1
|
Delumeau A, Quétel I, Harnais F, Sellin A, Gros O, Talarmin A, Marcelino I. Bacterial microbiota management in free-living amoebae (Heterolobosea lineage) isolated from water: The impact of amoebae identity, grazing conditions, and passage number. Sci Total Environ 2023; 900:165816. [PMID: 37506913 DOI: 10.1016/j.scitotenv.2023.165816] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 07/24/2023] [Accepted: 07/24/2023] [Indexed: 07/30/2023]
Abstract
Free-living amoebae (FLA) are ubiquitous protozoa mainly found in aquatic environments. They are well-known reservoirs and vectors for the transmission of amoeba-resistant bacteria (ARB), most of which are pathogenic to humans. Yet, the natural bacterial microbiota associated with FLA remains largely unknown. Herein, we characterized the natural bacterial microbiota of different FLA species isolated from recreational waters in Guadeloupe. Monoxenic cultures of Naegleria australiensis, Naegleria sp. WTP3, Paravahlkampfia ustiana and Vahlkampfia sp. AK-2007 (Heterolobosea lineage) were cultivated under different grazing conditions, during successive passages. The whole bacterial microbiota of the waters and the amoebal cysts was characterized using 16S rRNA gene metabarcoding. The culturable subset of ARB was analyzed by mass spectrometry (MALDI-TOF MS), conventional 16S PCR, and disk diffusion method (to assess bacterial antibiotic resistance). Transmission electron microscopy was used to locate the ARB inside the amoebae. According to alpha and beta-diversity analyses, FLA bacterial microbiota were significantly different from the ones of their habitat. While Vogesella and Aquabacterium genera were detected in water, the most common ARB belonged to Pseudomonas, Bosea, and Escherichia/Shigella genera. The different FLA species showed both temporary and permanent associations with differentially bacterial taxa, suggesting host specificity. These associations depend on the number of passages and grazing conditions. Additionally, Naegleria, Vahlkampfia and Paravahlkampfia cysts were shown to naturally harbor viable bacteria of the Acinetobacter, Escherichia, Enterobacter, Pseudomonas and Microbacterium genera, all being pathogenic to humans. To our knowledge, this is the first time Paravahlkampfia and Vahlkampfia have been demonstrated as hosts of pathogenic ARB in water. Globally, the persistence of these ARB inside resistant cysts represents a potential health risk. To ensure the continued safety of recreational waters, it is crucial to (i) regularly control both the amoebae and their ARB and (ii) improve knowledge on amoebae-bacteria interactions to establish better water management protocols.
Collapse
Affiliation(s)
- Aurélie Delumeau
- Institut Pasteur de la Guadeloupe, Unité TReD-Path, Les Abymes, Guadeloupe, France
| | - Isaure Quétel
- Institut Pasteur de la Guadeloupe, Unité TReD-Path, Les Abymes, Guadeloupe, France
| | - Florian Harnais
- Institut Pasteur de la Guadeloupe, Unité TReD-Path, Les Abymes, Guadeloupe, France
| | - Arantxa Sellin
- Institut Pasteur de la Guadeloupe, Unité TReD-Path, Les Abymes, Guadeloupe, France
| | - Olivier Gros
- Institut de Systématique, Évolution, Biodiversité (ISYEB), Muséum National d'Histoire Naturelle, CNRS, Sorbonne Université, EPHE, Université des Antilles, Pointe-à-Pitre, Guadeloupe, France
| | - Antoine Talarmin
- Institut Pasteur de la Guadeloupe, Unité TReD-Path, Les Abymes, Guadeloupe, France
| | - Isabel Marcelino
- Institut Pasteur de la Guadeloupe, Unité TReD-Path, Les Abymes, Guadeloupe, France.
