Vibrio cholerae O1 from Accra, Ghana carrying a class 2 integron and the SXT element.
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.
Opintan
Japheth A
JA
Department of Microbiology, University of Ghana Medical School, PO Box 4236, Accra, Ghana.
Newman
Mercy J
MJ
Nsiah-Poodoh
Owusu Agyemang
OA
Okeke
Iruka N
IN