Emergence of tetracycline resistance due to a multiple drug resistance plasmid in Vibrio cholerae O139

Abstract Of the 173 clinical strains of Vibrio cholerae O139 isolated from India, Bangladesh, and Thailand tested, six strains from India were resistant to tetracycline, ampicillin, chloramphenicol, kanamycin, and gentamicin. These six strains harbored a self-transmissible plasmid that mediated resistance to tetracycline, ampicillin, chloramphenicol, kanamycin, gentamicin, sulfamethoxazole, trimethoprim, and O/129. The multiple drug resistance plasmids were 200 kb in size and belonged to the incompatibility group C. Although a majority of the O139 strains (94.8%) were highly resistant to streptomycin, sulfamethoxazole, trimethoprim, and O/129, the tetracycline-susceptible strains so far tested were plasmid-negative. The data suggest the existence of two distinct multiple antimicrobial agent resistance (MAR) patterns in V. cholerae O139.     

01群与非01群0139型霍乱弧菌毒力的对比研究

非０１群０１３９型霍乱弧菌是近年引起南亚次大陆霍乱流行的新型病原体,将其与０１群霍乱弧菌的毒力特性进行对比研究对于了解其特性及研制相关的菌苗具有重要意义。本文报告了４株０１３９型霍乱弧菌与０１群霍乱弧菌菌株的对比测定结果。发现０１３９型霍乱弧菌与０１群霍乱弧菌有所不同,呈不透明的菌落形态,光学显微镜及电子显微镜检显示有荚膜的表型,在体内具有较高的繁殖能力并产生肠毒素,体内侵袭试验结果表明所有４株０     

Incidence and toxigenicity of Vibrio cholerae in a freshwater lake during the epidemic of cholera caused by serogroup O139 Bengal in Calcutta, India

Abstract The extent of contamination of a freshwater lake with Vibrio cholerae 0139 Bengal and the toxigenicity of all the V. cholerae isolates recovered during the period of the study were examined during and after an explosive outbreak of 0139 cholera in Calcutta. Strains biochemically characterized as V. cholerae could be isolated throughout the period of study examined from the freshwater lake samples. Most probable number of V. cholerae belonging to the 0139 serogroup in surface waters was 3 to 4 per 100 ml during major part of the study but isolation of this serogroup from sediment and plankton samples was infrequent. Of the total of 150 strains recovered, 23 (15.3%) agglutinated with the 0139 antiserum while the remaining belonged to the non-O1 non-O139 serogroups. None of the strains agglutinated with the O1 antiserum. All the 23 strains of V. cholerae O139 produced cholera toxin while 7.9% of the 127 non-O1 non-O139 strains also produced cholera toxin. Resistance to ampilicillin, furazolidone and streptomycin was encountered among strains belonging to both V. cholerae O139 and V. cholerae non-O1 non-O139 strains, but the percentage of resistant strains in the former was much higher than in the latter. During this cholera epidemic, possibly due to the introduction of large numbers of toxigenic V. cholerae such as the O139 serogroup, there was an increase in the number of toxigenic vibrios among the innocuous aquatic residents. This presumably occured through genetic exchange and, if substantiated, could play an important role in the re-emergence of epidemics.     

Experimental resistance of Vibrio cholerae el tor to nalidixic acid and fluoroquinolones]

It was shown that sensitivity of Vibrio cholerae eltor P-5879 to tetracycline, levomycetin, furazolidone, trimethoprim/sulfamethoxazole, aminoglycosides, beta-lactams, rifampicin, quinolones in vitro correlated with drugs efficacy in the treatment of experimental cholera of albino mice. Mutants of V. cholerae eltor P-5879 Nalr resistant to nalidixic acid (MIC 160-200 mg/l) formed with frequency 10(-9)-110(-8) had no cross resistance to fluoroquinolones. But the efficacy of ofloxacin, lomefloxacin, norfloxacin against these mutants in vivo reduced, though it was not changed in vitro. Mutants of V. cholerae eltor P-5879 resistant to fluoroquinolones and selected after culturing in the presence of the drugs had cross resistance to all quinolones studied. Infection caused by Cpfr mutant could not be treated with nalidixic acid and fluoroquinolones, therapeutic efficacy of rifampicin and beta-lactams, also reduced though sensitivity in vitro was not changed. The results of investigation proves the necessity of quinolones use for cholerae treatment as it is recommended for other severe enteric infections.     