| |
Collapse
|
2
|
Saint-Hilaire M, Plumain D, Thomé JP, Adam C, Scholl G, Vedy S, Ferdinand S, Talarmin A, Guyomard-Rabenirina S. Validation of an HPLC-MS/MS method with QuEChERS extraction using isotopic dilution to analyze chlordecone in human serum. J Chromatogr B Analyt Technol Biomed Life Sci 2023; 1229:123894. [PMID: 37837856 DOI: 10.1016/j.jchromb.2023.123894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 09/05/2023] [Accepted: 09/23/2023] [Indexed: 10/16/2023]
Abstract
Until 1993, chlordecone (CLD) was extensively used in banana fields in French West Indies. In a previous study, CLD was detected in 90 % of Martinican and Guadeloupean adult's serum. In order to simplify the analyses of CLD in the serum, a new QuEChERS-HPLC-MS/MS method was implemented and validated by the Pasteur Institute of Guadeloupe (IPG). This method was validated with accuracy profiles according to the French Standard NF V03-110 plus the ISO 15189 and European guidelines. Linearity, repeatability, accuracy, intermediate precision, specificity, limit of detection (LOD), limit of quantification (LOQ) and uncertainty were determined. The accuracy profile allowed the method to be validated between 0.06 µg L-1 and 1.00 µg L-1 of serum. The LOD was 0.02 µg L-1, the LOQ was 0.06 µg L-1 and the uncertainty of the method was 21 %. A comparison of 49 serum samples between the IPG (LC-MS/MS) and the LEAE-CART (GC-HRMS) laboratories demonstrated that this new method can reliably determine CLD in human serum. Stability tests were performed and duration of the storage of raw samples and extracts before analysis by HPLC-MS/MS. Raw samples were stable after collection for at least one week at 5 °C or 25 °C and for at least 3 months at -20 °C. Extracts in acetonitrile were stable for at least 1 month at -20 °C. These stability results facilitate the daily use of the method. This method should help the entire population of Guadeloupe and Martinique by allowing a routinely analyzed for CLD and will be useful for future projects aimed at improving population health monitoring.
Collapse
Affiliation(s)
- Maïlie Saint-Hilaire
- Institut Pasteur Guadeloupe, Morne Joliviere, 97139 Les Abymes, Guadeloupe, France.
| | - Didier Plumain
- Institut Pasteur Guadeloupe, Morne Joliviere, 97139 Les Abymes, Guadeloupe, France
| | - Jean-Pierre Thomé
- Université de Liège, LEAE -CART, Freshwater and Oceanic Sciences Unit of Research (FOCUS), B6C, Allée du 6 Août, 11, 4000 Liège, Belgium
| | - Catherine Adam
- Université de Liège, LEAE -CART, Freshwater and Oceanic Sciences Unit of Research (FOCUS), B6C, Allée du 6 Août, 11, 4000 Liège, Belgium
| | - Georges Scholl
- Université de Liège, CART, Molecular Systems Unit of Research (MolSys), B6C, Allée du 6 Août, 11, 4000 Liège, Belgium
| | - Serge Vedy
- Institut Pasteur Guadeloupe, Morne Joliviere, 97139 Les Abymes, Guadeloupe, France
| | - Séverine Ferdinand
- Institut Pasteur Guadeloupe, Morne Joliviere, 97139 Les Abymes, Guadeloupe, France
| | - Antoine Talarmin
- Institut Pasteur Guadeloupe, Morne Joliviere, 97139 Les Abymes, Guadeloupe, France
| | | |
Collapse
|
3
|
Gamiette G, Ferdinand S, Couvin D, Dard C, Talarmin A. The recent introduction of Angiostrongylus cantonensis and its intermediate host Achatina fulica into Guadeloupe detected by phylogenetic analyses. Parasit Vectors 2023; 16:276. [PMID: 37563598 PMCID: PMC10416417 DOI: 10.1186/s13071-023-05872-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 07/06/2023] [Indexed: 08/12/2023] Open
Abstract
