Susceptibility to Fluoroquinolones of Vibrio cholerae 01 Isolated From Diarrheal Patients in Zimbabwe (original) (raw)
Related papers
Antibiotic resistance patterns amongst clinical Vibrio cholerae O1 isolates from Accra, Ghana
One of the protocols in the treatment and control of cholera infection is antibiotic therapy. However, increasing rates of antibiotic resistance amongst enteric bacteria including Vibrio cholerae have been reported in recent times. There has been no continuous surveillance of antibiotic susceptibility profiles for V. cholerae O1 in Ghana. This study determined resistance profiles of V. cholerae O1 to selected and commonly used antimicrobial agents and assessed resistance patterns across year periods. Additionally, the range of antibiotics currently effective for treatment and infection control during cholera outbreaks was ascertained. We screened a cumulative total of 277 isolates archived between 2010 and 2012 from the Greater Accra Region-Ghana, using the disc diffusion method. The recommendations of the Clinical and Laboratory Standards Institute were used to interpret our results. Resistance patterns were high for co-trimoxazole 232/241 (96.3%), trimethoprim 265/276 (96.0%), erythromycin 255/270 (94.4%), and were low for azithromycin 0/11 (0%), ciprofloxacin 1/274 (0.4%), doxycycline 40/235 (14.5%) and tetracycline 43/232 (15.6%). There was significant increase in antibiotic resistance rates across the year groups studied, except for ciprofloxacin (P =0.5089), trimethoprim (P =0.0533) and erythromycin (P=0.3200). High levels of antibiotic resistance among the present population of V. cholerae O1 isolates were observed. However, during cholera outbreaks, azithromycin, ciprofloxacin, doxycycline and tetracycline are alternatives in the treatment and control of infection when not contra-indicated.
Antimicrobial resistance of Vibrio cholerae from sub-Saharan Africa: A systematic review
African Journal of Laboratory Medicine
Recently, the occurrence of new variant pathogenic strains of V. cholerae has been attributed to new CTX prophage rearrangements. 6 Resistant V. cholerae have disseminated globally and now threaten Background: The World Health Assembly adopted the Global Action Plan on Antimicrobial Resistance, which includes improving the knowledge base through surveillance and research. Noteworthily, the World Health Organization has advocated a Global Antimicrobial Resistance Surveillance System to address the plan's surveillance objective, with most African countries enrolling in or after 2017. Aim: The aim of this article was to review prior data on antimicrobial resistance of Vibrio cholerae from sub-Saharan Africa with a view for future control and intervention strategies. Methods: We used the Preferred Reporting Items for Systematic Review and Meta-Analysis (or 'PRISMA') guidelines to search the PubMed and African Journals Online databases, as well as additional articles provided by the Nigeria Centre for Disease Control, for articles reporting on the antibiotic susceptibility of V. cholerae between January 2000 and December 2017. Results: We identified 340 publications, of which only 25 (reporting from 16 countries within the sub-Saharan African region) were eligible. The majority (20; 80.0%) of the cholera toxigenic V. cholerae isolates were of the serogroup O1 of the El Tor biotype with Ogawa and Inaba serotypes predominating. Resistance was predominantly documented to trimethoprimsulphamethoxazole (50% of the studies), ampicillin (43.3% of the studies), chloramphenicol (43.3% of the studies) and streptomycin (30% of the studies). Resistance mechanisms were reported in 40% of the studies. Conclusion: Our results demonstrate a documented antimicrobial resistance of V. cholerae to multiple antibiotic classes, including cell wall active agents and antimetabolites with evidence of phenotypic/genotypic resistance to fluoroquinolones.
