Molecular evidence of cholera outbreak caused by a toxigenic Vibrio cholerae O1 El tor variant strain in Kelantan, Malaysia.
A total of 20 Vibrio cholerae isolates were recovered for investigation from a cholera outbreak in Kelantan, Malaysia, that occurred between November and December 2009. All isolates were biochemically characterized as V. cholerae serogroup O1 Ogawa of the El Tor biotype. They were found to be resistant to multiple antibiotics, including tetracycline, erythromycin, sulfamethoxazole-trimethoprim, streptomycin, penicillin G, and polymyxin B, with 35% of the isolates being resistant to ampicillin. All isolates were sensitive to ciprofloxacin, norfloxacin, chloramphenicol, gentamicin, and kanamycin. Multiplex PCR analysis confirmed the biochemical identification and revealed the presence of virulence genes, viz., ace, zot, and ctxA, in all of the isolates. Interestingly, the sequencing of the ctxB gene showed that the outbreak strain harbored the classical cholera toxin gene and therefore belongs to the newly assigned El Tor variant biotype. Clonal analysis by pulsed-field gel electrophoresis demonstrated that a single clone of a V. cholerae strain was responsible for this outbreak. Thus, we present the first molecular evidence that the toxigenic V. cholerae O1 El Tor variant has invaded Malaysia, highlighting the need for continuous monitoring to facilitate early interventions against any potential epidemic by this biotype.
Ang
Geik Yong
GY
Department of Medical Microbiology and Parasitology, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu 16150, Malaysia. yeancyn@yahoo.com
Yu
Choo Yee
CY
Balqis
Kamarudin
K
Elina
Husni Tan
HT
Azura
Hussin
H
Hani
Mat Hussin
MH
Yean
Chan Yean
CY
D000900:Anti-Bacterial Agents / Q000494:pharmacology; D015373:Bacterial Typing Techniques; D002771:Cholera / Q000453:epidemiology / Q000382:microbiology*; D002772:Cholera Toxin / Q000096:biosynthesis* / Q000235:genetics; D004269:DNA, Bacterial / Q000737:chemistry / Q000235:genetics; D004196:Disease Outbreaks; D024881:Drug Resistance, Bacterial; D006801:Humans; D008296:Malaysia / Q000453:epidemiology; D008826:Microbial Sensitivity Tests; D008969:Molecular Sequence Data; D016133:Polymerase Chain Reaction; D017422:Sequence Analysis, DNA; D041241:Vibrio cholerae O1 / Q000145:classification* / Q000235:genetics / Q000302:isolation & purification / Q000472:pathogenicity*; D037521:Virulence Factors / Q000096:biosynthesis / Q000235:genetics
D000900:Anti-Bacterial Agents; D004269:DNA, Bacterial; D037521:Virulence Factors; D002772:Cholera Toxin
J Clin Microbiol. 1993 Sep;31(9):2474-82
7691876
J Clin Microbiol. 2003 Oct;41(10):4502-11
14532174
Clin Microbiol Rev. 1992 Oct;5(4):387-99
1423217
Trop Biomed. 2009 Dec;26(3):320-5
20237446
Microbiol Immunol. 2008 Jun;52(6):314-7
18577166
J Clin Microbiol. 1994 Dec;32(12):2975-9
7883885
Epidemiol Infect. 2000 Feb;124(1):25-30
10722126
Bull World Health Organ. 1967;36(6):871-83
4865453
J Clin Microbiol. 2001 Jul;39(7):2594-7
11427575
Bull World Health Organ. 1980;58(5):747-51
6975183
Epidemiol Infect. 1991 Aug;107(1):225-33
1879486
Proc Natl Acad Sci U S A. 1993 Jun 1;90(11):5267-71
8389476
Acta Trop. 2002 Aug;83(2):169-76
12088858
J Clin Microbiol. 2006 Nov;44(11):4211-3
16957040
Am J Clin Pathol. 1966 Apr;45(4):493-6
5325707
Proc Natl Acad Sci U S A. 2003 Feb 4;100(3):1304-9
12538850
J Clin Microbiol. 2002 Sep;40(9):3296-9
12202569
Microbiol Mol Biol Rev. 1998 Dec;62(4):1301-14
9841673
Lancet. 2004 Jan 17;363(9404):223-33
14738797
J Clin Microbiol. 1996 Oct;34(10):2537-43
8880516
J Microbiol Methods. 2008 Sep;75(1):142-4
18579241
Lancet. 1993 Mar 13;341(8846):704
8095621
J Clin Microbiol. 1997 Sep;35(9):2299-306
9276406
J Clin Microbiol. 1991 May;29(5):1058-9
1676035
Clin Microbiol Rev. 1995 Jan;8(1):48-86
7704895
Lancet. 1993 Aug 14;342(8868):382-3
8101894
Microbiol Rev. 1983 Dec;47(4):510-50
6363898
Emerg Infect Dis. 2008 Jun;14(6):987-8
18507925
Clin Microbiol Infect. 2007 Oct;13 Suppl 3:1-46
17716294
Med J Malaysia. 2000 Mar;55(1):143-5
11072502
Lancet. 1993 Jun 26;341(8861):1661
8100020
J Med Microbiol. 2002 Mar;51(3):264-268
11871621
J Clin Microbiol. 1993 Jan;31(1):22-5
7678018
J Clin Microbiol. 1985 Sep;22(3):405-8
2995438
J Clin Microbiol. 1995 Sep;33(9):2233-9
7494007
Emerg Infect Dis. 2004 Nov;10(11):2057-9
16010751
J Med Microbiol. 2006 Nov;55(Pt 11):1563-1569
17030917
Indian J Med Res. 2008 Dec;128(6):695-8
19246791
J Clin Microbiol. 1994 Jul;32(7):1685-90
7929758
Emerg Infect Dis. 2009 Jan;15(1):131-2
19116078
J Bacteriol. 2002 Aug;184(15):4259-69
12107144
Proc Natl Acad Sci U S A. 2002 Feb 5;99(3):1556-61
11818571