BACKGROUND Angiostrongylus cantonensis (rat lungworm) is the main pathogen responsible for eosinophilic meningitis in humans. One of its intermediate snail hosts, Achatina fulica, was already present in many countries around the world before it appeared in the West Indies in the late 1980s. In the French territories in the Caribbean and northern South America, the first cases of human neuroangiostrongyliasis were reported in Martinique, Guadeloupe and French Guiana in 2002, 2013 and 2017, respectively. In order to better characterize angiostrongyliasis in Guadeloupe, particularly its geographical origin and route of introduction, we undertook molecular characterization of adult worms of Angiostrongylus cantonensis and its intermediate host Achatina fulica. METHODS Genomic DNA of adult Angiostrongylus cantonensis and Achatina fulica was extracted and amplified by polymerase chain reaction (PCR) targeting the mitochondrial genes cytochrome B and C for A. cantonensis and 16S ribosomal RNA for A. fulica. The PCR products were sequenced and studied by phylogenetic analysis. RESULTS Cytochrome B and cytochrome C molecular markers indicate a monophyletic lineage of A. cantonensis adult worms in Guadeloupe. Two sequences of A. fulica were identified. CONCLUSIONS These results confirm the recent introduction of both Angiostrongylus cantonensis and Achatina fulica into Guadeloupe. Achatina fulica in Guadeloupe shares a common origin with those in Barbados and New Caledonia, while Angiostrongylus cantonensis in Guadeloupe shares a common origin with those in Brazil, Hawaii and Japan.
Collapse
Affiliation(s)
- Gelixa Gamiette
- Réservoir et Diversité des Pathogènes, Unité Transmission, Institut Pasteur de Guadeloupe, Pointe-à-Pitre, France.
| | - Séverine Ferdinand
- Réservoir et Diversité des Pathogènes, Unité Transmission, Institut Pasteur de Guadeloupe, Pointe-à-Pitre, France
| | - David Couvin
- Réservoir et Diversité des Pathogènes, Unité Transmission, Institut Pasteur de Guadeloupe, Pointe-à-Pitre, France
| | - Céline Dard
- Institute for Advanced Biosciences, Team Host-Pathogen Interactions and Immunity to Infection, INSERM U1209-CNRS UMR5309, Université Grenoble Alpes, Grenoble, France
| | - Antoine Talarmin
- Réservoir et Diversité des Pathogènes, Unité Transmission, Institut Pasteur de Guadeloupe, Pointe-à-Pitre, France
| |
Collapse
|
4
|
Bonifay T, Le Turnier P, Epelboin Y, Carvalho L, De Thoisy B, Djossou F, Duchemin JB, Dussart P, Enfissi A, Lavergne A, Mutricy R, Nacher M, Rabier S, Talaga S, Talarmin A, Rousset D, Epelboin L. Review on Main Arboviruses Circulating on French Guiana, An Ultra-Peripheric European Region in South America. Viruses 2023; 15:1268. [PMID: 37376570 PMCID: PMC10302420 DOI: 10.3390/v15061268] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 05/23/2023] [Accepted: 05/25/2023] [Indexed: 06/29/2023] Open
Abstract
French Guiana (FG), a French overseas territory in South America, is susceptible to tropical diseases, including arboviruses. The tropical climate supports the proliferation and establishment of vectors, making it difficult to control transmission. In the last ten years, FG has experienced large outbreaks of imported arboviruses such as Chikungunya and Zika, as well as endemic arboviruses such as dengue, Yellow fever, and Oropouche virus. Epidemiological surveillance is challenging due to the differing distributions and behaviors of vectors. This article aims to summarize the current knowledge of these arboviruses in FG and discuss the challenges of arbovirus emergence and reemergence. Effective control measures are hampered by the nonspecific clinical presentation of these diseases, as well as the Aedes aegypti mosquito's resistance to insecticides. Despite the high seroprevalence of certain viruses, the possibility of new epidemics cannot be ruled out. Therefore, active epidemiological surveillance is needed to identify potential outbreaks, and an adequate sentinel surveillance system and broad virological diagnostic panel are being developed in FG to improve disease management.
