Skip to main content
    • Aa
    • Aa
  • Get access
    Check if you have access via personal or institutional login
  • Cited by 22
  • Cited by
    This article has been cited by the following publications. This list is generated based on data provided by CrossRef.

    Ballal, M. 2016. Antibiotic Resistance.

    Chatterjee, Shruti Zahid, M. Shamim Hasan Awasthi, Sharda Prasad Chowdhury, Nityananda Asakura, Masahiro Hinenoya, Atsushi Ramamurthy, T. Iwaoka, Emiko Aoki, Shunji and Yamasaki, Shinji 2016. In Vitro Inhibition of Cholera Toxin Production in <i>Vibrio cholerae</i> by Methanol Extract of Sweet Fennel Seeds and Its Components. Japanese Journal of Infectious Diseases, Vol. 69, Issue. 5, p. 384.

    Sarwar, Shamila Chakraborti, Soumyananda Bera, Supriyo Sheikh, Irshad Ali Hoque, Kazi Mirajul and Chakrabarti, Pinak 2016. The antimicrobial activity of ZnO nanoparticles against Vibrio cholerae: Variation in response depends on biotype. Nanomedicine: Nanotechnology, Biology and Medicine, Vol. 12, Issue. 6, p. 1499.

    Khalifa, Hazim O. Kamimoto, Maki Shimamoto, Toshi and Shimamoto, Tadashi 2015. Antimicrobial Effects of Blueberry, Raspberry, and Strawberry Aqueous Extracts and their Effects on Virulence Gene Expression inVibrio cholerae. Phytotherapy Research, Vol. 29, Issue. 11, p. 1791.

    Dixit, Sameer M Johura, Fatema-Tuz Manandhar, Sulochana Sadique, Abdus Rajbhandari, Rajesh M Mannan, Shahnewaj B Rashid, Mahamud-ur Islam, Saiful Karmacharya, Dibesh Watanabe, Haruo Sack, R Bradley Cravioto, Alejandro and Alam, Munirul 2014. Cholera outbreaks (2012) in three districts of Nepal reveal clonal transmission of multi-drug resistant Vibrio choleraeO1. BMC Infectious Diseases, Vol. 14, Issue. 1,

    Leopold, S. J. van Leth, F. Tarekegn, H. and Schultsz, C. 2014. Antimicrobial drug resistance among clinically relevant bacterial isolates in sub-Saharan Africa: a systematic review. Journal of Antimicrobial Chemotherapy, Vol. 69, Issue. 9, p. 2337.

    Akoachere, Jane-Francis Tatah Kihla Masalla, Thomas Njinuwoh and Njom, Henry Akum 2013. Multi-drug resistant toxigenic Vibrio cholerae O1 is persistent in water sources in New Bell-Douala, Cameroon. BMC Infectious Diseases, Vol. 13, Issue. 1,

    Chomvarin, C. Johura, F.-T. Mannan, S. B. Jumroenjit, W. Kanoktippornchai, B. Tangkanakul, W. Tantisuwichwong, N. Huttayananont, S. Watanabe, H. Hasan, N. A. Huq, A. Cravioto, A. Colwell, R. R. and Alam, M. 2013. Drug response and genetic properties of Vibrio cholerae associated with endemic cholera in north-eastern Thailand, 2003-2011. Journal of Medical Microbiology, Vol. 62, Issue. Pt_4, p. 599.

    Ebrahimizadeh, Walead Mousavi Gargari, Seyedlatif Rajabibazl, Masoumeh Safaee Ardekani, Leila Zare, Hamed and Bakherad, Hamid 2013. Isolation and characterization of protective anti-LPS nanobody against V. cholerae O1 recognizing Inaba and Ogawa serotypes. Applied Microbiology and Biotechnology, Vol. 97, Issue. 10, p. 4457.

    Kamruzzaman, Muhammad Bari, S.M. Nayeemul and Faruque, Shah M. 2013. In vitro and in vivo bactericidal activity of Vitex negundo leaf extract against diverse multidrug resistant enteric bacterial pathogens. Asian Pacific Journal of Tropical Medicine, Vol. 6, Issue. 5, p. 352.

    Laxminarayan, Ramanan Duse, Adriano Wattal, Chand Zaidi, Anita K M Wertheim, Heiman F L Sumpradit, Nithima Vlieghe, Erika Hara, Gabriel Levy Gould, Ian M Goossens, Herman Greko, Christina So, Anthony D Bigdeli, Maryam Tomson, Göran Woodhouse, Will Ombaka, Eva Peralta, Arturo Quizhpe Qamar, Farah Naz Mir, Fatima Kariuki, Sam Bhutta, Zulfiqar A Coates, Anthony Bergstrom, Richard Wright, Gerard D Brown, Eric D and Cars, Otto 2013. Antibiotic resistance—the need for global solutions. The Lancet Infectious Diseases, Vol. 13, Issue. 12, p. 1057.

