1
|
Mwaba J, Debes AK, Murt KN, Shea P, Simuyandi M, Laban N, Kazimbaya K, Chisenga C, Li S, Almeida M, Meisel JS, Shibemba A, Kantenga T, Mukonka V, Kwenda G, Sack DA, Chilengi R, Stine OC. Three transmission events of Vibrio cholerae O1 into Lusaka, Zambia. BMC Infect Dis 2021; 21:570. [PMID: 34126945 PMCID: PMC8200794 DOI: 10.1186/s12879-021-06259-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 05/27/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Cholera has been present and recurring in Zambia since 1977. However, there is a paucity of data on genetic relatedness and diversity of the Vibrio cholerae isolates responsible for these outbreaks. Understanding whether the outbreaks are seeded from existing local isolates or if the outbreaks represent separate transmission events can inform public health decisions. RESULTS Seventy-two V. cholerae isolates from outbreaks in 2009/2010, 2016, and 2017/2018 in Zambia were characterized using multilocus variable number tandem repeat analysis (MLVA) and whole genome sequencing (WGS). The isolates had eight distinct MLVA genotypes that clustered into three MLVA clonal complexes (CCs). Each CC contained isolates from only one outbreak. The results from WGS revealed both clustered and dispersed single nucleotide variants. The genetic relatedness of isolates based on WGS was consistent with the MLVA, each CC was a distinct genetic lineage and had nearest neighbors from other East African countries. In Lusaka, isolates from the same outbreak were more closely related to themselves and isolates from other countries than to isolates from other outbreaks in other years. CONCLUSIONS Our observations are consistent with i) the presence of random mutation and alternative mechanisms of nucleotide variation, and ii) three separate transmission events of V. cholerae into Lusaka, Zambia. We suggest that locally, case-area targeted invention strategies and regionally, well-coordinated plans be in place to effectively control future cholera outbreaks.
Collapse
Affiliation(s)
- John Mwaba
- Centre for Infectious Disease Research in Zambia, Lusaka, Zambia
- Department of Biomedical Sciences, University of Zambia School of Health Sciences, Lusaka, Zambia
- Department of Pathology and Microbiology, University Teaching Hospitals, Lusaka, Zambia
| | - Amanda K Debes
- Johns Hopkins Bloomberg School of Public Health, MD, Baltimore, USA
| | - Kelsey N Murt
- Johns Hopkins Bloomberg School of Public Health, MD, Baltimore, USA
| | - Patrick Shea
- Johns Hopkins Bloomberg School of Public Health, MD, Baltimore, USA
| | | | - Natasha Laban
- Centre for Infectious Disease Research in Zambia, Lusaka, Zambia
| | - Katayi Kazimbaya
- Centre for Infectious Disease Research in Zambia, Lusaka, Zambia
- Department of Biomedical Sciences, University of Zambia School of Health Sciences, Lusaka, Zambia
| | | | - Shan Li
- University of Maryland School of Medicine, Baltimore, MD, USA
| | - Mathieu Almeida
- University of Maryland, College Park, College Park, MD, USA
- Université Paris-Saclay, INRAE, MGP, 78350, Jouy-en-Josas, France
| | | | - Aaron Shibemba
- Department of Pathology and Microbiology, University Teaching Hospitals, Lusaka, Zambia
| | - Timothy Kantenga
- Department of Biomedical Sciences, University of Zambia School of Health Sciences, Lusaka, Zambia
- Department of Pathology and Microbiology, University Teaching Hospitals, Lusaka, Zambia
| | | | - Geoffrey Kwenda
- Department of Biomedical Sciences, University of Zambia School of Health Sciences, Lusaka, Zambia
| | - David A Sack
- Johns Hopkins Bloomberg School of Public Health, MD, Baltimore, USA
| | - Roma Chilengi
- Centre for Infectious Disease Research in Zambia, Lusaka, Zambia
| | - O Colin Stine
- University of Maryland School of Medicine, Baltimore, MD, USA.
