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dc.contributor.authorEibach, Daniel
dc.contributor.authorHerrera-León, Silvia 
dc.contributor.authorGil, Horacio 
dc.contributor.authorHogan, Benedikt
dc.contributor.authorEhlkes, Lutz
dc.contributor.authorAdjabeng, Michael
dc.contributor.authorKreuels, Benno
dc.contributor.authorNagel, Michael
dc.contributor.authorOpare, David
dc.contributor.authorFobil, Julius N
dc.contributor.authorMay, Jürgen
dc.identifier.citationPLoS Negl Trop Dis. 2016; 10 (5): e0004751es_ES
dc.description.abstractBACKGROUND: Ghana is affected by regular cholera epidemics and an annual average of 3,066 cases since 2000. In 2014, Ghana experienced one of its largest cholera outbreaks within a decade with more than 20,000 notified infections. In order to attribute this rise in cases to a newly emerging strain or to multiple simultaneous outbreaks involving multi-clonal strains, outbreak isolates were characterized, subtyped and compared to previous epidemics in 2011 and 2012. METHODOLOGY/PRINCIPAL FINDINGS: Serotypes, biotypes, antibiotic susceptibilities were determined for 92 Vibrio cholerae isolates collected in 2011, 2012 and 2014 from Southern Ghana. For a subgroup of 45 isolates pulsed-field gel electrophoresis, multilocus sequence typing and multilocus-variable tandem repeat analysis (MLVA) were performed. Eighty-nine isolates (97%) were identified as ctxB (classical type) positive V. cholerae O1 biotype El Tor and three (3%) isolates were cholera toxin negative non-O1/non-O139 V. cholerae. Among the selected isolates only sulfamethoxazole/trimethoprim resistance was detectable in 2011, while 95% of all 2014 isolates showed resistance towards sulfamethoxazole/trimethoprim, ampicillin and reduced susceptibility to ciprofloxacin. MLVA achieved the highest subtype discrimination, revealing 22 genotypes with one major outbreak cluster in each of the three outbreak years. Apart from those clusters genetically distant genotypes circulate during each annual epidemic. CONCLUSIONS/SIGNIFICANCE: This analysis suggests different endemic reservoirs of V. cholerae in Ghana with distinct annual outbreak clusters accompanied by the occurrence of genetically distant genotypes. Preventive measures for cholera transmission should focus on aquatic reservoirs. Rapidly emerging multidrug resistance must be monitored closely.es_ES
dc.description.sponsorshipThis work was supported by the German Center for Infection Research (Deutsches Zentrum für Infektionsforschung, DZIF). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscriptes_ES
dc.publisherPublic Library of Science (PLOS) es_ES
dc.subject.meshAdult es_ES
dc.subject.meshAnti-Bacterial Agents es_ES
dc.subject.meshBacterial Typing Techniques es_ES
dc.subject.meshCholera es_ES
dc.subject.meshDNA, Bacterial es_ES
dc.subject.meshDisease Outbreaks es_ES
dc.subject.meshDrug Resistance, Multiple, Bacterial es_ES
dc.subject.meshElectrophoresis, Gel, Pulsed-Field es_ES
dc.subject.meshFemale es_ES
dc.subject.meshGenotype es_ES
dc.subject.meshGhana es_ES
dc.subject.meshHumans es_ES
dc.subject.meshMale es_ES
dc.subject.meshMinisatellite Repeats es_ES
dc.subject.meshMultilocus Sequence Typing es_ES
dc.subject.meshPolymerase Chain Reaction es_ES
dc.subject.meshSequence Analysis, DNA es_ES
dc.subject.meshSerogroup es_ES
dc.subject.meshSulfamethoxazole es_ES
dc.subject.meshTrimethoprim es_ES
dc.subject.meshVibrio cholerae es_ES
dc.subject.meshVibrio cholerae O1 es_ES
dc.subject.meshVirulence Factors es_ES
dc.subject.meshYoung Adult es_ES
dc.titleMolecular Epidemiology and Antibiotic Susceptibility of Vibrio cholerae Associated with a Large Cholera Outbreak in Ghana in 2014es_ES
dc.typejournal articlees_ES
dc.rights.licenseAtribución-NoComercial-CompartirIgual 4.0 Internacional*
dc.contributor.funderGerman Center for Infection Research (Alemania) 
dc.identifier.journalPLoS neglected tropical diseaseses_ES
dc.repisalud.centroISCIII::Centro Nacional de Microbiologíaes_ES
dc.rights.accessRightsopen accesses_ES

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Atribución-NoComercial-CompartirIgual 4.0 Internacional
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