Outcomes of the Neonatal Trial of High-Frequency Oscillation at 16 to 19 Years
Christopher Harris, Alessandra Bisquera, Alan Lunt, Janet L. Peacock, Anne Greenough
Abstract
and only extended-spectrum cephalosporinresistant 7PET isolates from sporadic or smalloutbreak cases had been observed in Africa before 2018. 1 It is noteworthy that a large typhoid outbreak (>3000 suspected cases) that was caused by a ciprofloxacin-resistant strain -and that led to the use of extended-spectrum cephalosporins -occurred in Harare, Zimbabwe, between October 2017 and February 2018. 4,5 This situation might have contributed to the extendedspectrum cephalosporin-resistant patterns that were seen among the cholera outbreak strain several months later.The 2018 Zimbabwean isolates were susceptible to azithromycin, which was consequently used to treat severe cases of cholera during the outbreak.However, azithromycin-resistance genes, such as mph(A) or mph(E), were sporadically identified in CTX-M-15-producing 7PET isolates obtained in Zimbabwe (Table S4), the Democratic Republic of Congo, 1 and Kenya 2 from 2010 through 2015.The acquisition by this T13 7PET strain of an IncA/C2 plasmid with both the mph and tet genes would jeopardize the oral antibiotic treatment of cholera.We emphasize the need for cross-border collaboration and continued laboratory surveillance to stem this highly drug-resistant T13 cholera strain in Africa.