| |
Collapse
|
2
|
Mwape K, Kwenda G, Kalonda A, Mwaba J, Lukwesa-Musyani C, Ngulube J, Smith AM, Mwansa J. Characterisation of Vibrio cholerae isolates from the 2009, 2010 and 2016 cholera outbreaks in Lusaka province, Zambia. Pan Afr Med J 2020; 35:32. [PMID: 32499849 PMCID: PMC7245973 DOI: 10.11604/pamj.2020.35.32.18853] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Accepted: 11/29/2019] [Indexed: 11/24/2022] Open
Abstract
Introduction In 2009 and 2010, more than 6,000 cholera cases were recorded during these outbreaks with more than 80% of cases recorded in Lusaka province. After a five-year break, in 2016 an outbreak occurred in Lusaka, causing more than 1,000 cases of cholera. This study will strengthen the epidemiological information on the changing characteristics of the cholera outbreaks, for treatment, prevention and control of the disease. Methods This was a laboratory-based descriptive cross-sectional study conducted at the University Teaching Hospital in Lusaka, Zambia. A total of 83 V. cholerae O1 isolates were characterised by biochemical testing, serotyping, antimicrobial susceptibility testing, and macrorestriction analysis using Pulsed-Field Gel Electrophoresis. Results Macrorestriction analysis of the isolates demonstrated high genetic diversity among the isolates with 16 different patterns. The largest pattern comprised 9 isolates while the smallest one had 1 isolate. 2009 and 2010 isolates were highly resistant to nalidixic acid and cotrimoxazole, but highly sensitive to azithromycin and ampicillin. Of the fifty-two isolates from the 2016 cholera outbreak, 90% (47) were sensitive to cotrimoxazole, 94% (49) to tetracycline, and 98% (51) to azithromycin, while 98% (51) were resistant to nalidixic acid and 31(60%) to ampicillin. Conclusion macrorestriction analysis demonstrated high genetic diversity among the V. cholerae O1 strains, suggesting that these isolates were probably not from a similar source. This study also revealed the emergence of multidrug resistance among the 2016 V. cholerae outbreak isolates but were susceptible to cotrimoxazole, tetracycline, and azithromycin, which can be used for treatment of the cholera cases.
Collapse
Affiliation(s)
- Kapambwe Mwape
- Department of Basic Sciences, Michael Chilufya Sata School of Medicine, Copperbelt University, Ndola, Zambia.,Department of Pathology and Microbiology, School of Medicine, University of Zambia, Lusaka, Zambia
| | - Geoffrey Kwenda
- Department of Biomedical Sciences, School of Health Sciences, University of Zambia, Lusaka, Zambia
| | - Annie Kalonda
- Department of Biomedical Sciences, School of Health Sciences, University of Zambia, Lusaka, Zambia
| | - John Mwaba
- Department of Biomedical Sciences, School of Health Sciences, University of Zambia, Lusaka, Zambia.,Department of Pathology and Microbiology, University Teaching Hospital, Lusaka, Zambia
| | | | - Joseph Ngulube
- Department of Pathology and Microbiology, University Teaching Hospital, Lusaka, Zambia
| | - Anthony Marius Smith
- Bacteriology Division, Centre for Enteric Diseases, National Institute for Communicable Diseases, National Health Laboratory Service, Johannesburg, South Africa.,Department of Clinical Microbiology and Infectious Diseases, School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - James Mwansa
- Department of Medical Microbiology, Faculty of Medicine, Lusaka Apex Medical University, Lusaka, Zambia
| |
Collapse
|
3
|
Smith AM. Review of molecular subtyping methodologies used to investigate outbreaks due to multidrug-resistant enteric bacterial pathogens in sub-Saharan Africa. Afr J Lab Med 2019; 8:760. [PMID: 31205868 PMCID: PMC6556818 DOI: 10.4102/ajlm.v8i1.760] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Accepted: 09/25/2018] [Indexed: 01/05/2023] Open
Abstract
