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Journal of Clinical Microbiology, September 2006, p. 3422-3425, Vol. 44, No. 9
0095-1137/06/$08.00+0 doi:10.1128/JCM.01269-06
Copyright © 2006, American Society for Microbiology. All Rights Reserved.
Antibiotic Susceptibility and Molecular Diversity of Bacillus anthracis Strains in Chad: Detection of a New Phylogenetic Subgroup
Angaya Maho,1
Alexandra Rossano,2
Herbert Hächler,2,3,
Anita Holzer,2,3
Esther Schelling,4
Jakob Zinsstag,4
Mahamat H. Hassane,1
Bhen S. Toguebaye,5
Ayayi J. Akakpo,6
Matthew Van Ert,7
Paul Keim,7,8
Leo Kenefic,7
Joachim Frey,2,3 and
Vincent Perreten2*
Laboratoire de Recherches Vétérinaires et Zootechniques, BP433 Farcha, N'Djaména, Chad,1
Swiss Tropical Institute, PO Box, CH-4002 Basel, Switzerland,4
Département de Biologie Animale, Université Cheik Anta Diop, Dakar, Sénégal,5
Département de Microbiologie, Ecole Inter-Etats des Sciences et Médecine Vétérinaire, Dakar, Sénégal,6
Department of Biological Sciences, Northern Arizona University, Flagstaff, Arizona 86011-5640,7
The Translational Genomics Research Institute (TGen), 400 N. Fifth Street Ste. 1600, Phoenix, Arizona 85004,8
National Centre for Anthrax,3
Institute of Veterinary Bacteriology, University of Berne, CH-3001 Bern, Switzerland2
Received 21 June 2006/
Accepted 16 July 2006

ABSTRACT
We genotyped 15
Bacillus anthracis isolates from Chad, Africa,
using multiple-locus variable-number tandem repeat analysis
and three additional direct-repeat markers. We identified two
unique genotypes that represent a novel genetic lineage in the
A cluster. Chadian isolates were susceptible to 11 antibiotics
and free of 94 antibiotic resistance genes.

