Between September 2018 and March 2019, a cholera epidemic took place in Zimbabwe, causing 10 000 cases and 69 deaths. The Enteric Bacterial Pathogens Unit at the Institut Pasteur (Paris) took part to the study of a strain of Vibrio cholerae (Vibrio cholerae O1) responsible for this epidemic. This study was made with scientists from the National Institute for Communicable Diseases of South Africa and the Zimbabwe Health Ministry.
The strain belongs to the T13 lineage
The analysis of the bacterial genome showed that the epidemic strain belonged to the new lineage T13, which originates from south Asia and arrived in western Africa in 2013-2014. This same T13 lineage had been identified by scientists of the Enteric Bacterial Pathogens Unit (Institut Pasteur) as the cause of the Yemen Cholera epidemic(1).
A strain resistant to many antibiotics
However the Zimbabwe epidemic strain was highly resistant to antibiotics, as opposed to the one from Yemen. In particular, it was resistant to tetracyclines, which are given as first-line treatment in combination with rehydration solutions. Fourteen additional antibiotic resistance genes were identified by the genetic analysis of this strain from Zimbabwe. Before this epidemic, an antibacterial resistance structure in the bacterial chromosome of cholera vibrios prevented the acquisition of such resistance plasmids and thus stabilised the content of resistance genes. Scientists from the Enteric Pathogenic Bacteria Unit are now working to understand the coexistence of these two resistance structures in this new T13 lineage.
(1) Genomic insights into the 2016–2017 cholera epidemic in Yemen, Nature, January 2, 2019.
François-Xavier Weill1, Daryl Domman2,3,elisabeth Njamkepo1, Abdullrahman A. Almesbahi4, Mona Naji4, Samar Saeed Nasher4, Ankur rakesh5, Abdullah M. Assiri6, Naresh Chand Sharma7, Samuel Kariuki8, Mohammad reza Pourshafie9, Jean rauzier1, Abdinasir Abubakar10, Jane Y. Carter11, Joseph F. Wamala12, Caroline Seguin13, Christiane Bouchier14, thérèse Malliavin15, Bita Bakhshi16, Hayder H. N. Abulmaali17, Dhirendra Kumar7,18, Samuel M. Njoroge8, Mamunur rahman Malik10, John Kiiru8, Francisco J. Luquero5, Andrew S. Azman19, thandavarayan ramamurthy18, Nicholas r. thomson2,20 & Marie-Laure Quilici1
1Institut Pasteur, Unité des Bactéries Pathogènes Entériques, Paris, France.
2Wellcome Sanger Institute, Hinxton, UK.
3Bioscience Division, Los Alamos National Laboratory, Los Alamos, NM, USA.
4National Centre of Public Health Laboratories (NCPHL), Sana’a, Yemen.
5Epicentre, Paris, France.
6Ministry of Health, Riyadh, Saudi Arabia.
7Maharishi Valmiki Infectious Diseases Hospital, Delhi, India.
8Centre for Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya.
9Pasteur Institute of Iran, Department of Bacteriology, Tehran, Iran.
10WHO Regional Office for the Eastern Mediterranean (EMRO), Cairo, Egypt.
11Amref Health Africa, Nairobi, Kenya.
12WHO, Juba, South Sudan.
13Médecins Sans Frontières (MSF), Dubai, United Arab Emirates.
14Institut Pasteur, Plate-forme Génomique (PF1), Paris, France.
15Unité de Bioinformatique Structurale, UMR 3528, CNRS; C3BI, USR 3756, Institut Pasteur, Paris, France.
16Department of Bacteriology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
17Central Public Health Laboratory (CPHL), Baghdad, Iraq.
18Translational Health Science and Technology Institute (THSTI), Faridabad, Haryana, India.
19Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
20London School of Hygiene and Tropical Medicine, London, UK.
(2) Highly Resistant Cholera Outbreak Strain in Zimbabwe, The New England Journal of Medicine, August 13, 2020.
Tapfumanei Mashe1, Daryl Domman2, Andrew Tarupiwa1, Portia Manangazira1, Isaac Phiri1, Kudzai Masunda3, Prosper Chonzi3, Elisabeth Njamkepo4, Masindi Ramudzulu5, Sekesai Mtapuri-Zinyowera1, Anthony M. Smith5, François-Xavier Weill4
1Ministry of Health and Child Care, Harare, Zimbabwe
2University of New Mexico Health Sciences Center, Albuquerque, NM
3Beatrice Road Infectious Diseases Hospital, Harare, Zimbabwe
4Institut Pasteur, Paris, France
5National Institute for Communicable Diseases, Johannesburg, South Africa