Vibrio cholerae O1 with Reduced Susceptibility to Ciprofloxacin and Azithromycin Isolated from a Rural Coastal Area of Bangladesh

Abstract

Cholera outbreaks occur each year in the remote coastal areas of Bangladesh and epidemiological surveillance and routine monitoring of cholera in these areas is challenging. In this study, a total of 97 Vibrio cholerae O1 isolates from Mathbaria, Bangladesh, collected during 2010 and 2014 were analyzed for phenotypic and genotypic traits, including antimicrobial susceptibility. Of the 97 isolates, 95 possessed CTX-phage mediated genes, ctxA, ace, and zot, and two lacked the cholera toxin gene, ctxA. Also both CTX+ and CTX− V. cholerae O1 isolated in this study carried rtxC, tcpAET, and hlyA. The classical cholera toxin gene, ctxB1, was detected in 87 isolates, while eight had ctxB7. Of 95 CTX+ V. cholerae O1, 90 contained rstRET and 5 had rstRCL. All isolates, except two, contained SXT related integrase intSXT. Resistance to penicillin, streptomycin, nalidixic acid, sulfamethoxazole-trimethoprim, erythromycin, and tetracycline varied between the years of study period. Most importantly, 93% of the V. cholerae O1 were multidrug resistant. Six different resistance profiles were observed, with resistance to streptomycin, nalidixic acid, tetracycline, and sulfamethoxazole-trimethoprim predominant every year. Ciprofloxacin and azithromycin MIC were 0.003–0.75 and 0.19–2.00 μg/ml, respectively, indicating reduced susceptibility to these antibiotics. Sixteen of the V. cholerae O1 isolates showed higher MIC for azithromycin (≥0.5 μg/ml) and were further examined for 10 macrolide resistance genes, erm(A), erm(B), erm(C), ere(A), ere(B), mph(A), mph(B), mph(D), mef(A), and msr(A) with none testing positive for the macrolide resistance genes.

Estimation of Vibrio Species Incidences and Antibiotic Resistance in Diarrhea Patients.

“…was seen throughout the years; however, slight peaks were observed during rainy, winter, and summer seasons. Similar seasonal trends have been observed from coastal area, but frequency is much higher as compared to current study [27,[37][38][39][40][41]. This may be due to lack of stagnant water reservoirs in the region and direct drainage of rain water into major river systems.…”

“…In comparison to our observation, higher Vibrio infection rates ranging from 10% to 15% are reported from different parts of India [34,35]. Furthermore, surveillance studies from Bangladesh reported up to 18% of Vibrio infections among diarrheal populations [3,37]. Overall, our study depicts low levels of Vibrio spp.…”

Isolation and antibiotic profile ofVibriospp. in final effluents of two wastewater treatment plants in the Eastern Cape of South Africa

“…which is mostly associated sea animals and marine environments are also reported to be susceptible to the antibiotic [69]. Reduced susceptible has been reported in two West Africa countries [70,71], India [72] and Bangladesh [73] showing the possibility of the organism to develop resistance. It was highlighted in the Leclercq et al, [74], when antibiogram with quinolones are read, resistance to the most active fluoroquinolone in vitro indicates resistance to all fluoroquinolones in both Gram-negative and Gram-positive organisms An exception to this rule in Gram-negative organisms is the potential production of the AAC(6’)-Ib-cr enzyme, which affects ciprofloxacin but not levofloxacin [74].…”

Haitian-like genetic traits with creeping MIC of Azithromycin in Vibrio cholerae O1 isolates from Puducherry, India

“…The MIC values of the isolates are shown in Table 2. Reduced susceptibility to azithromycin has been documented in Bangladesh strains isolated between 2010 and 2014 [26]. Although isolates from Mozambique were susceptible to azithromycin in 2012-2013, 13 % of the isolates showed resistance phenotype in 2015 [27].…”