TEXT
Bacillus anthracis, the etiological agent of anthrax, is a sporulating
bacterium causing disease primarily in herbivores in many countries
of Southern Europe, South America, Asia, and Africa (
22). In
Chad, anthrax is hyperendemic in cattle (
22), and human cases
of intestinal and cutaneous anthrax are reported each year (World
Anthrax Data Site [
http://www.vetmed.lsu.edu/whocc/]). However,
studies of the genetic diversity and antibiotic susceptibilities
of
B. anthracis in this country have not been conducted. Here,
we used a previously reported eight-marker multiple-locus variable-number
tandem repeat (VNTR) analysis (MLVA) method (
13) and three additional
direct-repeat (DR) markers (
15) to examine the genetic diversity
of this pathogen in Chad. We also evaluated the Chadian
B. anthracis isolates for antibiotic resistance by using physiological and
genetic methods.
Between 1996 and 2003, 174 blood samples were taken from the heart region or jugular vein of cattle carcasses in five southern prefectures in Chad. The samples were screened for B. anthracis by cultivation on tryptone soy agar plates containing 5% sheep blood. After incubation at 37°C for 48 h, cultures from 15 samples were identified as B. anthracis on the basis of colony morphology, absence of hemolysis, and susceptibility to B. anthracis-specific
phage (2, 21). These cultures were sent to the Swiss Reference Centre (Bern, Switzerland) for further physiological and genetic testing.
Template DNA for PCR was obtained by cell lysis followed by filtration (18). PCRs were performed using Taq DNA polymerase (Roche Diagnostics, Basel, Switzerland) and an annealing temperature of 55°C if not otherwise specified. We used PCR to screen the samples for the presence of B. anthracis chromosomal (Ba813) and plasmid (pXO1 and pXO2) sequences (see Table 1 for PCR targets and primer sequences). Eight VNTR markers, vrrA, vrrB1, vrrB2, vrrC1, vrrC2, CG3, pXO1-aaT, and pXO2-at, were amplified by PCR according to the method of Keim et al. (13) and sequenced on an ABI Prism 3100 genetic analyzer (Applied Biosystems, Foster City, CA) with dRhodamine-labeled terminators. The sizes of the VNTR amplicons were compared to previously published allele sizes (13, 20) as well as to the 11 B. anthracis strain genome sequences from GenBank (http://www.ncbi.nlm.nih.gov).
Since comparisons of the sequence sizes to the fragment size
data revealed minor size discrepancies (1 bp for
vrrA, 3 bp
for
vrrC1, and a previously reported 3-bp shift in the pXO1
size [P. Keim, personal communication] [
6]), MLVA-8 fragment
analysis of 88 diverse genotypes (
13) and two Chadian isolates
(isolate ChadA1, group VII, and isolate ChadA8, group VIII)
was performed in the Keim genetics laboratory (Northern Arizona
University) to ensure the comparability and accuracy of the
raw VNTR scores from the Chadian strains with reference to those
from the genotypes published by Keim et al. in 2000 (
13) (Fig.
1).
Three additional DR regions of the
B. anthracis chromosome (markers
AJ03, AA03, and AT07) were amplified by PCR as described previously
(
15), except that an annealing temperature of 45°C was used.
The sequences for the different markers were compared to each
other by multiple sequence alignment with ClustalW (
http://www.ch.embnet.org)
and the numbers of DRs determined (Table
2). The Sterne strain
NCTC8234 was used as a control, and the positions of the DRs
were matched to the complete nucleotide (nt) sequence of this
strain (GenBank accession no. AE017225). In the Sterne strain,
the AJ03 marker is characterized by a succession of two 40-bp
DRs (
1092652CGAT-32 nt-GCGC
1092731), the AA03 by a succession
of three slightly imperfect repeats (
1721256TTCA-61/62/63 nt-TTAG
1721502),
and the AT07 marker by a succession of seven 39-bp DRs (
4234463ACTA-31
nt-TGAT
4234735).
View this table:
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TABLE 2. Genetic diversity and antibiotic susceptibilities of B. anthracis strains from different regions in Chad
|
The antibiotic susceptibilities of the Chadian
B. anthracis isolates were measured in Müller-Hinton broth by using
custom Sensititre susceptibility plates (Trek Diagnostics Systems,
East-Grinstead, England, and MCS Diagnostics BV, JL Swalmen,
The Netherlands), according to the CLSI guidelines (
7). To exclude
the possibility that Chadian
B. anthracis isolates possessed
antibiotic resistance genes that were not phenotypically expressed
in vitro, we screened for the presence of 94 gram-positive bacterial
antibiotic resistance genes using a microarray (
18).
PCR analysis revealed that the 15 isolates were B. anthracis and positive for the pXO1 and pXO2 plasmids. The fragment sizes and DNA sequences for the eight MLVA markers were identical in all Chadian strains. The effective sizes and the corrected, normalized scores for the eight MLVA alleles of the Chadian strains are listed in Table 2. Of note, this is the first report of a 133-bp allele in pXO2. Analysis by unweighted-pair group method using average linkages clustered samples into a new genetic group in the A branch according to Keim's classification system (Aß) (Fig. 1) (13). We used the system proposed by Levy et al. (15) to classify the 15 B. anthracis isolates into two different, novel genotypic groups (VII and VIII) (Table 2). These groups are new since this combination of DRs within the three markers has yet to be reported for B. anthracis, and the five-DR pattern in the AT07 marker in all Chadian strains is unique. We found no obvious geographic clustering of group VII and VIII strains (Fig. 2).
The Chadian isolates were susceptible to the antibiotics tested
but displayed decreased susceptibilities to ceftiofur, erythromycin,
and the combination quinupristin-dalfopristin and a slightly
higher MIC for clindamycin (MIC, 0.5 µg/ml) than the Sterne
strain NCTC8234 (Table
2).
Microarray-based analysis revealed that the strains were free of all antibiotic resistance genes tested except the ß-lactamase genes bla1 and bla2, which are endogenous to B. anthracis but are not expressed (5).
This study is the first to describe the genetic and physiological attributes of B. anthracis strains in Chad. Certainly, this region of Africa has been underrepresented in previous studies of the global genetic diversity of B. anthracis (13). On a regional level, the identical MLVA genotypes of the Chadian strains indicate a high degree of genetic similarity among B. anthracis isolates within the country. This is supported by the existence of only two unique, closely related strains identified by the three additional DR markers (groups VII and VIII) and the absence of antibiotic resistance genes in all the tested isolates. Similarly, our data suggest a low level of phenotypic diversity as it relates to antibiotic resistance. The finding that Chadian isolates were susceptible to 11 antibiotics and free of antibiotic resistance genes is significant from a public health perspective and can be used for therapeutic measures in the treatment of people affected with B. anthracis in this country.
From a global perspective, our MLVA and DR analysis showed that the Chadian strains displayed unique genetic signatures and are not closely related to any of the worldwide B. anthracis strains analyzed to date (6, 9, 10, 11, 13, 19, 20). Indeed, the long branch lengths of the Aß group indicate a considerable degree of evolutionary divergence for these two strains from the remaining B. anthracis isolates in the A lineage (Fig. 1). In summary, our results provide a first look at the genetic diversity and antibiotic resistance patterns of this pathogen in Chad and can be useful for future epidemiological analyses of anthrax outbreaks in this region.

ACKNOWLEDGMENTS
We thank Haim Levy for helpful advice and Jana U'Ren for technical
assistance.
This work was partially supported by grant 4049-067448 from the National Research Programme NRP49 on antibiotic resistance of the Swiss National Science Foundation and by the Swiss Agency for Development and Cooperation for the training of Chadian capacity.

FOOTNOTES
* Corresponding author. Mailing address: Institute of Veterinary Bacteriology, University of Berne, Länggass-Strasse 122, Postfach, CH-3001 Bern, Switzerland. Phone: 41 31 631 2430. Fax: 41 31 631 2634. E-mail:
vincent.perreten{at}vbi.unibe.ch.

Present address: Institute of Medical Microbiology, Cantonal Hospital, CH-6000 Lucerne 16, Switzerland. 

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Journal of Clinical Microbiology, September 2006, p. 3422-3425, Vol. 44, No. 9
0095-1137/06/$08.00+0 doi:10.1128/JCM.01269-06
Copyright © 2006, American Society for Microbiology. All Rights Reserved.
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