Understanding antimicrobial resistance to manage cholera

Genomic epidemiology of the Yemen cholera outbreak reveals the genetic basis for emergence of multidrug resistance with implications for Vibrio cholerae surveillance and control.

Within a decade of its initial spread from the Bay of Bengal, 7PET V. cholerae reached Pakistan and Africa, then disseminated to Latin America in the 1990s, Haiti in 2010 and Yemen in 2016. Among these occurrences, the largest is taking place in Yemen. Genomic epidemiology revealed that the 7PET T13 sublineage circulating in Yemen was seeded by a single transmission originating in South Asia to Yemen, and it was susceptible to all antibiotics. Subsequent surveillance unveiled a troubling development that Yemeni V. cholerae strains isolated in late 2018 had acquired multidrug resistance.