at 6 week intervals over a period of 14 months. We studied the virulence profiles of V. cholerae positive water samples using 22 different virulence gene markers present in toxigenic O1/O139 and non-O1/O139 V. cholerae using polymerase chain reaction (PCR). A total of 1,463 water samples were collected, with 1,082 samples from point-of-drinking water in 388 households and 381 samples from 66 water sources. V. cholerae was detected in 10% of point-of-drinking water samples and in 9% of source water samples. Twenty-three percent of households and 38% of the sources were positive for V. cholerae in at least one visit. Samples collected from point-of-drinking and linked sources in a 7 day interval showed significantly higher odds (P < 0.05) of V. cholerae presence in point-of-drinking compared to source [OR = 17.24 (95% CI = 7.14-42.89)] water. Based on the 7 day interval data, 53% (17/32) of source water samples were negative for V. cholerae while linked point-of-drinking water samples were positive. There were significantly higher odds (p < 0.05) of the presence of V. cholerae O1 [OR = 9.13 (95% CI = 2.85-29.26)] and V. cholerae O139 [OR = 4.73 (95% CI = 1.19-18.79)] in source water samples than in point-of-drinking water samples. Contamination of water at the point-of-drinking is less likely to depend on the contamination at the water source. Hygiene education interventions and programs should focus and emphasize on water at the point-of-drinking, including repeated cleaning of drinking vessels, which is of paramount importance in preventing cholera.
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Affiliation(s)
- Jannatul Ferdous
- Department of Microbiology, University of Dhaka, Dhaka, Bangladesh.,Section for Global Health, Department of Public Health, Copenhagen Center for Disaster Research, University of Copenhagen, Copenhagen, Denmark
| | - Rebeca Sultana
- Section for Global Health, Department of Public Health, Copenhagen Center for Disaster Research, University of Copenhagen, Copenhagen, Denmark.,International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh.,Institute of Health Economics, University of Dhaka, Dhaka, Bangladesh
| | - Ridwan B Rashid
- Department of Microbiology, University of Dhaka, Dhaka, Bangladesh
| | - Md Tasnimuzzaman
- Department of Microbiology, University of Dhaka, Dhaka, Bangladesh
| | - Andreas Nordland
- Section for Global Health, Department of Public Health, Copenhagen Center for Disaster Research, University of Copenhagen, Copenhagen, Denmark
| | - Anowara Begum
- Department of Microbiology, University of Dhaka, Dhaka, Bangladesh
| | - Peter K M Jensen
- Section for Global Health, Department of Public Health, Copenhagen Center for Disaster Research, University of Copenhagen, Copenhagen, Denmark
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17
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George CM, Rashid M, Almeida M, Saif-Ur-Rahman KM, Monira S, Bhuyian MSI, Hasan K, Mahmud TT, Li S, Brubaker J, Perin J, Rahman Z, Mustafiz M, Sack DA, Sack RB, Alam M, Stine OC. Genetic relatedness of Vibrio cholerae isolates within and between households during outbreaks in Dhaka, Bangladesh. BMC Genomics 2017; 18:903. [PMID: 29178823 PMCID: PMC5702050 DOI: 10.1186/s12864-017-4254-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Accepted: 11/01/2017] [Indexed: 01/03/2023] Open
Abstract
Background Household contacts of cholera patients have a 100 times higher risk of developing a cholera infection than the general population. To compare the genetic relatedness of clinical and water source Vibrio cholerae isolates from cholera patients’ households across three outbreaks, we analyzed these isolates using whole-genome-sequencing (WGS) and multilocus variable-number tandem-repeat analysis (MLVA). Results The WGS analyses revealed that 80% of households had source water isolates that were more closely related to clinical isolates from the same household than to any other isolates. While in another 20% of households an isolate from a person was more closely related to clinical isolates from another household than to source water isolates from their own household. The mean pairwise differences in single nucleotide-variant (SNV) counts for isolates from the same household were significantly lower than those for different households (2.4 vs. 7.7 p < 0.0001), and isolates from the same outbreak had significantly fewer mean pairwise differences compared to isolates from different outbreaks (mean: 6.2 vs. 8.0, p < 0.0001). Based on MLVA in outbreak 1, we observed that the majority of households had clinical isolates with MLVA genotypes related to other clinical isolates and unrelated to water source isolates from the same household. While in outbreak 3, there were different MLVA genotypes between households, however within the majority of households, the clinical and water source isolates had the same MLVA genotypes. The beginning of outbreak 2 resembled outbreak 1 and the latter part resembled outbreak 3. We validated our use of MLVA by comparing it to WGS. Isolates with the identical MLVA genotype had significantly fewer mean pairwise SNV differences than those isolates with different MLVA genotypes (mean: 4.8 vs. 7.7, p < 0.0001). Furthermore, consistent with WGS results, the number of pairwise differences in the five MLVA loci for isolates within the same household was significantly lower than isolates from different households (mean: 1.6 vs. 3.0, p < 0.0001). Conclusion These results suggest that transmission patterns for cholera are a combination of person-to-person and water-to-person cholera transmission with the proportions of the two modes varying within and between outbreaks. Electronic supplementary material The online version of this article (10.1186/s12864-017-4254-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Christine Marie George
- Department of International Health, Program in Global Disease Epidemiology and Control, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Room E5535, Baltimore, MD, 21205-2103, USA.
| | - Mahamud Rashid
- International Centre for Diarrhoeal Disease Research, Shaheed Tajuddin Ahmed Ave, Dhaka, 1213, Bangladesh
| | - Mathieu Almeida
- University of Maryland School of Medicine, 655 W Baltimore S, Baltimore, MD, 21201, USA
| | - K M Saif-Ur-Rahman
- International Centre for Diarrhoeal Disease Research, Shaheed Tajuddin Ahmed Ave, Dhaka, 1213, Bangladesh
| | - Shirajum Monira
- International Centre for Diarrhoeal Disease Research, Shaheed Tajuddin Ahmed Ave, Dhaka, 1213, Bangladesh
| | - Md Sazzadul Islam Bhuyian
- International Centre for Diarrhoeal Disease Research, Shaheed Tajuddin Ahmed Ave, Dhaka, 1213, Bangladesh
| | - Khaled Hasan
- Johns Hopkins School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205-2103, USA
| | - Toslim T Mahmud
- International Centre for Diarrhoeal Disease Research, Shaheed Tajuddin Ahmed Ave, Dhaka, 1213, Bangladesh
| | - Shan Li
- University of Maryland School of Medicine, 655 W Baltimore S, Baltimore, MD, 21201, USA
| | - Jessica Brubaker
- Johns Hopkins School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205-2103, USA
| | - Jamie Perin
- Johns Hopkins School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205-2103, USA
| | - Zillur Rahman
- International Centre for Diarrhoeal Disease Research, Shaheed Tajuddin Ahmed Ave, Dhaka, 1213, Bangladesh
| | - Munshi Mustafiz
- International Centre for Diarrhoeal Disease Research, Shaheed Tajuddin Ahmed Ave, Dhaka, 1213, Bangladesh
| | - David A Sack
- Johns Hopkins School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205-2103, USA
| | - R Bradley Sack
- Johns Hopkins School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205-2103, USA
| | - Munirul Alam
- International Centre for Diarrhoeal Disease Research, Shaheed Tajuddin Ahmed Ave, Dhaka, 1213, Bangladesh
| | - O Colin Stine
- University of Maryland School of Medicine, 655 W Baltimore S, Baltimore, MD, 21201, USA
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