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JAC Advance Access published online on August 27, 2008
Journal of Antimicrobial Chemotherapy, doi:10.1093/jac/dkn334
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© The Author 2008. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org
The online version of this article has been published under an open access model. Users are entitled to use, reproduce, disseminate, or display the open access version of this article for non-commercial purposes provided that: the original authorship is properly and fully attributed; the Journal and Oxford University Press are attributed as the original place of publication with the correct citation details given; if an article is subsequently reproduced or disseminated not in its entirety but only in part or as a derivative work this must be clearly indicated. For commercial re-use, please contact journals.permissions@oxfordjournals.org

Original research

Vibrio cholerae O1 from Accra, Ghana carrying a class 2 integron and the SXT element

Japheth A. Opintan1, Mercy J. Newman1, Owusu Agyemang Nsiah-Poodoh1 and Iruka N. Okeke2,*

1 Department of Microbiology, University of Ghana Medical School, PO Box 4236, Accra, Ghana 2 Department of Biology, Haverford College, 370 Lancaster Avenue, Haverford, PA 19041, USA

Received 16 May 2008; returned 16 June 2008; revised 24 July 2008; accepted 25 July 2008

* Corresponding author. Tel: +1-610-896-1470; Fax: +1-610-896-4963; E-mail: iokeke{at}haverford.edu

Objectives: Vibrio cholerae O1 from a 2006 outbreak in Accra were commonly resistant to multiple antimicrobials and, in particular, to trimethoprim/sulfamethoxazole, drugs commonly used in the treatment of cholera. We sought to determine the genetic basis for trimethoprim/sulfamethoxazole resistance in outbreak isolates.

Methods: Twenty-seven isolates from the outbreak were screened by PCR and sequencing for class 1 and 2 integrons and for the SXT element.

Results: Twenty-one of the 27 isolates examined, all from the Accra metropolitan area, carried both SXT, an integrated chromosomal element, and a class 2 integron bearing dfrA1, sat and aadA1 cassettes. All these isolates had identical random amplification of polymorphic DNA profiles and two of them also carried a class 1 integron.

Conclusions: Most strains characterized carried multiple elements conferring resistance to trimethoprim. This suggests that trimethoprim/sulfamethoxazole should not be used empirically in cholera treatment.

Key Words: trimethoprim resistance , antimicrobial resistance , antibiotic resistance , cholera


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