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Journal of Clinical Microbiology, October 2000, p. 3774-3779, Vol. 38, No. 10
0095-1137/00/$04.00+0
Copyright © 2000, American Society for Microbiology. All rights reserved.

Class 1 Integron-Borne, Multiple-Antibiotic Resistance Encoded by a 150-Kilobase Conjugative Plasmid in Epidemic Vibrio cholerae O1 Strains Isolated in Guinea-Bissau

Anders Dalsgaard,1,* Anita Forslund,1 Andreas Petersen,1 Derek J. Brown,1 Francisco Dias,2 Serifo Monteiro,2 Kåre Mølbak,3,4 Peter Aaby,3,4 Amabelia Rodrigues,5 and Anita Sandström2

Department of Veterinary Microbiology, The Royal Veterinary and Agricultural University, DK-1870 Frederiksberg C,1 and Danish Epidemiology Science Centre, Statens Seruministitut, Copenhagen,4 Denmark, and Laboratório Nacional de Saúde Pública2 and Department of Epidemiology, Ministry of Public Health,5 Bissau, and Projecto de Saúde, Bandim,3 Guinea-Bissau

Received 25 February 2000/Returned for modification 14 May 2000/Accepted 31 July 2000

In the 1996-1997 cholera epidemic in Guinea-Bissau, surveillance for antimicrobial resistance showed the emergence of a multidrug-resistant strain of Vibrio cholerae O1 during the course of the epidemic. The strain was resistant to ampicillin, erythromycin, tetracycline, furazolidone, aminoglycosides, trimethoprim, and sulfamethoxazole. Concomitant with the emergence of this strain, we observed a resurgence in the number of registered cholera cases as well as an increase in the case fatality rate from 1.0% before the emergence of the multiple-drug-resistant strain to 5.3% after the emergence of the strain. Our study shows that the strain contained a 150-kb conjugative multiple-antibiotic resistance plasmid with class 1 integron-borne gene cassettes encoding resistance to trimethoprim (dhfrXII) and aminoglycosides [ant(3")-1a]). The finding of transferable resistance to almost all of the antibiotics commonly used to treat cholera is of great public health concern. Studies should be carried out to determine to what extent the strain or its resistance genes have been spread to other areas where cholera is endemic.

* Corresponding author. Mailing address: Department of Veterinary Microbiology, The Royal Veterinary and Agricultural University, Bülowsvej 13, DK-1870 Frederiksberg C, Denmark. Phone: 45-35-282720. Fax: 45-35-282757. E-mail: ad{at}kvl.dk.

Journal of Clinical Microbiology, October 2000, p. 3774-3779, Vol. 38, No. 10
0095-1137/00/$04.00+0
Copyright © 2000, American Society for Microbiology. All rights reserved.


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