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Epidemiology of antimicrobial resistant cholera in Kenya and East Africa
M J Finch1, J G Morris, J Kaviti
1Department of Medicine, University of Maryland School of Medicine, Baltimore 21201.
Abstract:
Strains of Vibrio cholerae O1, El Tor resistant to multiple antimicrobial agents, were isolated in Kenya between 1982 and 1985. Strains of serotype Ogawa were resistant to tetracycline, ampicillin, and trimethoprim/sulfamethoxazole. Resistance was mediated in all instances by a plasmid ca 100 mD of incompatibility group C. Based on analysis of restriction endonuclease digests, all Ogawa isolates had an identical resistance plasmid. This plasmid differed from plasmids in resistant V. cholerae O1 strains isolated in Tanzania, Nigeria, and Bangladesh. On Southern blot analysis of restriction endonuclease digests of chromosomal DNA using DNA probes there were no apparent differences between Kenyan V. cholerae O1 strains isolated before and after emergence of antibiotic resistance; however, a majority of El Tor strains isolated in other geographic areas had the same Southern blot pattern. Our data document the apparent endemicity of multiply antimicrobial resistant V. cholerae O1 strains in Kenya, and the persistence of a single unique resistance plasmid among isolates of serotype Ogawa.
Insights
Multiple antimicrobial-resistant Vibrio cholerae O1 strains were found in Kenya. A single, unique resistance plasmid persisted in Ogawa serotype strains, indicating endemicity of these resistant bacteria.
Area of Science:
- Microbiology
- Epidemiology
- Genetics
Background:
- Vibrio cholerae O1 El Tor strains resistant to multiple antimicrobial agents were isolated in Kenya between 1982 and 1985.
- These strains, specifically serotype Ogawa, demonstrated resistance to tetracycline, ampicillin, and trimethoprim/sulfamethoxazole.
Purpose of the Study:
- To characterize the antimicrobial resistance patterns and genetic elements of Vibrio cholerae O1 strains isolated in Kenya.
- To investigate the origin and persistence of antibiotic resistance in these strains and compare them to international isolates.
Main Methods:
- Plasmid analysis using restriction endonuclease digests to identify resistance genes.
- Southern blot analysis of chromosomal DNA to assess genetic relatedness.
- Comparison of plasmid profiles and chromosomal DNA patterns with strains from Tanzania, Nigeria, and Bangladesh.
Main Results:
- Resistance was mediated by a plasmid of approximately 100 mD in incompatibility group C.
- All Kenyan Ogawa isolates shared an identical resistance plasmid, distinct from those found in other countries.
- No significant differences were observed in chromosomal DNA patterns of Kenyan strains before and after the emergence of resistance, suggesting local adaptation.
Conclusions:
- The data suggest the endemicity of multiply antimicrobial-resistant Vibrio cholerae O1 in Kenya.
- A single, unique resistance plasmid has persisted among Ogawa serotype isolates in Kenya, highlighting a specific evolutionary trajectory for resistance.
- Further surveillance is warranted to monitor the spread and evolution of antimicrobial resistance in Vibrio cholerae.