PLOS ONE, 2015
Objective We identified a poor clinical response to treatment of cholera with a single 1 g dose of ciprofloxacin, a standard treatment for cholera. Methods To determine reasons for the poor response and better therapeutic approaches we examined the minimal inhibitor concentration (MIC, n = 275) and disc-diffusion zone sizes (n = 205) for ciprofloxacin and nalidixic acid of V. cholerae O1 strains isolated in Bangladesh from 1994 to 2012, and reexamined data from 161patients infected with Vibrio cholerae O1 recruited in four clinical trials who received single-or multiple-dose ciprofloxacin for treatment of cholera and compared their clinical response to the V. cholerae O1 susceptibility. Results Although all 275 isolates of V. cholerae O1 remained susceptible to ciprofloxacin using standard MIC and disc-diffusion thresholds, the MIC 90 to ciprofloxacin increased from 0.010 in 1994 to 0.475 μgm/ml in 2012. Isolates became frankly resistant to nalidixic with the MIC 90 increasing from 21 μgm/ml in 1994 to >256 μgm/ml and 166 of 205 isolates from 1994 to 2005 being frankly resistant using disc-diffusion testing. Isolates resistant to nalidixic acid by disc-diffusion testing had a median ciprofloxacin MIC of 0.190 μgm/ml (10 th-90 th centiles 0.022 to 0.380); nalidixic acid-susceptible isolates had a median ciprofloxacin MIC of 0.002 (0.002 to 0.012).The rate of clinical success with single-dose ciprofloxacin treatment for nalidixic acid-susceptible strains was 94% (61 of 65 patients) and bacteriologic success 97% (63/65) compared to 18% (12/67) and 8% (5/67) respectively with nalidixic acid-resistant strains (P<0.001 for both comparisons). Multiple-dose treatment with ciprofloxacin had PLOS ONE |
Journal of Clinical Microbiology, 2011
This paper details the phenotypic, genotypic, and antibiotic sensitivity patterns of 88 Vibrio cholerae strains from Zimbabwe. Of the 88 strains, 83 were classified as "altered El Tor" and 5 as "hybrid El Tor" strains. All of the strains were susceptible to tetracycline, doxycycline, ciprofloxacin, and azithromycin by disc diffusion, but susceptibility to tetracycline and azithromycin diminished when observed using the MIC method.
Vibrio Cholera, causative agent of acute gastrointestinal disease or cholera is a natural inhabitant of aquatic environment. Cholera is endemic disease in Latin America, Southern Asia and parts of Africa, where poor sanitation and seasonal outbreaks are particularly associated with seasonal outbreaks. Large number of outbreaks of Vibrio cholera gastroenteritis in Asian countries indicates the need to evaluate the prevalence of that pathogenic species in different regions of Asia. This study was conducted to ascertain the prevalence and antibiotic resistance of Vibrio cholera in the endemic areas of Pakistan. Samples were collected from epidemic cell of National Institute of Health (NIH) during the time period of July 1998 to 1999, on the basis of reported cases of gastroenteritis/ cholera infections. A total of 172 isolates were collected from the 303 stools and vomitus samples of infected patients and their sensitivity to 18 antimicrobial agents were determined by disk diffusion method. All the isolates of Vibrio cholera showed 100% resistance to streptomycin and trimethoprim/ sulfamethoxazole throughout the study period. The O139 strain isolated from water was resistant to streptomycin and Kanamycin. In contrast Norfloxicin were found to be very effective with only 4% resistance rate during 1998 while Tobramycin showed the best results with only 1% resistance as compared to resistance percentage of Tetracycline 10%, Erythromycin 16%, Chloramphenicol 17%, Cefamendol 40%, Ampicillin 58%, Nalidixic acid 66%, Nitrofurantion 95% during 1999. The comparison of antibiotic sensitivity showed almost similar pattern of antibiotics sensitivity with little variations due to geographical barriers. Furthermore, the trends of increased resistance to antibiotics indicate that indiscriminate use of antimicrobial agents during hospitalization and self-medication contributed to the emergence of drug resistance in the prevalent strain of Vibrio cholera.
Antibiotic resistance data, made available from laboratory records during eight cholera outbreaks between 1990 and 2004 showed Vibrio cholerae serogroup O1 to have a low level of resistance (2–3%) to tetracycline during 1990–1991. Resistance increased for tetracycline (95%), chloramphenicol (78%), doxycycline (70%) and trimethoprim–sulphamethoxazole (97%) in subsequent outbreaks. A significant drop in resistance to tetracycline and chloramphenicol followed the adoption of a national policy to replace tetracycline with erythromycin for treating cholera. Sixty-nine strains from cholera outbreaks in Zambia between 1996 and 2004, were examined for antibiotic resistance and basic molecular traits. A 140 MDa conjugative, multidrug-resistant plasmid was found to encode tetracycline resistance in strains from 1996/1997 whereas strains from 2003/2004 were resistant to furazolidone, but susceptible to tetracycline, and lacked this plasmid. PCR revealed 25 of 27 strains from 1996/1997 harboured the intl1 class 1 integron but lacked SXT, a conjugative transposon element. Similar screening of 42 strains from 2003/2004 revealed all carried SXT but not the intl1 class 1 integron. All 69 strains, except two, one lacking ctxA and the other rstR and thus presumably truncated in the CTX prophage region, were positive for important epidemic markers namely rfbO1, ctxA, rstR2, andtcpA of El Tor biotype. Effective cholera management is dependent on updated reports on culture and sensitivity to inform the choice of antibiotic. Since the emergence of antibiotic resistance may significantly influence strategies for controlling cholera, continuous monitoring of epidemic strains is crucial.