title: Vibrio cholerae O1 from Accra, Ghana carrying a class 2 integron and the SXT element.
abstract: OBJECTIVE
  Vibrio cholerae O1 from a 2006 outbreak in Accra were commonly resistant to multiple antimicrobials and, in particular, to trimethoprim/sulfamethoxazole, drugs commonly used in the treatment of cholera. We sought to determine the genetic basis for trimethoprim/sulfamethoxazole resistance in outbreak isolates.
  
  
  METHODS
  Twenty-seven isolates from the outbreak were screened by PCR and sequencing for class 1 and 2 integrons and for the SXT element.
  
  
  RESULTS
  Twenty-one of the 27 isolates examined, all from the Accra metropolitan area, carried both SXT, an integrated chromosomal element, and a class 2 integron bearing dfrA1, sat and aadA1 cassettes. All these isolates had identical random amplification of polymorphic DNA profiles and two of them also carried a class 1 integron.
  
  
  CONCLUSIONS
  Most strains characterized carried multiple elements conferring resistance to trimethoprim. This suggests that trimethoprim/sulfamethoxazole should not be used empirically in cholera treatment.
authors.affiliation: Department of Microbiology, University of Ghana Medical School, PO Box 4236, Accra, Ghana.
authors.forename: Japheth A
authors.initials: JA
authors.lastname: Opintan
authors.forename: Mercy J
authors.initials: MJ
authors.lastname: Newman
authors.forename: Owusu Agyemang
authors.initials: OA
authors.lastname: Nsiah-Poodoh
authors.forename: Iruka N
authors.initials: IN
authors.lastname: Okeke