Collapse
Affiliation(s)
- Timothee Bonifay
- Centre d’Investigation Clinique Antilles-Guyane, Inserm 1424, Centre Hospitalier de Cayenne, 97306 Cayenne, French Guiana, France; (T.B.); (P.L.T.)
| | - Paul Le Turnier
- Centre d’Investigation Clinique Antilles-Guyane, Inserm 1424, Centre Hospitalier de Cayenne, 97306 Cayenne, French Guiana, France; (T.B.); (P.L.T.)
- Infectious Diseases Department, Centre Hospitalier de Cayenne, 97306 Cayenne, French Guiana, France
| | - Yanouk Epelboin
- Microbiota of Insect Vectors Group, Institut Pasteur de la Guyane, 97300 Cayenne, French Guiana, France
| | - Luisiane Carvalho
- Santé Publique France, Cellule Guyane, 97300 Cayenne, French Guiana, France
| | - Benoit De Thoisy
- Laboratoire des Interactions Virus-Hôtes, Institut Pasteur de la Guyane, 97300 Cayenne, French Guiana, France
| | - Félix Djossou
- Infectious Diseases Department, Centre Hospitalier de Cayenne, 97306 Cayenne, French Guiana, France
| | - Jean-Bernard Duchemin
- Unité d’Entomologie Médicale, Institut Pasteur de la Guyane, 97300 Cayenne, French Guiana, France
| | | | - Antoine Enfissi
- Laboratoire de Virologie, Institut Pasteur de la Guyane, 97300 Cayenne, French Guiana, France
| | - Anne Lavergne
- Laboratoire des Interactions Virus-Hôtes, Institut Pasteur de la Guyane, 97300 Cayenne, French Guiana, France
- Laboratoire de Virologie, Institut Pasteur de la Guyane, 97300 Cayenne, French Guiana, France
| | - Rémi Mutricy
- Emergency Department, Centre Hospitalier de Cayenne, 97306 Cayenne, French Guiana, France
| | - Mathieu Nacher
- Centre d’Investigation Clinique Antilles-Guyane, Inserm 1424, Centre Hospitalier de Cayenne, 97306 Cayenne, French Guiana, France; (T.B.); (P.L.T.)
| | - Sébastien Rabier
- Centre d’Investigation Clinique Antilles-Guyane, Inserm 1424, Centre Hospitalier de Cayenne, 97306 Cayenne, French Guiana, France; (T.B.); (P.L.T.)
| | - Stanislas Talaga
- Unité d’Entomologie Médicale, Institut Pasteur de la Guyane, 97300 Cayenne, French Guiana, France
| | - Antoine Talarmin
- Unité Transmission, Réservoir et Diversité des Pathogènes, Institut Pasteur de Guadeloupe, 97139 Les Abymes, Guadeloupe, France
| | - Dominique Rousset
- Laboratoire de Virologie, Institut Pasteur de la Guyane, 97300 Cayenne, French Guiana, France
| | - Loïc Epelboin
- Centre d’Investigation Clinique Antilles-Guyane, Inserm 1424, Centre Hospitalier de Cayenne, 97306 Cayenne, French Guiana, France; (T.B.); (P.L.T.)
- Infectious Diseases Department, Centre Hospitalier de Cayenne, 97306 Cayenne, French Guiana, France
| |
Collapse
|
5
|
Pot M, Ducat C, Reynaud Y, Couvin D, Ferdinand S, Breurec S, Talarmin A, Guyomard-Rabenirina S. Draft genome sequence of Enterobacter chengduensis ECC445, isolated from fresh water in the West Indies. BMC Genom Data 2023; 24:16. [PMID: 36906565 PMCID: PMC10007730 DOI: 10.1186/s12863-023-01116-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 02/21/2023] [Indexed: 03/13/2023] Open
Abstract
OBJECTIVES The Enterobacter cloacae complex is considered an important opportunistic pathogen. It comprises many members that remain difficult to delineate by phenotypic approaches. Despite its importance in human infection, there is a lack of information on associated members in other compartments. Here we report the first de novo assembled and annotated whole-genome sequence of a E. chengduensis strain isolated from the environment. DATA DESCRIPTION ECC445 specimen was isolated in 2018 from a drinking water catchment point in Guadeloupe. It was clearly related to E. chengduensis species according to hsp60 typing and genomic comparison. Its whole-genome sequence is 5,211,280-bp long divided into 68 contigs, and presents a G + C content of 55.78%. This genome and associated datasets provided here will serve as a useful resource for further analyses of this rarely reported Enterobacter species.
