ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2022
Transmission of Antimicrobial Resistant Yersinia pestis During a Pneumonic Plague Outbreak.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers.
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23 citing papers in PubMed, 34 citations in OpenAlex.
- An adenoviral-vectored vaccine protects mice against aerosol challenge with Yersinia pestis.Molecular therapy : the journal of the American Society of Gene Therapy · 2026Article
- Structural and Biophysical Characterization of the Yersinia Type Three Secretion System ATPase YscN.Proteins · 2026Article
- Protective outcomes of high-affinity monoclonal antibodies against drug-resistant plague strains.Frontiers in immunology · 2026Article
- Anti-infective compounds forSustainable microbiology · 2026Review
- Evaluating the early diversification of Yersinia pestis and its phylogeographic expansion over 96 years of evolution in Madagascar.Communications biology · 2025Article
- A Novel, Broad-Spectrum, Virulent Bacteriophage TargetingPathogens (Basel, Switzerland) · 2025Article
- Hotspots of genetic change in Yersinia pestis.Nature communications · 2025Article
- Nanolipoprotein particle (NLP) vaccine confers protection againstFrontiers in immunology · 2025Article
- Multiplex PCR System for the Diagnosis of Plague.Current molecular medicine · 2025Review
- Development of Effective Medical Countermeasures Against the Main Biowarfare Agents: The Importance of Antibodies.Microorganisms · 2024Review
- Imaging analysis of pneumonic plague infection in Xizang, China: a case report and literature review.BMC pulmonary medicine · 2024Review
- Review of genotyping methods for Yersinia pestis in Madagascar.PLoS neglected tropical diseases · 2024Review
- Phylogenetic Relationships and Evolution of the GenusViruses · 2024Article
- Multiple Introductions of Yersinia pestis during Urban Pneumonic Plague Epidemic, Madagascar, 2017.Emerging infectious diseases · 2024Article
- The Natural and Clinical History of Plague: From the Ancient Pandemics to Modern Insights.Microorganisms · 2024Review
- Plague Gives Surprises in the Second Decade of the Twenty-First Century.The American journal of tropical medicine and hygiene · 2023Article
- Polyclonal Antibodies Derived from Transchromosomic Bovines Vaccinated with the Recombinant F1-V Vaccine Increase Bacterial Opsonization In Vitro and Protect Mice from Pneumonic Plague.Antibodies (Basel, Switzerland) · 2023Article
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- Two NovelViruses · 2022Article
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Authors and funding
15 authors at 5 institutions in 3 countries.
Funding
Abstract
backgroundPneumonic plague (PP), caused by Yersinia pestis, is the most feared clinical form of plague due to its rapid lethality and potential to cause outbreaks. PP outbreaks are now rare due to antimicrobial therapy.
methodsA PP outbreak in Madagascar involving transmission of a Y. pestis strain resistant to streptomycin, the current recommended first-line treatment in Madagascar, was retrospectively characterized using epidemiology, clinical diagnostics, molecular characterization, and animal studies.
resultsThe outbreak occurred in February 2013 in the Faratsiho district of Madagascar and involved 22 cases, including 3 untreated fatalities. The 19 other cases participated in funeral practices for the fatal cases and fully recovered after combination antimicrobial therapy: intramuscular streptomycin followed by oral co-trimoxazole. The Y. pestis strain that circulated during this outbreak is resistant to streptomycin resulting from a spontaneous point mutation in the 30S ribosomal protein S12 (rpsL) gene. This same mutation causes streptomycin resistance in 2 unrelated Y. pestis strains, one isolated from a fatal PP case in a different region of Madagascar in 1987 and another isolated from a fatal PP case in China in 1996, documenting this mutation has occurred independently at least 3 times in Y. pestis. Laboratory experiments revealed this mutation has no detectable impact on fitness or virulence, and revertants to wild-type are rare in other species containing it, suggesting Y. pestis strains containing it could persist in the environment.
conclusionsUnique antimicrobial resistant (AMR) strains of Y. pestis continue to arise in Madagascar and can be transmitted during PP outbreaks.
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