The Evolution of Phenotypic Properties and Molecular Genetic Organization of Genomes of Vibrio Cholerae O1 El Tor Variant Strains Isolated from Patients and Environmental Objects in the Caucasus in 1970–1998

Introduction: The formation of highly pathogenic strains of Vibrio cholerae resistant to antibiotics determines the pathogenesis, clinical picture, epidemiology, and laboratory diagnosis of cholera. It is necessary to study the structure of the genome of V. cholerae of any serological groups isolated during routine monitoring of environmental objects or patients with acute intestinal infections in order to detect toxigenic genes inherent to epidemic strains of V. cholerae O1. Our objective was to study changes in phenotypic properties and molecular genetic bases of persistence, epidemic and pathogenetic potential of El Tor variant of Vibrio cholerae O1 isolated from patients and environmental objects in the Caucasus in 1970-1998. Materials and methods: We studied phenotypic and molecular genetic characteristics of 32 V. cholerae O1 strains isolated from patients and environmental objects in the Caucasus (1970-1998) using a microbiological assay and PCR test, respectively. Results: We established that the following biotypes of V. cholerae O1 were found in the Caucasus: a) El Tor, ctxA-, and Hly+ nontoxigenic strains of V. cholerae O1, typical in their phenotypic and molecular genetic properties. Their toxigenic potential is represented by exo- and endotoxins different from the enterotoxin of toxigenic V. cholerae; b) toxigenic El Tor, ctxAB EL +, rtxC+, and Hly- variant biotypes of V. cholerae O1, typical in their phenotypic, molecular and genetic properties during outbreaks of invasive cholera, producing a CT-2 enterotoxin and containing genes responsible for persistent, pathogenic and pandemic potential, and c) typical in terms of their main phenotypic characteristics but molecularly genetically altered variants (hybrids) of El Tor variant of Vibrio cholerae O1 including El Tor ctxAB CL +, rtxC+, Hly-. Conclusions: The main manifestation of evolutionary changes in a typical toxigenic vibrio of the El Tor variant biotype was the replacement of the ctxB El gene in its genome with the ctxB CL gene encoding the classical type of enterotoxin (CT-1), which significantly increased the persistent, toxic, epidemic, and pandemic potential of genetically modified variants of El Tor biotype Vibrio cholerae. The genome of these strains contains an integrative and conjugative element SXT with genes for antibiotic multiresistance.