Collapse
Affiliation(s)
- Matthieu Pot
- Transmission, Reservoir and Diversity of Pathogens Unit, Pasteur Institute of Guadeloupe, Pointe-À-Pitre, France
| | - Célia Ducat
- Transmission, Reservoir and Diversity of Pathogens Unit, Pasteur Institute of Guadeloupe, Pointe-À-Pitre, France
| | - Yann Reynaud
- Transmission, Reservoir and Diversity of Pathogens Unit, Pasteur Institute of Guadeloupe, Pointe-À-Pitre, France
| | - David Couvin
- Transmission, Reservoir and Diversity of Pathogens Unit, Pasteur Institute of Guadeloupe, Pointe-À-Pitre, France
| | - Séverine Ferdinand
- Transmission, Reservoir and Diversity of Pathogens Unit, Pasteur Institute of Guadeloupe, Pointe-À-Pitre, France
| | - Sébastien Breurec
- Transmission, Reservoir and Diversity of Pathogens Unit, Pasteur Institute of Guadeloupe, Pointe-À-Pitre, France
- Faculty of Medicine Hyacinthe Bastaraud, University of the Antilles, Pointe-À-Pitre, France
- grid.7429.80000000121866389Centre for Clinical Investigation 1424, INSERM, Pointe-À-Pitre/Les Abymes, France
- Laboratory of Clinical Microbiology, University Hospital Centre of Guadeloupe, Pointe-À-Pitre/Les Abymes, France
| | - Antoine Talarmin
- Transmission, Reservoir and Diversity of Pathogens Unit, Pasteur Institute of Guadeloupe, Pointe-À-Pitre, France
| | | |
Collapse
|
6
|
Dereeper A, Allouch N, Guerlais V, Garnier M, Ma L, De Jonckheere JF, Joseph SJ, Ali IKM, Talarmin A, Marcelino I. Naegleria genus pangenome reveals new structural and functional insights into the versatility of these free-living amoebae. Front Microbiol 2023; 13:1056418. [PMID: 36817109 PMCID: PMC9928731 DOI: 10.3389/fmicb.2022.1056418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 12/21/2022] [Indexed: 02/04/2023] Open
Abstract
Introduction Free-living amoebae of the Naegleria genus belong to the major protist clade Heterolobosea and are ubiquitously distributed in soil and freshwater habitats. Of the 47 Naegleria species described, N. fowleri is the only one being pathogenic to humans, causing a rare but fulminant primary amoebic meningoencephalitis. Some Naegleria genome sequences are publicly available, but the genetic basis for Naegleria diversity and ability to thrive in diverse environments (including human brain) remains unclear. Methods Herein, we constructed a high-quality Naegleria genus pangenome to obtain a comprehensive catalog of genes encoded by these amoebae. For this, we first sequenced, assembled, and annotated six new Naegleria genomes. Results and Discussion Genome architecture analyses revealed that Naegleria may use genome plasticity features such as ploidy/aneuploidy to modulate their behavior in different environments. When comparing 14 near-to-complete genome sequences, our results estimated the theoretical Naegleria pangenome as a closed genome, with 13,943 genes, including 3,563 core and 10,380 accessory genes. The functional annotations revealed that a large fraction of Naegleria genes show significant sequence similarity with those already described in other kingdoms, namely Animalia and Plantae. Comparative analyses highlighted a remarkable genomic heterogeneity, even for closely related strains and demonstrate that Naegleria harbors extensive genome variability, reflected in different metabolic repertoires. If Naegleria core genome was enriched in conserved genes essential for metabolic, regulatory and survival processes, the accessory genome revealed the presence of genes involved in stress response, macromolecule modifications, cell signaling and immune response. Commonly reported N. fowleri virulence-associated genes were present in both core and accessory genomes, suggesting that N. fowleri's ability to infect human brain could be related to its unique species-specific genes (mostly of unknown function) and/or to differential gene expression. The construction of Naegleria first pangenome allowed us to move away from a single reference genome (that does not necessarily represent each species as a whole) and to identify essential and dispensable genes in Naegleria evolution, diversity and biology, paving the way for further genomic and post-genomic studies.