Background In sub-Saharan Africa, molecular epidemiological investigation of outbreaks caused by antimicrobial-resistant enteric bacterial pathogens have mostly been described for Salmonella species, Vibrio cholerae, Shigella species and Escherichia coli. For these organisms, I reviewed all publications describing the use of molecular subtyping methodologies to investigate outbreaks caused by multidrug-resistant (MDR) enteric bacterial infections. Objectives To describe the use of molecular subtyping methodologies to investigate outbreaks caused by MDR enteric bacterial pathogens in sub-Saharan Africa and to describe the current status of molecular subtyping capabilities in the region. Methods A PubMed database literature search (English language only) was performed using the search strings: ‘Africa outbreak MDR’, ‘Africa outbreak multi’, ‘Africa outbreak multidrug’, ‘Africa outbreak multi drug’, ‘Africa outbreak resistance’, ‘Africa outbreak resistant’, ‘Africa outbreak drug’, ‘Africa outbreak antibiotic’, ‘Africa outbreak antimicrobial’. These search strings were used in combination with genus and species names of the organisms listed above. All results were included in the review. Results The year 1991 saw one of the first reports describing the use of molecular subtyping methodologies in sub-Saharan Africa; this included the use of plasmid profiling to characterise Salmonella Enteritidis. To date, several methodologies have been used; pulsed-field gel electrophoresis analysis and multilocus sequence typing have been the most commonly used methodologies. Investigations have particularly highlighted the emergence and spread of MDR clones; these include Salmonella Typhi H58 and Salmonella Typhimurium ST313 clones. In recent times, whole-genome sequencing (WGS) analysis approaches have increasingly been used. Conclusion Traditional molecular subtyping methodologies are still commonly used and still have their place in investigations; however, WGS approaches have increasingly been used and are slowly gaining a stronghold. African laboratories need to start adapting their molecular surveillance methodologies to include WGS, as it is foreseen that WGS analysis will eventually replace all traditional methodologies.
Collapse
Affiliation(s)
- Anthony M Smith
- Centre for Enteric Diseases, National Institute for Communicable Diseases, National Health Laboratory Service, Johannesburg, South Africa.,Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| |
Collapse
|
4
|
Yirenya-Tawiah DR, Darkwa A, Dzodzomenyo M. Environmental surveillance for Vibrio cholerae in selected households' water storage systems in Accra Metropolitan Area (AMA) prior to the 2014 cholera outbreak in Accra, Ghana. Environ Sci Pollut Res Int 2018; 25:28335-28343. [PMID: 30083898 DOI: 10.1007/s11356-018-2860-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Accepted: 07/27/2018] [Indexed: 06/08/2023]
Abstract
Cholera is a global public health problem with high endemicity in many developing countries in Africa. In 2014, Ghana experienced its largest epidemic with more than 20,000 cases and 200 deaths; most of it occurred in the Accra Metropolitan Area (AMA). Ghana's disease surveillance system is mainly clinically based and focused on case detection and management. Environmental exploration for the etiological agents is missing from the surveillance strategy. This study therefore assessed the occurrence of toxigenic Vibrio cholerae in water storage systems in selected high risk areas in the AMA area prior to the 2014 outbreak. Three hundred twenty water samples from 80 households' water storage systems were analyzed for toxigenic Vibrio cholerae using the bacterial culture method. Presumptive V. cholerae was isolated from 83.8% of households' water storage systems. The viable cells ranged from 1 to 1400 CFU/100 ml. Vibrio cholerae O1 serotype was isolated from five households in Old Fadama, one household in Shiabu, and one household in Bukom in the month of May and a similar trend was observed for the months of June and July. The presence of Vibro cholerae in the water storage vessels used for drinking confirms the need to consider environmental surveillance for toxigenic Vibro cholerae particularly in high-risk areas to strengthen the existing surveillance system.