Multidrug resistance to antibacterial drugs of Salmonella enterica subsp. enterica strains isolated in Poland in the 1998-1999 period]

A total of 510 Salmonella enterica subsp. enterica strains representing 56 serotypes, isolated from human stool specimens during 1998-2000 in sanitary-epidemiological units in Poland were tested for their susceptibility by a standard disk diffusion method for: ampicillin, cefotaxime, chloramphenicol, tetracycline, streptomycin, gentamicin, kanamycin, nalidixic acid, ciprofloxacin, furazolidone, cotrimoxazole, sulfonamides and trimethoprim. For 201 of the investigated strains, belonging to 5 most common isolated serotypes (S. Enteritidis, S. Typhimurium, S. Hadar, S. Infantis and S. Virchow) the minimal inhibitory concentrations (MICs) for the aforementioned antibiotics, as well as for amoxicillin with clavulanian were determined. Selected strains were screened for production extended spectrum b-lactamases (ESBLs). It was observed that 42.9% of Salmonella enterica subsp. enterica strains were resistant to 2 or more antibiotics, with the highest prevalence of MDR strains among serotypes Typhimurium, Hadar and Virchow. Resistance to ampicillin, streptomycin, tetracycline, nalidixic acid, furazolidone and sulphonamides was observed most frequently. Over 93% of S. Virchow strains were resistant to furazolidone. No strains resistant to ciprofloxacin were detected according to the NCCLS guidelines, but 31.3% of isolates exhibiting reduced ciprofloxacin susceptibility (MICs ranging between 0.125 and 0.5 mg/l). Two strains S. Mbandaka and Salmonella group D (variant motility--) were resistant to cefotaxime and probably produced ESBL.     

Dynamics of drug resistance of Vibrio cholerae isolated from surface water reservoirs in Siberia and the Soviet Far East in 1976-1990]

In the study on antibiotic resistance 1383 strains of El Tor Vibrio cholerae isolated from surface water reservoirs in 12 administrative territories of the Siberia and Far East within a period of 15 years were tested. The following antibiotics were used: ampicillin, streptomycin, monomycin, polymyxin, tetracycline, chloramphenicol, rifampicin and nalidixic acid. The resistance was unstable and its pattern was wave-like according to annual changes in the biological cycle. It was especially evident in regard to ampicillin, streptomycin, monomycin and polymyxin. The highest numbers of the strains were resistant to polymyxin, ampicillin and streptomycin (up to 100 per cent in some years). The lowest numbers of the strains were resistant to chloramphenicol (0.4 per cent) and tetracycline (1.9 per cent). No strains resistant to rifampicin and nalidixic acid were isolated. In some cases the antibiotic resistance level depended on the geographical zone where the strain was isolated. A direct quantitative dependence of the resistance level on the MIC was observed: the lower the MIC of the drug was, the lower the number of the strains resistant to it was. Within the 15-year period there was no general tendency to increase the resistance in V. cholerae to the antibiotics used.     

Antibiotic sensitivity of Vibrio parahaemolyticus isolated in the Turkmene SSR

Sensitivity of 82 cultures of parahemolytic vibrios to 8 antibiotics was studied. It was shown that the majority of the strains were highly sensitive to levomycetin and gentamicin, sensitive to tetracycline, rifampicin, streptomycin, neomycin and kanamycin and resistant to ampicillin.     

Dynamics of drug resistance in Proteus mirabilis cultures 1970-1985

Resistance of 669 clinical strains of Proteus mirabilis to 18 chemotherapeutic drugs was studied in dynamics within 1970-1985. An increase in the number of cultures resistant to ampicillin and carbenicillin was noted while the number of cultures resistant to cephalosporines did not change. Within the period from 1970 to 1975 there was observed a marked increase in the number of Proteus strains resistant to aminoglycoside antibiotics. After that period their number gradually lowered and in 1985 reached the level of 1970. Beginning from 1973 there were observed a decrease in the number of Proteus chloramphenicol resistant strains and simultaneous occurrence of cultures sensitive to this antibiotic. The predominating number of the tested strains preserved during the whole observation period their resistance to tetracycline, doxycycline, rifampicin, novobiocin, furazolidone and furagin. No increase in the number of Proteus strains with multiple drug resistance including those resistant to 5-7 drugs was noted in the observation periods of 1970-1975, 1980 and 1985. The most frequent were Proteus strains resistant to 2-4 drugs. Among them cultures resistant to chloramphenicol and aminoglycoside antibiotics of the first generation predominated. Grouping of the strains by the same resistance spectra provided dividing the rested cultures of Proteus mirabilis into 69 variants.     