Collapse
Affiliation(s)
- Alexis Dereeper
- Institut Pasteur de la Guadeloupe, Unité TReD-Path, Les Abymes, Guadeloupe, France
| | - Nina Allouch
- Institut Pasteur de la Guadeloupe, Unité TReD-Path, Les Abymes, Guadeloupe, France
| | - Vincent Guerlais
- Institut Pasteur de la Guadeloupe, Unité TReD-Path, Les Abymes, Guadeloupe, France
| | - Maëlle Garnier
- Institut Pasteur de la Guadeloupe, Unité TReD-Path, Les Abymes, Guadeloupe, France
| | - Laurence Ma
- Institut Pasteur de Paris, Biomics, Paris, France
| | | | - Sandeep J. Joseph
- Centers for Disease Control and Prevention (CDC), Atlanta, GA, United States
| | - Ibne Karim M. Ali
- Centers for Disease Control and Prevention (CDC), Atlanta, GA, United States
| | - Antoine Talarmin
- Institut Pasteur de la Guadeloupe, Unité TReD-Path, Les Abymes, Guadeloupe, France
| | - Isabel Marcelino
- Institut Pasteur de la Guadeloupe, Unité TReD-Path, Les Abymes, Guadeloupe, France,*Correspondence: Isabel Marcelino,
| |
Collapse
|
7
|
Dereeper A, Gruel G, Pot M, Couvin D, Barbier E, Bastian S, Bambou JC, Gelu-Simeon M, Ferdinand S, Guyomard-Rabenirina S, Passet V, Martino F, Piveteau P, Reynaud Y, Rodrigues C, Roger PM, Roy X, Talarmin A, Tressieres B, Valette M, Brisse S, Breurec S. Limited Transmission of Klebsiella pneumoniae among Humans, Animals, and the Environment in a Caribbean Island, Guadeloupe (French West Indies). Microbiol Spectr 2022; 10:e0124222. [PMID: 36094181 PMCID: PMC9603589 DOI: 10.1128/spectrum.01242-22] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Accepted: 08/08/2022] [Indexed: 12/30/2022] Open
Abstract
Guadeloupe (French West Indies), a Caribbean island, is an ideal place to study the reservoirs of the Klebsiella pneumoniae species complex (KpSC) and identify the routes of transmission between human and nonhuman sources due to its insularity, small population size, and small area. Here, we report an analysis of 590 biological samples, 546 KpSC isolates, and 331 genome sequences collected between January 2018 and May 2019. The KpSC appears to be common whatever the source. Extended-spectrum-β-lactamase (ESBL)-producing isolates (21.4%) belonged to K. pneumoniae sensu stricto (phylogroup Kp1), and all but one were recovered from the hospital setting. The distribution of species and phylogroups across the different niches was clearly nonrandom, with a distinct separation of Kp1 and Klebsiella variicola (Kp3). The most frequent sequence types (STs) (≥5 isolates) were previously recognized as high-risk multidrug-resistant (MDR) clones, namely, ST17, ST307, ST11, ST147, ST152, and ST45. Only 8 out of the 63 STs (12.7%) associated with human isolates were also found in nonhuman sources. A total of 22 KpSC isolates were defined as hypervirulent: 15 associated with human infections (9.8% of all human isolates), 4 (8.9%) associated with dogs, and 3 (15%) associated with pigs. Most of the human isolates (33.3%) belonged to the globally successful sublineage CG23-I. ST86 was the only clone shared by a human and a nonhuman (dog) source. Our work shows the limited transmission of KpSC isolates between human and nonhuman sources and points to the hospital setting as a cornerstone of the spread of MDR clones and antibiotic resistance genes. IMPORTANCE In this study, we characterized the presence and genomic features of isolates of the Klebsiella