Collapse
Affiliation(s)
| | - Ama Darkwa
- Institute for Environment and Sanitation Studies, University of Ghana, Legon, Accra, Ghana
| | | |
Collapse
|
5
|
Bwire G, Sack DA, Almeida M, Li S, Voeglein JB, Debes AK, Kagirita A, Buyinza AW, Orach CG, Stine OC. Molecular characterization of Vibrio cholerae responsible for cholera epidemics in Uganda by PCR, MLVA and WGS. PLoS Negl Trop Dis 2018; 12:e0006492. [PMID: 29864113 PMCID: PMC6002109 DOI: 10.1371/journal.pntd.0006492] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Revised: 06/14/2018] [Accepted: 05/03/2018] [Indexed: 12/23/2022] Open
Abstract
Background For almost 50 years sub-Saharan Africa, including Uganda, has experienced several outbreaks due to Vibrio cholerae. Our aim was to determine the genetic relatedness and spread of strains responsible for cholera outbreaks in Uganda. Methodology/Principal findings Sixty-three V. cholerae isolates collected from outbreaks in Uganda between 2014 and 2016 were tested using multiplex polymerase chain reaction (PCR), multi-locus variable number of tandem repeat analysis (MLVA) and whole genome sequencing (WGS). Three closely related MLVA clonal complexes (CC) were identified: CC1, 32% (20/63); CC2, 40% (25/63) and CC3, 28% (18/63). Each CC contained isolates from a different WGS clade. These clades were contained in the third wave of the 7th cholera pandemic strain, two clades were contained in the transmission event (T)10 lineage and other in T13. Analysing the dates and genetic relatedness revealed that V. cholerae genetic lineages spread between districts within Uganda and across national borders. Conclusion The V. cholerae strains showed local and regional transmission within Uganda and the East African region. To prevent, control and eliminate cholera, these countries should implement strong cross-border collaboration and regional coordination of preventive activities. Cholera, an acute diarrheal disease, essentially was eliminated in the western world many decades ago, but has continued to cause many deaths in sub-Saharan Africa, South America and Asia. Cholera diagnosis in most countries in sub-Saharan Africa, including Uganda, is by stool culture, serology and biochemical methods. These testing methods are unable to establish the relatedness, virulence and spread of Vibrio cholerae in region. To determine the spread, relatedness and virulence of V. cholerae responsible for the various cholera outbreaks in Uganda, we used DNA-based testing methods. We tested 63 V. cholerae isolates from samples collected in Uganda from 2014–2016. Our results showed three distinct lineages of genetically related cholera-causing bacteria. These organisms showed internal spread in Uganda and cross-border spread to neighboring countries in East Africa. These findings provide a valuable baseline and help define the context for directing control measures and technologies for cholera prevention in East Africa.
Collapse
Affiliation(s)
- Godfrey Bwire
- Ministry of Health Uganda, Department of Community Health, Kampala, Uganda
- * E-mail:
| | - David A. Sack
- Johns Hopkins Bloomberg School of Public Health, Department of International Health, DOVE Project, Baltimore, Maryland United States of America
| | - Mathieu Almeida
- University of Maryland School of Medicine, Department of Epidemiology and Public Health, Baltimore, Maryland, United States of America
| | - Shan Li
- University of Maryland School of Medicine, Department of Epidemiology and Public Health, Baltimore, Maryland, United States of America
| | - Joseph B. Voeglein
- Johns Hopkins Bloomberg School of Public Health, Department of International Health, DOVE Project, Baltimore, Maryland United States of America
| | - Amanda Kay Debes
- Johns Hopkins Bloomberg School of Public Health, Department of International Health, DOVE Project, Baltimore, Maryland United States of America
| | - Atek Kagirita
- Uganda National Health Laboratory Services (UNHS/CPHL), Kampala, Uganda
| | | | | | - O. Colin Stine