    Mshana, Stephen E Matee, Mecky and Rweyemamu, Mark 2013. Antimicrobial resistance in human and animal pathogens in Zambia, Democratic Republic of Congo, Mozambique and Tanzania: an urgent need of a sustainable surveillance system. Annals of Clinical Microbiology and Antimicrobials, Vol. 12, Issue. 1, p. 28.

    Rinaldo, A. Bertuzzo, E. Mari, L. Righetto, L. Blokesch, M. Gatto, M. Casagrandi, R. Murray, M. Vesenbeckh, S. M. and Rodriguez-Iturbe, I. 2012. Reassessment of the 2010-2011 Haiti cholera outbreak and rainfall-driven multiseason projections. Proceedings of the National Academy of Sciences, Vol. 109, Issue. 17, p. 6602.

    Wang, Ruibai Lou, Jing Liu, Jie Zhang, Lijuan Li, Jie and Kan, Biao 2012. Antibiotic resistance of Vibrio cholerae O1 El Tor strains from the seventh pandemic in China, 1961–2010. International Journal of Antimicrobial Agents, Vol. 40, Issue. 4, p. 361.

    Mandal, Shyamapada Mandal, Manisha Deb and Pal, Nishith Kumar 2011. Cholera: a great global concern. Asian Pacific Journal of Tropical Medicine, Vol. 4, Issue. 7, p. 573.

    Okwori, EE Nwadioha, SI Nwokedi, EOP Odimayo, M and Jombo, GTA 2011. Bacterial pathogens and their antimicrobial susceptibility in Otukpo Benue state of Nigeria. Asian Pacific Journal of Tropical Biomedicine, Vol. 1, Issue. 2, p. S261.

    Holmner, Åsa Mackenzie, Alasdair and Krengel, Ute 2010. Molecular basis of cholera blood-group dependence and implications for a world characterized by climate change. FEBS Letters, Vol. 584, Issue. 12, p. 2548.

    Pugliese, N. Maimone, F. Scrascia, M. Materu, S. F. and Pazzani, C. 2009. SXT-related integrating conjugative element and IncC plasmids in Vibrio cholerae O1 strains in Eastern Africa. Journal of Antimicrobial Chemotherapy, Vol. 63, Issue. 3, p. 438.

    Smith, Kenneth P. Kumar, Sanath and Varela, Manuel F. 2009. Identification, cloning, and functional characterization of EmrD-3, a putative multidrug efflux pump of the major facilitator superfamily from Vibrio cholerae O395. Archives of Microbiology, Vol. 191, Issue. 12, p. 903.

    Opintan, J. A. Newman, M. J. Nsiah-Poodoh, O. A. and Okeke, I. N. 2008. Vibrio cholerae O1 from Accra, Ghana carrying a class 2 integron and the SXT element. Journal of Antimicrobial Chemotherapy, Vol. 62, Issue. 5, p. 929.


Multiply antibiotic-resistant Vibrio cholerae O1 biotype El Tor strains emerge during cholera outbreaks in Zambia

  • J. C. L. MWANSA (a1), J. MWABA (a1), C. LUKWESA (a1), N. A. BHUIYAN (a2), M. ANSARUZZAMAN (a2), T. RAMAMURTHY (a3), M. ALAM (a2) and G. BALAKRISH NAIR (a2)
  • DOI:
  • Published online: 23 November 2006

Antibiotic resistance data, made available from laboratory records during eight cholera outbreaks between 1990 and 2004 showed Vibrio cholerae serogroup O1 to have a low level of resistance (2–3%) to tetracycline during 1990–1991. Resistance increased for tetracycline (95%), chloramphenicol (78%), doxycycline (70%) and trimethoprim–sulphamethoxazole (97%) in subsequent outbreaks. A significant drop in resistance to tetracycline and chloramphenicol followed the adoption of a national policy to replace tetracycline with erythromycin for treating cholera. Sixty-nine strains from cholera outbreaks in Zambia between 1996 and 2004, were examined for antibiotic resistance and basic molecular traits. A 140 MDa conjugative, multidrug-resistant plasmid was found to encode tetracycline resistance in strains from 1996/1997 whereas strains from 2003/2004 were resistant to furazolidone, but susceptible to tetracycline, and lacked this plasmid. PCR revealed 25 of 27 strains from 1996/1997 harboured the intl1 class 1 integron but lacked SXT, a conjugative transposon element. Similar screening of 42 strains from 2003/2004 revealed all carried SXT but not the intl1 class 1 integron. All 69 strains, except two, one lacking ctxA and the other rstR and thus presumably truncated in the CTX prophage region, were positive for important epidemic markers namely rfbO1, ctxA, rstR2, and tcpA of El Tor biotype. Effective cholera management is dependent on updated reports on culture and sensitivity to inform the choice of antibiotic. Since the emergence of antibiotic resistance may significantly influence strategies for controlling cholera, continuous monitoring of epidemic strains is crucial.