Activity of 22 antibacterials against O1 and O139 serogroup Vibrio cholerae strains isolated from humans within 1927-2005 in various regions of the world]

Analysis of antibioticograms of 390 O1 and O139 serogroup Vibrio cholerae strains isolated from humans within 1927-2005 in various regions of the world showed that the strains of V. cholerae isolated within 1927-1966 were susceptible to 22 antibacterials, the strains isolated within 1938-1993 possessed 1-3 resistance markers and the strains isolated within 1994-2005 had 3-8 resistance markers including resistance to fluoroquinolones. All the strains of O139 serogroup V. cholerae isolated in 1993 and 1994 possessed 3 resistance markers. Studies on albino mice with generalized experimental cholera due to the V. cholerae eltor 1 strain (P-18826, 2005) isolated from a cholera patient, which was highly resistant to nalidixic acid, streptomycin, ampicillin and trimethoprim/sulfamethoxazole and showed cross resistance to fluoroquinolones (ciprofloxacin, ofloxacin, pefloxacin and norfloxacin) and moderate resistance to ceftriaxone and cefotaxime, revealed that the only efficient antibiotics were tetracyclines and aminoglycosides (except streptomycin). The investigation demonstrated an extension of the antibiotic resistance spectra of the epidemically significant strains of the cholera pathogen and the necessity of using antibacterial drugs in strict accordance with the antibioticograms in emergent prophylaxis and therapy of cholera and immediate replacement of the drug by a more active one.     

香港养殖海鲷弧菌致病菌药物敏感性及耐药质粒研究

从发病海鲷(Sparus sarba)中共分离到51株弧菌(\%Vibrio)\%,经API20E细菌快速鉴定系统及Alsina和Blanch关键生理生化特性分析鉴定为7个种,它们分别是：溶藻胶弧菌(\%V.alginolyticus)(24株),创伤弧菌(V.vulnificus)(12株)和副溶血弧菌(V.parahaemolyticus)(7株),火神弧菌(V.logei)(4株),远洋弧菌Ⅱ菌(V.pelagius Ⅱ)(2株),河弧菌(V.fluvialis)(1株)和地中海弧菌(V.mediterranei)(1株)\%。其中3种优势菌溶藻胶弧菌创伤弧菌和副溶血弧菌证实对海鲷有致病性。另外采用平板稀释法检测了51株菌对16种抗菌素的敏感性。发现所有菌株对ceftriaxone,链霉素,萘啶酮酸和利福霉素敏感,几乎所有菌株对ceftazidime, netilimicin,氯霉素和sulfamethoxazole敏感.大部分菌株对氨苄青霉素 (60.8%),cefuroxime(667%),丁胺卡那霉素(55%),卡那霉素(588%)和三甲氧苄氨嘧啶(765%)等具有较强的耐药性。通过对菌株中所含有的耐药质粒进行分析,发现15株菌株含有1～4个质粒,分子量范围为9～123kb之间,对12株既含有较大分子量质粒又具有耐药性的菌株进行了质粒转化试验,结果其中9株菌的质粒具有转化能力,转化率为１０－１１～１０－９,表明所分离的菌株的抗药性是由于细菌染色体相关突变造成的。     

Retrospective VNTR-analysis of genotypes of Vibrio cholerae 01 strains isolated, during the 7th cholera pandemic, in Rostov Region

Antiplague Research Institute, Rostov-on-Don, Russia Retrospective multi-locus VNTR-analysis was made for 166 Vibrio cholerae strains isolated, 1967-2001, in Rostov Region from clinical samples (82 strains) and from water samples (84 strains). On the basis of cluster analysis of heterogeneous identification strain genotypes, 45 variations of individual strains were shared between 11 separate clusters, among which the F cluster vibrios were predominant. Having emerged, 1970, in the region, they were widely spread during the 1973-1975 cholera pandemic and were registered, among the isolated strains, till 1992 indicating the possibility of long persistence of V. cholerae 01 in the natural aquatic environment. Presumably, the ecosystem specificity contributed to the long-term vibrio persistence.     