- University of Maryland School of Medicine, Department of Epidemiology and Public Health, Baltimore, Maryland, United States of America
| |
Collapse
|
6
|
Carlson CJ, Getz WM, Kausrud KL, Cizauskas CA, Blackburn JK, Bustos Carrillo FA, Colwell R, Easterday WR, Ganz HH, Kamath PL, Økstad OA, Turner WC, Kolstø AB, Stenseth NC. Spores and soil from six sides: interdisciplinarity and the environmental biology of anthrax (Bacillus anthracis). Biol Rev Camb Philos Soc 2018; 93:1813-1831. [PMID: 29732670 DOI: 10.1111/brv.12420] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2017] [Revised: 03/27/2018] [Accepted: 04/03/2018] [Indexed: 12/11/2022]
Abstract
Environmentally transmitted diseases are comparatively poorly understood and managed, and their ecology is particularly understudied. Here we identify challenges of studying environmental transmission and persistence with a six-sided interdisciplinary review of the biology of anthrax (Bacillus anthracis). Anthrax is a zoonotic disease capable of maintaining infectious spore banks in soil for decades (or even potentially centuries), and the mechanisms of its environmental persistence have been the topic of significant research and controversy. Where anthrax is endemic, it plays an important ecological role, shaping the dynamics of entire herbivore communities. The complex eco-epidemiology of anthrax, and the mysterious biology of Bacillus anthracis during its environmental stage, have necessitated an interdisciplinary approach to pathogen research. Here, we illustrate different disciplinary perspectives through key advances made by researchers working in Etosha National Park, a long-term ecological research site in Namibia that has exemplified the complexities of the enzootic process of anthrax over decades of surveillance. In Etosha, the role of scavengers and alternative routes (waterborne transmission and flies) has proved unimportant relative to the long-term persistence of anthrax spores in soil and their infection of herbivore hosts. Carcass deposition facilitates green-ups of vegetation to attract herbivores, potentially facilitated by the role of anthrax spores in the rhizosphere. The underlying seasonal pattern of vegetation, and herbivores' immune and behavioural responses to anthrax risk, interact to produce regular 'anthrax seasons' that appear to be a stable feature of the Etosha ecosystem. Through the lens of microbiologists, geneticists, immunologists, ecologists, epidemiologists, and clinicians, we discuss how anthrax dynamics are shaped at the smallest scale by population genetics and interactions within the bacterial communities up to the broadest scales of ecosystem structure. We illustrate the benefits and challenges of this interdisciplinary approach to disease ecology, and suggest ways anthrax might offer insights into the biology of other important pathogens. Bacillus anthracis, and the more recently emerged Bacillus cereus biovar anthracis, share key features with other environmentally transmitted pathogens, including several zoonoses and panzootics of special interest for global health and conservation efforts. Understanding the dynamics of anthrax, and developing interdisciplinary research programs that explore environmental persistence, is a critical step forward for understanding these emerging threats.
Collapse
Affiliation(s)
- Colin J Carlson
- National Socio-Environmental Synthesis Center (SESYNC), University of Maryland, Annapolis, MD 21401, U.S.A.,Department of Biology, Georgetown University, Washington, DC 20057, U.S.A
| | - Wayne M Getz
- Department of Environmental Science, Policy, and Management, University of California, Berkeley, CA 94720, U.S.A.,School of Mathematical Sciences, University of KwaZulu-Natal, PB X 54001, Durban 4000, South Africa
| | - Kyrre L Kausrud
- Centre for Ecological and Evolutionary Synthesis (CEES), Department of Biosciences, University of Oslo, PO Box 1066 Blindern, N-0316, Oslo, Norway
| | - Carrie A Cizauskas
- Department of Environmental Science, Policy, and Management, University of California, Berkeley, CA 94720, U.S.A
| | - Jason K Blackburn
