Global status of tetracycline resistance among clinical isolates of Vibrio cholerae: a systematic review and meta-analysis

Abstract

Background There has been an increasing resistance rate to tetracyclines, the first line treatment for cholera disease caused by V. cholera strains, worldwide. The aim of the present study was to determine the global status of resistance to this class of antibiotic among V. cholera isolates. Methods For the study, electronic databases were searched using the appropriate keywords including: ‘Vibrio’, ‘cholera’, ‘Vibrio cholerae’, ‘V. cholerae’, ‘resistance’, ‘antibiotic resistance’, ‘antibiotic susceptibility’, ‘antimicrobial resistance’, ‘antimicrobial susceptibility’, ‘tetracycline’, and ‘doxycycline’. Finally, after some exclusion, 52 studies from different countries were selected and included in the study and meta-analysis was performed on the collected data. Results The average resistance rate for serogroup O1 to tetracycline and doxycycline was 50% and 28%, respectively (95% CI). A high level of heterogeneity (I2 > 50%, p-value < 0.05) was observed in the studies representing resistance to tetracycline and doxycycline in O1 and non-O1, non-O139 serogroups. The Begg’s tests did not indicate the publication bias (p-value > 0.05). However, the Egger’s tests showed some evidence of publication bias in the studies conducted on serogroup O1. Conclusions The results of the present study show that the overall resistance to tetracyclines is relatively high and prevalent among V. cholerae isolates, throughout the world. This highlights the necessity of performing standard antimicrobial susceptibility testing prior to treatment choice along with monitoring and management of antibiotic resistance patterns of V. cholerae strains in order to reduce the emergence and propagation of antibiotic resistant strains as well as the failure of treatment.

Global status of antimicrobial resistance among environmental isolates of Vibrio cholerae O1/O139: a systematic review and meta-analysis

“…The tetracycline-resistance determinants may be developed, transferred and exchanged between environmental and clinical V. cholera isolates through the horizontal gene transfer mechanisms, the active efflux of antibiotics from the bacterial cell, the production of ribosomal protection proteins (encoded by tet genes), target site mutation, decreased drug permeability, and enzymatic degradation of the antibiotics [ 35 , 36 ]. Recently, a systematic review and meta-analysis [ 37 ] of tetracyclines resistance in clinical V. cholera O1 isolates showed higher rates than observed in our study; 20% (95% CI, 10–30) for tetracycline and 7% (95% CI, 3–10) for doxycycline. The analyses differed in the origin of the isolates since, in our analyses, the data on V. cholera isolates of clinical origin were not included.…”

Potential Antimicrobial Properties of Coffee Beans and Coffee By-Products Against Drug-Resistant Vibrio cholerae

“…The plates were then incubated at 37°C for 18 h. Each plate was examined for the inhibition zone. Tetracycline, the first line treatment for cholera disease, was used as a positive control at a concentration of 30 μg/mL, and media solution was used as a negative control ( 50 ).…”

Antimicrobial Resistance in Cholera: A Need for Quick Intervention in Nigeria, West Africa

“…Resistance strains, mostly in serogroup O1 are responsible for a major outbreak of cholera in the world. 22 due to extensive inappropriate use of these regimens. 22 Resistance is mainly due to the presence of mobile genetic elements such as plasmids and transposons and other mechanisms such as decreased drug permeability, enzymatic degradation of the antibiotic, active efflux, and production of ribosomal protection proteins encoded by genes called tet genes.…”

“…22 Resistance is mainly due to the presence of mobile genetic elements such as plasmids and transposons and other mechanisms such as decreased drug permeability, enzymatic degradation of the antibiotic, active efflux, and production of ribosomal protection proteins encoded by genes called tet genes. 22 Antimicrobial susceptibility testing before the administration of antibiotics would help to curb the development of resistance and failure of treatment. 22 Probiotics, vaccines, and phage therapy are notable approaches to reducing the resistance strain of V. cholerae.…”

“…22 Antimicrobial susceptibility testing before the administration of antibiotics would help to curb the development of resistance and failure of treatment. 22 Probiotics, vaccines, and phage therapy are notable approaches to reducing the resistance strain of V. cholerae. 22…”