Comparative evaluation of activity of antibacterial agents in vitro and their efficacy in experimental cholera due to strains of Vibrio cholerae O1 and O139 serogroups in albino mice]

Activity of 16 antibacterial agents against human isolates of Vibrio cholerae O1 and O139 serogroups (P-5879, 4990, 143/23, and MO-45, P- 16065 respectively) was studied in vitro. The efficacy of the agents was studied in a model of generalized cholera in albino mice. Susceptibility of Vibrio cholerae P-5879 (used as the control) in the in vitro experiments with respect to the antibacterial agents correlated with their in vivo efficacy. The strains of Vibrio cholerae O1 and O139 serogroups isolated within the recent years had transmissive markers of resistance to streptomycin, trimethoprime/sulfamethoxazole, tetracycline, chloramphenicol and not transmitted by conjugation markers of resistance to rifampicin, furazolidone, nalidixic acid. The specific feature of the experimental infection due to such strains was the failure not only of the antibacterials of the resistance spectrum of the pathogen but also of the antibiotics showing in vitro susceptibility (betalactams, fluoroquinolones) that required additional bacteriological control on the 2nd or 3rd day of the etiotropic therapy for early replacement of the antibacterial agent.     

Antibiotic resistance and its transmissibility in strains of opportunistic enterobacteria

Sensitivity of 39 opportunistic Enterobacteria strains was studied with respect to tetracycline, kanamycin, ampicillin, levomycetin, streptomycin and nevigramon. The strains were isolated from children with acute intestinal infections of obscure etiology. 38 isolates were resistant to one or more drugs. The highest number of the strains was resistant to kanamycin, ampicillin and levomycetin, i.e. 81.5, 84.2 and 84.2 per cent of the cultures respectively. Nevigramon proved to be the most effective in vitro (76.4 per cent of the sensitive strains). The ability of the strains to transfer the antibiotic resistance markers on conjugation was tested. Transmission of R plasmids was shown in 75 per cent of the isolates.     

Transferable drug resistance of Escherichia coli isolated from infant diarrhoea.

The resistance to several drugs was determined in 29 pathogenic strains of Escherichia coli (026, 055 and 0111) isolated from infant diarrhoea and 18 non-pathogenic E. coli strains isolated from the same individuals. Both pathogenic and nonpathogenic strains were resistant to at least 1 to 10 drugs, but only in four cases resistance patterns of the pathogenic strains were identical with those of non pathogenic ones. The majority of the strains were resistant to sulfonamide, tetracycline, ampicillin, carbenicillin, neomycin and kanamycin. The drug resistance (except the resistance to nalidixic acid and rifampicin) was associated with conjugative R-plasmids. Some of the tested strains carried two R-plasmids in one cell, being in hetero R-state.     

Sensitivity of Shigella to antibiotics]

Three hundred and twenty two Shigella cultures isolated from dysentery patients within 1986-1989 were tested with the use of standard paper disks for their sensitivity to levomycetin, streptomycin, tetracycline, monomycin, neomycin, kanamycin, erythromycin, gentamicin, carbenicillin, ampicillin, oxacillin, methicillin and doxycycline. The number of the cultures belonging to Shigella sonnei amounted to 85.1 per cent of the total number of the strains studied. 91.9, 89.5, 87.3, 87.3, 80.1 and 80.1 per cent of the cultures were sensitive to gentamicin, kanamycin, carbenicillin, neomycin, levomycetin and ampicillin, respectively. 99.4 per cent of the isolates were resistant to streptomycin and 97.2 per cent were resistant to tetracycline. The sensitivity to erythromycin remained rather high (70.2 per cent). The overwhelming majority of the Shigella sonnei isolates had multiple resistance.     

Epidemic isolates of Vibrio cholerae 0139 express antigenically distinct types of colonization pili

Abstract Vibrio cholerae belonging to the recently described serogroup 0139, which are responsible for the current cholera epidemics in India and Bangladesh, were shown to express pilus-like structures partially cross-reacting with the toxin-coregulated pilus of V. cholerae strain (0395) belonging to the 01 serogroup and classical biotype. The 0139 pili were composed of 20 kDa subunit proteins which were antigenically related to the 20 kDa pilus protein of another diarrhoeagenic non-01 V. cholerae strain (serogroup 034) isolated earlier. The pili described in this study were found to be involved in the intestinal colonization process and, therefore, may contribute towards the virulence of the 0139 epidemic isolates.     

Drug resistance in Salmonellae isolated at Chandigarh (India) during 1972–1978

A total of 1316 strains of Salmonella belonging to 20 serotypes isolated at P.G.I. Chandigarh (India) were tested for drug resistance. Drug resistance was noticed in 494 (38.3%) of the strains; 194 (14.8%) of these strains were resistant to one drug, while 300 (23.5%) had multiple drug resistance. All isolated strains were sensitive to gentamicin, furazolidone and nalidixic acid.Resistance to streptomycin was observed in 233 (17.7%), chloramphenicol 197 (14,9%), tetracycline 293 (22.3%), ampicillin 428 (32.5%), kanamycin 206 (15.7%), neomycin 206 (15.7%) and sulphadiazine 215 (19.9%).Multiple drug resistance was most common in S. bareilly, S. typhimurium and S. anatum serotypes. Increase in incidence of drug resistance in Salmonellae has been noticed during 1972–1978.     

