Cholera Outbreaks Caused by an Altered
            <i>Vibrio cholerae</i>
            O1 El Tor Biotype Strain Producing Classical Cholera Toxin B in Vietnam in 2007 to 2008

Nguyen, Binh Minh; Lee, Jehee; Cuong, Ngo Tuan; Choi, Seon Young; Hiển, Nguyễn Trần; Anh, Đặng Đức; Lee, Hye Ri; Ansaruzzaman, M.; Endtz, Hubert P.; Chun, Jongsik; Lopez, Anna Lena; Czerkinsky, Cécil; Clemens, John D.; Kim, Dong Wook

doi:10.1128/jcm.02040-08

Cited by 109 publications

(112 citation statements)

References 13 publications

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“…A few V. cholerae O1 ET carrying a tandem repeat of the CL CTX prophage on the small chromosome, indistinguishable from the Mozambique ET variant, were isolated in Vietnam between 1995(Nguyen et al, 2009. In a subsequent study, Tran et al (2012) showed that V. cholerae O1 ET involved in recurrent cholera in Vietnam (2007Vietnam ( -2010 was an ET variant carrying ctxB CL and rstR ET genes, as observed for ET strains involved in recurrent cholera in Khon Kaen, Thailand.…”

Section: Discussionmentioning

confidence: 98%

“…In a subsequent study, Tran et al (2012) showed that V. cholerae O1 ET involved in recurrent cholera in Vietnam (2007Vietnam ( -2010 was an ET variant carrying ctxB CL and rstR ET genes, as observed for ET strains involved in recurrent cholera in Khon Kaen, Thailand. Although the source of V. cholerae O1 ET analogous to the Mozambique variant of ET causing outbreaks in Thailand between 2003 and 2007 is not known, the Vietnamese ET strains carrying a tandem repeat of the CL CTX prophage and not involved in any major cholera outbreak were proposed to have been recently introduced into Vietnam (Nguyen et al, 2009). Our observations of temporal fluctuation in resistance to antimicrobial agents and a genetic transition from Mozambique variant type ET to Asian altered ET suggest that V. cholerae has a natural reservoir (niche), which has allowed the bacterium to evolve locally in Khon Kaen, although the appearance of the V. cholerae O1 altered ET carrying ctxB CL and rstR ET alleles has been hypothesized to be a recent event in Thailand (Okada et al, 2012).…”

Section: Discussionmentioning

confidence: 99%

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Drug response and genetic properties of Vibrio cholerae associated with endemic cholera in north-eastern Thailand, 2003–2011

Chomvarin

Johura

Mannan

et al. 2013

Journal of Medical Microbiology

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Cholera, caused by Vibrio cholerae, results in significant morbidity and mortality worldwide, including Thailand. Representative V. cholerae strains associated with endemic cholera (n532), including strains (n53) from surface water sources, in Khon Kaen, Thailand (2003-2011, were subjected to microbiological, molecular and phylogenetic analyses. According to phenotypic and related genetic data, all tested V. cholerae strains belonged to serogroup O1, biotype El Tor (ET), Inaba (IN) or Ogawa (OG). All of the strains were sensitive to gentamicin and ciprofloxacin, while multidrug-resistant (MDR) strains showing resistance to erythromycin, tetracycline, trimethoprim/ sulfamethoxazole and ampicillin were predominant in 2007. V. cholerae strains isolated before and after 2007 were non-MDR. All except six diarrhoeal strains possessed ctxA and ctxB genes and were toxigenic altered ET, confirmed by MAMA-PCR and DNA sequencing. Year-wise data revealed that V. cholerae INET strains isolated between 2003 and 2004, plus one strain isolated in 2007, lacked the RS1 sequence (rstC) and toxin-linked cryptic plasmid (TLC)-specific genetic marker, but possessed CTX CL prophage genes ctxB CL and rstR CL . A sharp genetic transition was noted, namely the majority of V. cholerae strains in 2007 and all in 2010 and 2011 were not repressor genotype rstR CL but instead were rstR ET , and all ctx + strains possessed RS1 and TLCspecific genetic markers. DNA sequencing data revealed that strains isolated since 2007 had a mutation in the tcpA gene at amino acid position 64 (NAS). Four clonal types, mostly of environmental origin, including subtypes, reflected genetic diversity, while distinct signatures were observed for clonally related, altered ET from Thailand, Vietnam and Bangladesh, confirmed by distinct subclustering patterns observed in the PFGE (NotI)-based dendrogram, suggesting that endemic cholera is caused by V. cholerae indigenous to Khon Kaen.3These authors contributed equally to this work.Abbreviations: AMP, ampicillin; CL, classical; CTX, cholera toxin; E, erythromycin; ET, El Tor; MAMA, mismatch amplification mutation assay; MDR, multidrug resistant; SXT, trimethoprim/sulfamethoxazole; TE, tetracycline; TLC, toxin-linked cryptic plasmid. INTRODUCTIONCholera is a severe form of acute diarrhoea, caused by the gamma-proteobacterium Vibrio cholerae. V. cholerae comprises more than 200 'O' serogroups even though the disease historically has been considered to be caused only by V. cholerae serogroups O1 and O139 . Serogroup O1 has two biotypes, Classical (CL) and El Tor (ET), of which the former is associated with the first six pandemics starting in 1817 before the latter was isolated at the beginning of the current ongoing seventh cholera pandemic in the 1960s (Kaper et al., 1995). The CL biotype differs from the ET biotype in some phenotypic traits, primarily haemolysis of sheep erythrocytes, agglutination of chicken erythrocytes, Voges-Proskauer reaction, sensitivity to polymyxin B and sensitivity to specific phages (Kaper e...