Corresponding author
*Author for correspondence: Dr J. C. L. Mwansa, University Teaching Hospital, Department of Pathology and Microbiology, Lusaka, Zambia. (Email:
Linked references
Hide All

This list contains references from the content that can be linked to their source. For a full set of references and notes please see the PDF or HTML where available.

1. World Health Organization. Cholera in 1997. Weekly Epidemiological Record 1998; 73: 201208.

4. A Dalsgaard , Vibrio cholerae O1 outbreak isolates in Mozambique and South Africa in 1998 are multiple-drug resistant, contain the SXT element and the aadA2 gene located on class 1 integrons. Journal of Antimicrobial Chemotherapy 2001; 48: 827838.

6. E Athan , S Donohue , D Durrheim . A cholera outbreak and control in a rural region of South Africa. South African Medical Journal 1998; 88: 13061308.

7. RI Glass , Emergence of multiply antibiotic-resistant Vibrio cholerae in Bangladesh. Journal of Infectious Diseases 1980; 142: 939943.

8. JT Weber , Epidemic cholera in Ecuador: multidrug-resistance and transmission by water and seafood. Epidemiology and Infection 1994; 112: 111.

9. MK Waldor , H Tschape , JJ Mekalanos . A new type of conjugative transposon encodes resistance to sulfamethoxazole, trimethoprim, and streptomycin in Vibrio cholerae O139. Journal of Bacteriology 1996; 178: 41574165.

10. ME Jones , Widespread occurrence of integrons causing multiple antibiotic resistance in bacteria. Lancet 1997; 349: 17421743.

11. A Dalsgaard , Cholera in Vietnam: changes in genotypes and emergence of class I integrons containing aminoglycoside resistance gene cassettes in Vibrio cholerae O1 strains isolated from 1979 to 1996. Journal of Clinical Microbiology 1999; 37: 734741.

14. P Garg , Expanding multiple antibiotic resistance among clinical strains of Vibrio cholerae isolated from 1992–1997 in Calcutta, India. Epidemiology and Infection 2000; 124: 393399.

15. CI Kado , ST Liu . Rapid procedure for detection and isolation of large and small plasmids. Journal of Bacteriology 1981; 145: 13651373.

16. KA Talukder , Phenotypic and genotypic characterization of serologically atypical strains of Shigella flexneri type 4 isolated in Dhaka, Bangladesh. Journal of Clinical Microbiology 2002; 40: 29402947.

17. K Haider , Electropherotyping of plasmid DNA of different serotypes of Shigella flexneri isolated in Bangladesh. Epidemiology and Infection 1989; 102: 421428.

18. S Nusrin , Diverse CTX phages among toxigenic Vibrio cholerae O1 and O139 strains isolated between 1994 and 2002 in an area where cholera is endemic in Bangladesh. Journal of Clinical Microbiology 2004; 42: 58545856.

19. GB Nair , New variants of Vibrio cholerae O1 biotype El Tor with attributes of the classical biotype from hospitalized patients with acute diarrhea in Bangladesh. Journal of Clinical Microbiology 2002; 40: 32963299.

20. L Shi , Distribution and characterization of integrons in various serogroups of Vibrio cholerae strains isolated from diarrhoeal patients between 1992 and 2000 in Kolkata, India. Journal of Medical Microbiology 2006; 55: 575583.

21. V Burrus , MK Waldor . Formation of SXT tandem arrays and SXT-R391 hybrides. Journal of Bacteriology 2004; 186: 26362645.

22. RI Glass , Plasmid-borne multi-drug resistance in Vibrio cholerae serogroup O1 biotype El Tor: evidence for a point source outbreak in Bangladesh. Journal of Infectious Diseases 1983; 147: 204209.

25. G Jonson , J Holmgren , AM Svennerholm . Identification of a mannose-binding pilus on Vibrio cholerae El Tor. Microbial Pathogenesis 1991; 11: 433441.

26. M Ansaruzzaman , Cholera in Mozambique, variant of Vibrio cholerae. Emerging Infectious Diseases 2004; 10: 20572059.

Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Epidemiology & Infection
  • ISSN: 0950-2688
  • EISSN: 1469-4409
  • URL: /core/journals/epidemiology-and-infection
Please enter your name
Please enter a valid email address
Who would you like to send this to? *