ArticleBMC infectious diseases2014
Cholera outbreaks (2012) in three districts of Nepal reveal clonal transmission of multi-drug resistant Vibrio cholerae O1.
Article in BMC infectious diseases, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 2 of them syntheses that pooled it.
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Who cites it
23 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Antimicrobial resistance among clinicalPathogens and global health · 2023Pooled it
- Global status of antimicrobial resistance among environmental isolates of Vibrio cholerae O1/O139: a systematic review and meta-analysis.Antimicrobial resistance and infection control · 2022Pooled it
- Epidemiological investigation of a cholera outbreak in Nepal-India border communities: Public health implications.IJID regions · 2025Article
- Zambia's battle against cholera outbreaks and the path to public health resilience: a narrative review.Journal of water and health · 2024Review
- Cholera rages in Africa and the Middle East: A narrative review on challenges and solutions.Health science reports · 2024Review
- Cholera amid COVID-19: Call from three nations; India, Bangladesh, and Nepal.Annals of medicine and surgery (2012) · 2022Review
- Phylogenetic and antimicrobial drug resistance analysis ofMicrobial genomics · 2021Article
- Article
- Characterisation ofThe Pan African medical journal · 2020Article
- Diarrheal disease outbreak in Gaidatar village of Rautahat District, Nepal.BMC research notes · 2019Article
- Lessons Learned from Enhancing Sentinel Surveillance for Cholera in Post-Earthquake Nepal in 2016.The American journal of tropical medicine and hygiene · 2019Article
- Epidemiological and molecular forensics of cholera recurrence in Haiti.Scientific reports · 2019Article
- Differences in substrate specificity of V. cholerae FabH enzymes suggest new approaches for the development of novel antibiotics and biofuels.The FEBS journal · 2018Article
- Emergency response in water, sanitation and hygiene to control cholera in post-earthquake Nepal in 2016.Journal of water, sanitation, and hygiene for development : a journal of the International Water Association · 2018Article
- Analysis of Vibrio seventh pandemic island II and novel genomic islands in relation to attachment sequences among a wide variety of Vibrio cholerae strains.Microbiology and immunology · 2018Article
- Antimicrobial Resistance Risks of Cholera Prophylaxis for United Nations Peacekeepers.Antimicrobial agents and chemotherapy · 2017Article
- Article
- Characterization and Genetic Variation of Vibrio cholerae Isolated from Clinical and Environmental Sources in Thailand.PloS one · 2017Article
- Article
- Is a Cholera Outbreak Preventable in Post-earthquake Nepal?PLoS neglected tropical diseases · 2015Article
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Abstract
backgroundAlthough endemic cholera causes significant morbidity and mortality each year in Nepal, lack of information about the causal bacterium often hinders cholera intervention and prevention. In 2012, diarrheal outbreaks affected three districts of Nepal with confirmed cases of mortality. This study was designed to understand the drug response patterns, source, and transmission of Vibrio cholerae associated with 2012 cholera outbreaks in Nepal.
methodsV. cholerae (n = 28) isolated from 2012 diarrhea outbreaks {n = 22; Kathmandu (n = 12), Doti (n = 9), Bajhang (n = 1)}, and surface water (n = 6; Kathmandu) were tested for antimicrobial response. Virulence properties and DNA fingerprinting of the strains were determined by multi-locus genetic screening employing polymerase chain reaction, DNA sequencing, and pulsed-field gel electrophoresis (PFGE).
resultsAll V. cholerae strains isolated from patients and surface water were confirmed to be toxigenic, belonging to serogroup O1, Ogawa serotype, biotype El Tor, and possessed classical biotype cholera toxin (CTX). Double-mismatch amplification mutation assay (DMAMA)-PCR revealed the V. cholerae strains to possess the B-7 allele of ctx subunit B. DNA sequencing of tcpA revealed a point mutation at amino acid position 64 (N → S) while the ctxAB promoter revealed four copies of the tandem heptamer repeat sequence 5'-TTTTGAT-3'. V. cholerae possessed all the ORFs of the Vibrio seventh pandemic island (VSP)-I but lacked the ORFs 498-511 of VSP-II. All strains were multidrug resistant with resistance to trimethoprim-sulfamethoxazole (SXT), nalidixic acid (NA), and streptomycin (S); all carried the SXT genetic element. DNA sequencing and deduced amino acid sequence of gyrA and parC of the NAR strains (n = 4) revealed point mutations at amino acid positions 83 (S → I), and 85 (S → L), respectively. Similar PFGE (NotI) pattern revealed the Nepalese V. cholerae to be clonal, and related closely with V. cholerae associated with cholera in Bangladesh and Haiti.
conclusionsIn 2012, diarrhea outbreaks in three districts of Nepal were due to transmission of multidrug resistant V. cholerae El Tor possessing cholera toxin (ctx) B-7 allele, which is clonal and related closely with V. cholerae associated with cholera in Bangladesh and Haiti.
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