Prevalence of third-generation cephalosporin resistant Vibrio cholerae (3GCRVc) in water nexus: An environmental and public health concern

Although numerous studies have reported the control of cholera, it yet remained a global concern. Such concern has been further amplified by multiple-antibiotic-resistance (MAR) reports especially on cephalosporin-antibiotics amongst Vibrionaceae strains. According to the Clinical Laboratory Standard Institute (CLSI) guidelines, the cephalosporin-antibiotics are not primary choice antibiotics for cholera Vibrio management, but may be applied against resistant strains and risk-associated-resistant-markers. The study determines prevalence of third-generation-cephalosporin (3GC) resistance among environmental Vibrio cholerae strains. Water sources were sampled, recovered strains were subjected to standard antibacterial susceptibility testing (AST) using the 3GC antibiotics and interpreted employing CLSI guidelines. Isolates with resistance phenotypes were further confirmed genotypically using molecular biology techniques (Polymerase Chain Reaction; PCR). The analysis revealed non-agglutinating somatic antigen Vibrio cholerae ( SANAVc ) strains harboring 3GC associated resistant markers and a palpable high prevalence {27/61: 44.26%} amongst SANAVc . Predominant during the study was the observation of extended spectrum betalactamase resistance V. cholerae phenotype { ESβLVc ; 26/37; 70.3%}. The PCR detection shows multiple-antibiotics-resistant-genes (MAR-genes) both for plasmid and chromosomal borne including blaSHV (2/26; 7.7%), blaTEM (11/26; 42.3%), CTX-M (7/26; 26.9%), CTX-M-2 (3/26; 11.5%), CTX-M-9 (4/26; 15.4%), AmpC (17/21; 81.0). This study has revealed MAR-genes and phenotypes associated with 3GC which portends/indicates an environmental and public health concern especially when considering control/management of V. cholerae in the environmental-milieu. Such observation reveals the nature of resistance in that water-nexus and calls for an early detection/monitoring/surveillance strategies. This would include horizontal and vertical preventative strategies and antibiotic stewardship within suspected environments in the post-antibiotic era.