Frequency of R Factor-mediated Multiple Drug Resistance in Klebsiella and Aerobacter

A comparative study was done on the transfer frequency of R factors from 90 strains of multiple drug-resistant Aerobacter and 81 strains of Klebsiella to Escherichia coli CSH-2 (F(-), met(-), pro(-), Nal-r). The most common resistance patterns for the Aerobacter isolants were ampicillin streptomycin chloramphenicol tetracycline and ampicillin streptomycin chloramphenicol tetracycline kanamycin neomycin; for the Klebsiella isolants, the most common resistance pattern was ampicillin kanamycin streptomycin tetracycline chloramphenicol neomycin. R factors were isolated from 14.1% of the Aerobacter strains; 61.5% of these R factors harbored R determinants for ampicillin streptomycin tetracycline. R factors were isolated from 79.1% of the Klebsiella strains; four R factors were isolated with significant frequency; streptomycin chloramphenicol kanamycin neomycin, 37.5%; ampicillin streptomycin tetracycline kanamycin neomycin, 14.1%; ampicillin streptomycin tetracycline, 12.5%; and streptomycin chloramphenicol tetracycline, 12.5%.Chloramphenicol, kanamycin, and neomycin resistance was rarely transferred from the Aerobacter strains, although over 50% of the clinical isolants possessed resistance to these antibiotics. In contrast, over 75% of the Klebsiella strains transferred resistance to chloramphenicol, kanamycin, neomycin. Highest frequency of transferred resistance to individual drugs in the Aerobacter strains was to streptomycin (14.8%), whereas in the Klebsiella group resistance to four drugs was transferred at a very high frequency: streptomycin (80.8%), chloramphenicol (78.5%), kanamycin (76.4%), and neomycin (75.9%).     

Characterization of a clinical Vibrio cholerae O139 isolate from Mexico

Pathogenic strains of Vibrio cholerae O139 possess the cholera toxin A subunit (ctxA) gene as well as the gene for toxin co-regulated pili (tcpA). We report the isolation of a ctxA-negative, tcpA-negative V. cholerae O139 strain (INDREI) from a patient in Mexico diagnosed with gastrointestinal illness. Certain phenotypic characteristics of this strain were identical to those of V. cholerae O1 biotype El Tor. Unlike ctxA-positive V. cholerae O139 strains, this strain was sensitive to a wide panel of antibiotics, including ampicillin, chloramphenicol, ciprofloxacin, gentamicin, furazolidone, nalidixic acid, nitrofurantoin, tetracycline, trimethoprim-sulfamethoxazole, and streptomycin, but was resistant to polymyxin B. Ribotype and pulsed-field gel electrophoresis profiles of INDRE1 differed from those of ctxA-positive V. cholerae O139 and other V. cholerae strains. Phenotypic characteristics of the Mexico strain were similar to those reported for V. cholerae O139 isolates from Argentina and Sri Lanka.     

In vitro induction of transmissive resistance to tetracycline, chloramphenicol and ampicillin chloramphenicol in Vibrio cholera non-O1/non-O139 serogroups isolated within 1990-2005

Inducible character of resistance to tetracycline, chloramphenicol and ampicillin was investigated in 20 strains of Vibrio cholera non-O1/non-O139 serogroups isolated from inhabitants of Uzbekistan in 1990 (10 strains, ctx+) and in 2001 (5 strains, ctx-) and from inhabitants of Kalmykiya within 2003-2005 (5 strains, ctx-). Eight of the 20 isolates showed not only capacity for induction of the antibiotic resistance, but also its possible self transfer to Escherichia coli and reverse crosses in El Tor V. cholerae P-5879. It was shown that the effect of the antibacterial on the isolates phenotypic susceptibility could increase the resistance markers expression, when the genomes contained sites responsible for their expression, that required constant bacteriological control of the treatment efficacy and the use of the isolates antibioticograms for early replace of the inefficient drug by the efficient one. The prevalence of V. cholerae O1 and non-O1/non-O13 serogroups with multiple resistance to the antibacterial and the genetic potency for the antibiotic resistance development in the pathogen made difficult the choice of efficient drugs for prophylaxis and treatment of diseases caused by V. cholerae.