- Spatial Epidemiology & Ecology Research Lab, Department of Geography, University of Florida, Gainesville, FL 32611, U.S.A.,Emerging Pathogens Institute, University of Florida, Gainesville, FL, U.S.A
| | - Fausto A Bustos Carrillo
- Department of Epidemiology & Department of Biostatistics, School of Public Health, University of California, Berkeley, CA 94720-7360, U.S.A
| | - Rita Colwell
- CosmosID Inc., Rockville, MD 20850, U.S.A.,Center for Bioinformatics and Computational Biology, University of Maryland Institute for Advanced Computer Studies, University of Maryland, College Park, MD 20742, U.S.A.,Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, U.S.A
| | - W Ryan Easterday
- Centre for Ecological and Evolutionary Synthesis (CEES), Department of Biosciences, University of Oslo, PO Box 1066 Blindern, N-0316, Oslo, Norway
| | - Holly H Ganz
- UC Davis Genome Center, University of California, Davis, CA 95616, U.S.A
| | - Pauline L Kamath
- School of Food and Agriculture, University of Maine, Orono, ME 04469, U.S.A
| | - Ole A Økstad
- Centre for Integrative Microbial Evolution and Section for Pharmaceutical Biosciences, School of Pharmacy, University of Oslo, PO Box 1068 Blindern, N-0316, Oslo, Norway
| | - Wendy C Turner
- Department of Biological Sciences, University at Albany, State University of New York, Albany, NY 12222, U.S.A
| | - Anne-Brit Kolstø
- Centre for Integrative Microbial Evolution and Section for Pharmaceutical Biosciences, School of Pharmacy, University of Oslo, PO Box 1068 Blindern, N-0316, Oslo, Norway
| | - Nils C Stenseth
- Centre for Ecological and Evolutionary Synthesis (CEES), Department of Biosciences, University of Oslo, PO Box 1066 Blindern, N-0316, Oslo, Norway
| |
Collapse
|
7
|
Mégraud F, Musso D, Drancourt M, Lehours P. Curved and Spiral Bacilli. Infect Dis (Lond) 2017. [DOI: 10.1016/b978-0-7020-6285-8.00182-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
|
8
|
Machado A, Bordalo AA. Detection and Quantification of Vibrio cholerae, Vibrio parahaemolyticus, and Vibrio vulnificus in Coastal Waters of Guinea-Bissau (West Africa). Ecohealth 2016; 13:339-349. [PMID: 26940502 DOI: 10.1007/s10393-016-1104-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/28/2015] [Revised: 01/27/2016] [Accepted: 02/10/2016] [Indexed: 06/05/2023]
Abstract
V. cholerae, V. parahaemolyticus, and V. vulnificus are recognized human pathogens. Although several studies are available worldwide, both on environmental and clinical contexts, little is known about the ecology of these vibrios in African coastal waters. In this study, their co-occurrence and relationships to key environmental constraints in the coastal waters of Guinea-Bissau were examined using the most probable number-polymerase chain reaction (MPN-PCR) approach. All Vibrio species were universally detected showing higher concentrations by the end of the wet season. The abundance of V. cholerae (ISR 16S-23S rRNA) ranged 0-1.2 × 10(4) MPN/L, whereas V. parahaemolyticus (toxR) varied from 47.9 to 1.2 × 10(5) MPN/L. Although the presence of genotypes associated with virulence was found in environmental V. cholerae isolates, ctxA+ V. cholerae was detected, by MPN-PCR, only on two occasions. Enteropathogenic (tdh+ and trh+) V. parahaemolyticus were detected at concentrations up to 1.2 × 10(3) MPN/L. V. vulnificus (vvhA) was detected simultaneously in all surveyed sites only at the end of the wet season, with maximum concentrations of 1.2 × 10(5) MPN/L. Our results suggest that sea surface water temperature and salinity were the major environmental controls to all Vibrio species. This study represents the first detection and quantification of co-occurring Vibrio species in West African coastal waters, highlighting the potential health risk associated with the persistence of human pathogenic Vibrio species.
Collapse
Affiliation(s)
- Ana Machado
- Laboratory of Hydrobiology and Ecology, Institute of Biomedical Sciences (ICBAS-UP), University of Porto, Rua Jorge Viterbo Ferreira 228, 4050-313, Porto, Portugal.
