title: Class 1 integron-borne, multiple-antibiotic resistance encoded by a 150-kilobase conjugative plasmid in epidemic vibrio cholerae O1 strains isolated in Guinea-Bissau.
abstract: In the 1996-1997 cholera epidemic in Guinea-Bissau, surveillance for antimicrobial resistance showed the emergence of a multidrug-resistant strain of Vibrio cholerae O1 during the course of the epidemic. The strain was resistant to ampicillin, erythromycin, tetracycline, furazolidone, aminoglycosides, trimethoprim, and sulfamethoxazole. Concomitant with the emergence of this strain, we observed a resurgence in the number of registered cholera cases as well as an increase in the case fatality rate from 1.0% before the emergence of the multiple-drug-resistant strain to 5.3% after the emergence of the strain. Our study shows that the strain contained a 150-kb conjugative multiple-antibiotic resistance plasmid with class 1 integron-borne gene cassettes encoding resistance to trimethoprim (dhfrXII) and aminoglycosides [ant(3")-1a]). The finding of transferable resistance to almost all of the antibiotics commonly used to treat cholera is of great public health concern. Studies should be carried out to determine to what extent the strain or its resistance genes have been spread to other areas where cholera is endemic.
authors.affiliation: Department of Veterinary Microbiology, The Royal Veterinary and Agricultural University, DK-1870 Frederiksberg C, Denmark. ad@kvl.dk
authors.forename: A
authors.initials: A
authors.lastname: Dalsgaard
authors.forename: A
authors.initials: A
authors.lastname: Forslund
authors.forename: A
authors.initials: A
authors.lastname: Petersen
authors.forename: D J
authors.initials: DJ
authors.lastname: Brown
authors.forename: F
authors.initials: F
authors.lastname: Dias
authors.forename: S
authors.initials: S
authors.lastname: Monteiro
authors.forename: K
authors.initials: K
authors.lastname: Molbak
authors.forename: P
authors.initials: P
authors.lastname: Aaby
authors.forename: A
authors.initials: A
authors.lastname: Rodrigues
authors.forename: A
authors.initials: A
authors.lastname: Sandström
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D002771:Cholera / Q000453:epidemiology*; D002874:Chromosome Mapping; D003227:Conjugation, Genetic; D004352:Drug Resistance, Microbial; D018432:Drug Resistance, Multiple; D005838:Genotype; D006169:Guinea-Bissau / Q000453:epidemiology; D006801:Humans; D008826:Microbial Sensitivity Tests; D016133:Polymerase Chain Reaction; D011815:R Factors; D021521:Ribotyping; D012621:Seasons; D014734:Vibrio cholerae / Q000187:drug effects / Q000235:genetics* / Q000472:pathogenicity
chemical_list: D000900:Anti-Bacterial Agents