AUTHOR=Rashed Shah M. , Hasan Nur A. , Alam Munirul , Sadique Abdus , Sultana Marzia , Hoq Md. Mozammel , Sack R. Bradley , Colwell Rita R. , Huq Anwar 

TITLE=Vibrio cholerae O1 with Reduced Susceptibility to Ciprofloxacin and Azithromycin Isolated from a Rural Coastal Area of Bangladesh

JOURNAL=Frontiers in Microbiology

VOLUME=8

YEAR=2017

URL=https://www.frontiersin.org/journals/microbiology/articles/10.3389/fmicb.2017.00252

DOI=10.3389/fmicb.2017.00252

ISSN=1664-302X

ABSTRACT=<p>Cholera outbreaks occur each year in the remote coastal areas of Bangladesh and epidemiological surveillance and routine monitoring of cholera in these areas is challenging. In this study, a total of 97 <italic>Vibrio cholerae</italic> O1 isolates from Mathbaria, Bangladesh, collected during 2010 and 2014 were analyzed for phenotypic and genotypic traits, including antimicrobial susceptibility. Of the 97 isolates, 95 possessed CTX-phage mediated genes, <italic>ctxA, ace</italic>, and <italic>zot</italic>, and two lacked the cholera toxin gene, <italic>ctxA</italic>. Also both CTX<sup>+</sup> and CTX<sup>−</sup><italic>V. cholerae</italic> O1 isolated in this study carried <italic>rtxC, tcpA</italic><sup>ET</sup>, and <italic>hlyA</italic>. The classical cholera toxin gene, <italic>ctxB1</italic>, was detected in 87 isolates, while eight had <italic>ctxB7</italic>. Of 95 CTX<sup>+</sup><italic>V. cholerae</italic> O1, 90 contained <italic>rstR</italic><sup>ET</sup> and 5 had <italic>rstR</italic><sup>CL</sup>. All isolates, except two, contained SXT related integrase <italic>intSXT</italic>. Resistance to penicillin, streptomycin, nalidixic acid, sulfamethoxazole-trimethoprim, erythromycin, and tetracycline varied between the years of study period. Most importantly, 93% of the <italic>V. cholerae</italic> O1 were multidrug resistant. Six different resistance profiles were observed, with resistance to streptomycin, nalidixic acid, tetracycline, and sulfamethoxazole-trimethoprim predominant every year. Ciprofloxacin and azithromycin MIC were 0.003–0.75 and 0.19–2.00 μg/ml, respectively, indicating reduced susceptibility to these antibiotics. Sixteen of the <italic>V. cholerae</italic> O1 isolates showed higher MIC for azithromycin (≥0.5 μg/ml) and were further examined for 10 macrolide resistance genes, <italic>erm</italic>(A), <italic>erm</italic>(B), <italic>erm</italic>(C), <italic>ere</italic>(A), <italic>ere</italic>(B), <italic>mph</italic>(A), <italic>mph</italic>(B), <italic>mph</italic>(D), <italic>mef</italic>(A), and <italic>msr</italic>(A) with none testing positive for the macrolide resistance genes.</p>