- CIIMAR/CIMAR - Interdisciplinary Centre of Marine and Environmental Research, University of Porto, Rua dos Bragas 289, 4050-123, Porto, Portugal.
| | - Adriano A Bordalo
- Laboratory of Hydrobiology and Ecology, Institute of Biomedical Sciences (ICBAS-UP), University of Porto, Rua Jorge Viterbo Ferreira 228, 4050-313, Porto, Portugal
- CIIMAR/CIMAR - Interdisciplinary Centre of Marine and Environmental Research, University of Porto, Rua dos Bragas 289, 4050-123, Porto, Portugal
| |
Collapse
|
9
|
Eibach D, Herrera-León S, Gil H, Hogan B, Ehlkes L, Adjabeng M, Kreuels B, Nagel M, Opare D, Fobil JN, May J. Molecular Epidemiology and Antibiotic Susceptibility of Vibrio cholerae Associated with a Large Cholera Outbreak in Ghana in 2014. PLoS Negl Trop Dis 2016; 10:e0004751. [PMID: 27232338 PMCID: PMC4883745 DOI: 10.1371/journal.pntd.0004751] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2016] [Accepted: 05/11/2016] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Ghana is affected by regular cholera epidemics and an annual average of 3,066 cases since 2000. In 2014, Ghana experienced one of its largest cholera outbreaks within a decade with more than 20,000 notified infections. In order to attribute this rise in cases to a newly emerging strain or to multiple simultaneous outbreaks involving multi-clonal strains, outbreak isolates were characterized, subtyped and compared to previous epidemics in 2011 and 2012. METHODOLOGY/PRINCIPAL FINDINGS Serotypes, biotypes, antibiotic susceptibilities were determined for 92 Vibrio cholerae isolates collected in 2011, 2012 and 2014 from Southern Ghana. For a subgroup of 45 isolates pulsed-field gel electrophoresis, multilocus sequence typing and multilocus-variable tandem repeat analysis (MLVA) were performed. Eighty-nine isolates (97%) were identified as ctxB (classical type) positive V. cholerae O1 biotype El Tor and three (3%) isolates were cholera toxin negative non-O1/non-O139 V. cholerae. Among the selected isolates only sulfamethoxazole/trimethoprim resistance was detectable in 2011, while 95% of all 2014 isolates showed resistance towards sulfamethoxazole/trimethoprim, ampicillin and reduced susceptibility to ciprofloxacin. MLVA achieved the highest subtype discrimination, revealing 22 genotypes with one major outbreak cluster in each of the three outbreak years. Apart from those clusters genetically distant genotypes circulate during each annual epidemic. CONCLUSIONS/SIGNIFICANCE This analysis suggests different endemic reservoirs of V. cholerae in Ghana with distinct annual outbreak clusters accompanied by the occurrence of genetically distant genotypes. Preventive measures for cholera transmission should focus on aquatic reservoirs. Rapidly emerging multidrug resistance must be monitored closely.
