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J Infect Dis. 2013 Nov 1;208 Suppl 1:S39-45. doi: 10.1093/infdis/jit200.

Cholera outbreak in South Africa, 2008-2009: laboratory analysis of Vibrio cholerae O1 strains.

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1
Centre for Enteric Diseases, National Institute for Communicable Diseases, Division in the National Health Laboratory Service, Johannesburg.

Abstract

BACKGROUND:

A total of 720 Vibrio cholerae O1 strains were recovered for investigation from an outbreak of cholera in South Africa between November 2008 and April 2009.

METHODS:

Strains were characterized by serotype testing. Antimicrobial susceptibility testing. Genetic diversity of 248 strains was investigated using pulsed-field gel electrophoresis (PFGE) analysis. Extended characterization was performed on 90 strains. Molecular analysis included: polymerase chain reaction (PCR) identification of ctxA and tcpA genes, sequencing the ctxAB gene, and investigation of molecular mechanisms conferring antimicrobial resistance.

RESULTS:

The majority of strains were characterized as serotype Ogawa. Strains showed multidrug resistance. Approximately 1.0% of strains displayed extended-spectrum β-lactamase (ESBL) activity. Strains showed very similar PFGE patterns. Ninety strains selected for extended characterization showed the following results: Strains possessed the cholera toxin (CT) and all were PCR positive for the tcpA-El Tor variant. Sequencing of the ctxB gene matched the B-1 allele. Strains harbored the SXT element. Strains that displayed ESBL activity possessed a 140-kilobase-pair plasmid that produced the TEM-63 β-lactamase. Nalidixic acid-resistant strains harbored mutations in GyrA (Ser83-Ile) and ParC (Ser85-Leu).

CONCLUSIONS:

These data highlight the rapid development of antimicrobial resistance and spread of V. cholerae O1 El Tor variants expressing the classical CT within South Africa.

KEYWORDS:

SXT element; South Africa; TEM-63 β-lactamase; Vibrio cholerae O1 El Tor variant; cholera outbreak; classical cholera toxin; multidrug-resistant

PMID:
24101643
DOI:
10.1093/infdis/jit200
[Indexed for MEDLINE]
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