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Drug response and genetic properties of Vibrio cholerae associated with endemic cholera in north-eastern Thailand, 2003–2011

Chomvarin

Johura

Mannan

et al. 2013

Journal of Medical Microbiology

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“…Group I represents atypical El Tor strains with a tandem repeat of classical CTX prophage on the small chromosome, while Group II represents those possessing the RS1 and CTX prophage with El Tor type rstR and classical ctxB on the large chromosome. Based on these criteria, the Matlab and Mozambique variants were classified into Group I, while altered El Tor, such as those described by Nguyen et al (2009), fell into Group II. This classification system was also used by Goel et al (2011) to categorize the VCH35 isolate from Hyderabad, India into Group I, because it carried a tandem repeat of CTX prophage on the small chromosome.…”

Section: Discussionmentioning

confidence: 99%

“…Genetic analysis of CTX prophage array was performed using several combinations of primer pairs, as described by Nguyen et al (2009). The presence of a RS1 element was determined using the primer pair rstCF/rstCR.…”

Section: Genetic Analysis Of Ctx Prophage Arraymentioning

confidence: 99%

Genetic Analysis of CTX Prophage and Antibiotic Resistance Determinants in Vibrio cholerae O1 Belonging to the Atypical El Tor Biotype from Kelantan, Malaysia

Yu¹,

Ang²,

Yean³

2012

Cholera

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“…Since 2007, there have been several reports of cholera outbreaks or endemic cases caused by wave 3 strains in Southeast Asia (Ang et al, 2010;Okada et al, 2010;Choi et al, 2010). In Vietnam, about 20 000 cases were reported in 1964 at the beginning of the seventh pandemic of cholera; the early 1990s saw around 5000 cases per annum of cholera caused by V. cholerae O139; and in 2007, there was a large outbreak in northern Vietnam involving 1880 cases (World Health Organization, 2008) that were presumably caused by wave 3 strains (Nguyen et al, 2009;Choi et al, 2010) MLVA is a discriminatory and useful molecular epidemiological tool for studying the genetic relatedness of bacterial isolates based on the variability of VNTRs at multiple loci; the method has advantages for assessing short-term transmission of bacterial infectious diseases such as cholera (Choi et al, 2010;Moore et al, 2015). Our findings can aid in the surveillance of cholera in Vietnam and other countries where the disease is endemic.…”

Section: Introductionmentioning

confidence: 99%

Molecular epidemiology of Vibrio cholerae O1 in northern Vietnam (2007–2009), using multilocus variable-number tandem repeat analysis

Nguyen

Ngo

et al. 2016

Journal of Medical Microbiology

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Cholera is an infectious disease of major concern in Vietnam and other Asian countries. In 2009, there was a large outbreak of cholera in northern Vietnam. To investigate relationships among isolates of the causative pathogen Vibrio cholerae in this region since 2007, we carried out a multilocus variable-number tandem repeat analysis (MLVA) of 170 isolates collected between 2007 and 2009. A total of 24 MLVA types were identified using seven loci. Five clones (1-5) were identified using five loci of the large V. cholerae chromosome; clones 1 and 2 were major, and the others were minor. Clone 1 isolates were responsible for the 2009 outbreak. A shift in the predominant clone occurred between 2007 and 2009, with clone 1 likely derived from clone 2. Moreover, the former was less diverse than the latter, suggesting a single source of cholera dissemination. Epidemiological data indicated a wavelet prior to the large outbreak, suggesting that drinking water source or food chain became contaminated during dissemination. Our results reveal the utility of MLVA for analysis of V. cholerae isolates within a relatively short period and broaden our understanding of its transmission and response to cholera.

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Cholera Outbreaks Caused by an Altered Vibrio cholerae O1 El Tor Biotype Strain Producing Classical Cholera Toxin B in Vietnam in 2007 to 2008

Cited by 109 publications

References 13 publications

Drug response and genetic properties of Vibrio cholerae associated with endemic cholera in north-eastern Thailand, 2003–2011

Drug response and genetic properties of Vibrio cholerae associated with endemic cholera in north-eastern Thailand, 2003–2011

Genetic Analysis of CTX Prophage and Antibiotic Resistance Determinants in Vibrio cholerae O1 Belonging to the Atypical El Tor Biotype from Kelantan, Malaysia

Molecular epidemiology of Vibrio cholerae O1 in northern Vietnam (2007–2009), using multilocus variable-number tandem repeat analysis

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