pneumoniae species complex (KpSC) from human and nonhuman sources in Guadeloupe (French West Indies) in order to identify the reservoirs and routes of transmission. This is the first study in an island environment, an ideal setting that limits the contribution of external imports. Our data showed the limited transmission of KpSC isolates between the different compartments. In contrast, we identified the hospital setting as the epicenter of antibiotic resistance due to the nosocomial spread of successful multidrug-resistant (MDR) K. pneumoniae clones and antibiotic resistance genes. Ecological barriers and/or limited exposure may restrict spread from the hospital setting to other reservoirs and vice versa. These results highlight the need for control strategies focused on health care centers, using genomic surveillance to limit the spread, particularly of high-risk clones, of this important group of MDR pathogens.
Collapse
Affiliation(s)
- Alexis Dereeper
- Transmission, Reservoir and Diversity of Pathogens Unit, Pasteur Institute of Guadeloupe, Pointe-à-Pitre, France
| | - Gaëlle Gruel
- Transmission, Reservoir and Diversity of Pathogens Unit, Pasteur Institute of Guadeloupe, Pointe-à-Pitre, France
| | - Matthieu Pot
- Transmission, Reservoir and Diversity of Pathogens Unit, Pasteur Institute of Guadeloupe, Pointe-à-Pitre, France
| | - David Couvin
- Transmission, Reservoir and Diversity of Pathogens Unit, Pasteur Institute of Guadeloupe, Pointe-à-Pitre, France
| | - Elodie Barbier
- UMR AgroEcologie, INRAE, Bourgogne Franche-Comté University, Dijon, France
| | - Sylvaine Bastian
- Laboratory of Clinical Microbiology, University Hospital Center of Guadeloupe, Pointe-à-Pitre/Les Abymes, France
| | | | - Moana Gelu-Simeon
- Hepato-Gastroenterology Department, University Hospital Center of Guadeloupe, Pointe-à-Pitre/Les Abymes, France
| | - Séverine Ferdinand
- Transmission, Reservoir and Diversity of Pathogens Unit, Pasteur Institute of Guadeloupe, Pointe-à-Pitre, France
| | | | - Virginie Passet
- Institut Pasteur, University Paris Cité, Biodiversity and Epidemiology of Bacterial Pathogens, Paris, France
| | - Frederic Martino
- Intensive Care Department, University Hospital Center of Guadeloupe, Pointe-à-Pitre/Les Abymes, France
| | | | - Yann Reynaud
- Transmission, Reservoir and Diversity of Pathogens Unit, Pasteur Institute of Guadeloupe, Pointe-à-Pitre, France
| | - Carla Rodrigues
- Institut Pasteur, University Paris Cité, Biodiversity and Epidemiology of Bacterial Pathogens, Paris, France
| | - Pierre-Marie Roger
- Infectious Disease Department, University Hospital Center of Guadeloupe, Pointe-à-Pitre/Les Abymes, France
- Faculty of Medecine Hyacinthe Bastaraud, University of the Antilles, Pointe-à-Pitre, France
| | - Xavier Roy
- Veterinary Clinic, Baie-Mahault, Guadeloupe
| | - Antoine Talarmin
- Transmission, Reservoir and Diversity of Pathogens Unit, Pasteur Institute of Guadeloupe, Pointe-à-Pitre, France
| | - Benoit Tressieres
- INSERM Center for Clinical Investigation 1424, Pointe-à-Pitre/Les Abymes, France
| | - Marc Valette
- Intensive Care Department, University Hospital Center of Guadeloupe, Pointe-à-Pitre/Les Abymes, France
| | - Sylvain Brisse
- Institut Pasteur, University Paris Cité, Biodiversity and Epidemiology of Bacterial Pathogens, Paris, France
| | - Sébastien Breurec