Collapse
Affiliation(s)
- Daniel Eibach
- Bernhard Nocht Institute for Tropical Medicine (BNITM), Hamburg, Germany
- * E-mail:
| | - Silvia Herrera-León
- National Center of Microbiology, Institute of Health Carlos III, Madrid, Spain
| | - Horacio Gil
- National Center of Microbiology, Institute of Health Carlos III, Madrid, Spain
- European Public Health Microbiology Training Programme (EUPHEM), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Benedikt Hogan
- Bernhard Nocht Institute for Tropical Medicine (BNITM), Hamburg, Germany
- German Center for Infection Research (DZIF), partner site Hamburg-Borstel-Lübeck, Germany
| | - Lutz Ehlkes
- Bernhard Nocht Institute for Tropical Medicine (BNITM), Hamburg, Germany
- German Center for Infection Research (DZIF), partner site Hamburg-Borstel-Lübeck, Germany
| | - Michael Adjabeng
- Ghana Health Service, Disease Surveillance Service, Accra, Ghana
| | - Benno Kreuels
- Bernhard Nocht Institute for Tropical Medicine (BNITM), Hamburg, Germany
- German Center for Infection Research (DZIF), partner site Hamburg-Borstel-Lübeck, Germany
- University Medical Centre Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Michael Nagel
- Kumasi Centre for Collaborative Research in Tropical Medicine (KCCR), Kumasi, Ghana
| | - David Opare
- Ghana Health Service, National Public Health and Reference Laboratory (NPHRL), Accra, Ghana
| | - Julius N Fobil
- Department of Biological, Environmental and Occupational Health Sciences, School of Public Health, University of Ghana, Accra, Ghana
| | - Jürgen May
- Bernhard Nocht Institute for Tropical Medicine (BNITM), Hamburg, Germany
- German Center for Infection Research (DZIF), partner site Hamburg-Borstel-Lübeck, Germany
| |
Collapse
|
10
|
|
11
|
Smith AM, Njanpop-Lafourcade BM, Mengel MA, Gessner BD, Sauvageot D, Bidjada B, Miwanda BN, Saliou DM, N’Douba AK, Langa JP, Ismail H, Tau N, Sooka A, Keddy KH. Comparative Characterization of Vibrio cholerae O1 from Five Sub-Saharan African Countries Using Various Phenotypic and Genotypic Techniques. PLoS One 2015; 10:e0142989. [PMID: 26606536 PMCID: PMC4659613 DOI: 10.1371/journal.pone.0142989] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2015] [Accepted: 10/29/2015] [Indexed: 12/17/2022] Open
Abstract
We used standardized methodologies to characterize Vibrio cholerae O1 isolates from Guinea, Democratic Republic of the Congo (DRC), Togo, Côte d’Ivoire and Mozambique. We investigated 257 human isolates collected in 2010 to 2013. DRC isolates serotyped O1 Inaba, while isolates from other countries serotyped O1 Ogawa. All isolates were biotype El Tor and positive for cholera toxin. All isolates showed multidrug resistance but lacked ciprofloxacin resistance. Antimicrobial susceptibility profiles of isolates varied between countries. In particular, the susceptibility profile of isolates from Mozambique (East-Africa) included resistance to ceftriaxone and was distinctly different to the susceptibility profiles of isolates from countries located in West- and Central-Africa. Molecular subtyping of isolates using pulsed-field gel electrophoresis (PFGE) analysis showed a complex relationship among isolates. Some PFGE patterns were unique to particular countries and clustered by country; while other PFGE patterns were shared by isolates from multiple countries, indicating that the same genetic lineage is present in multiple countries. Our data add to a better understanding of cholera epidemiology in Africa.
Collapse
Affiliation(s)
- Anthony M. Smith
- Centre for Enteric Diseases, National Institute for Communicable Diseases, Division in the National Health Laboratory Service (NHLS), Johannesburg, South Africa
- Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- * E-mail:
| | | | | | | | - Delphine Sauvageot
- Agence de Médecine Préventive (AMP), Paris, France
- Institut National d’Hygiène, Lomé, Togo
| | | | - Berthe N. Miwanda
- Institut National de Recherche Biomédicale, Kinshasa, Democratic Republic of Congo
| | | | | | | | - Husna Ismail
- Centre for Enteric Diseases, National Institute for Communicable Diseases, Division in the National Health Laboratory Service (NHLS), Johannesburg, South Africa
- Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Nomsa Tau
- Centre for Enteric Diseases, National Institute for Communicable Diseases, Division in the National Health Laboratory Service (NHLS), Johannesburg, South Africa
- Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Arvinda Sooka
- Centre for Enteric Diseases, National Institute for Communicable Diseases, Division in the National Health Laboratory Service (NHLS), Johannesburg, South Africa
| | - Karen. H. Keddy
- Centre for Enteric Diseases, National Institute for Communicable Diseases, Division in the National Health Laboratory Service (NHLS), Johannesburg, South Africa
- Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| |
Collapse
|