- Transmission, Reservoir and Diversity of Pathogens Unit, Pasteur Institute of Guadeloupe, Pointe-à-Pitre, France
- Laboratory of Clinical Microbiology, University Hospital Center of Guadeloupe, Pointe-à-Pitre/Les Abymes, France
- Faculty of Medecine Hyacinthe Bastaraud, University of the Antilles, Pointe-à-Pitre, France
- INSERM Center for Clinical Investigation 1424, Pointe-à-Pitre/Les Abymes, France
| |
Collapse
|
8
|
Pot M, Reynaud Y, Couvin D, Dereeper A, Ferdinand S, Bastian S, Foucan T, Pommier JD, Valette M, Talarmin A, Guyomard-Rabenirina S, Breurec S. Emergence of a Novel Lineage and Wide Spread of a blaCTX-M-15/IncHI2/ST1 Plasmid among Nosocomial Enterobacter in Guadeloupe. Antibiotics (Basel) 2022; 11:1443. [PMID: 36290101 PMCID: PMC9598596 DOI: 10.3390/antibiotics11101443] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 10/10/2022] [Accepted: 10/17/2022] [Indexed: 04/04/2024] Open
Abstract
Between April 2018 and August 2019, a total of 135 strains of Enterobacter cloacae complex (ECC) were randomly collected at the University Hospital Center of Guadeloupe to investigate the structure and diversity of the local bacterial population. These nosocomial isolates were initially identified genetically by the hsp60 typing method, which revealed the clinical relevance of E. xiangfangensis (n = 69). Overall, 57/94 of the third cephalosporin-resistant strains were characterized as extended-spectrum-β-lactamase (ESBL) producers, and their whole-genome was sequenced using Illumina technology to determine the clonal relatedness and diffusion of resistance genes. We found limited genetic diversity among sequence types (STs). ST114 (n = 13), ST1503 (n = 9), ST53 (n = 5) and ST113 (n = 4), which belong to three different Enterobacter species, were the most prevalent among the 57 ESBL producers. The blaCTXM-15 gene was the most prevalent ESBL determinant (56/57) and was in most cases associated with IncHI2/ST1 plasmid replicon carriage (36/57). To fully characterize this predominant blaCTXM-15/IncHI2/ST1 plasmid, four isolates from different lineages were also sequenced using Oxford Nanopore sequencing technology to generate long-reads. Hybrid sequence analyses confirmed the circulation of a well-conserved plasmid among ECC members. In addition, the novel ST1503 and its associated species (ECC taxon 4) were analyzed, in view of its high prevalence in nosocomial infections. These genetic observations confirmed the overall incidence of nosocomial ESBL Enterobacteriaceae infections acquired in this hospital during the study period, which was clearly higher in Guadeloupe (1.59/1000 hospitalization days) than in mainland France (0.52/1,000 hospitalization days). This project revealed issues and future challenges for the management and surveillance of nosocomial and multidrug-resistant Enterobacter in the Caribbean.
Collapse
Affiliation(s)
- Matthieu Pot
- Transmission, Reservoir and Diversity of Pathogens Unit, Pasteur Institute of Guadeloupe, 97139 Les Abymes, France
| | - Yann Reynaud
- Transmission, Reservoir and Diversity of Pathogens Unit, Pasteur Institute of Guadeloupe, 97139 Les Abymes, France
| | - David Couvin
- Transmission, Reservoir and Diversity of Pathogens Unit, Pasteur Institute of Guadeloupe, 97139 Les Abymes, France
| | - Alexis Dereeper
- Transmission, Reservoir and Diversity of Pathogens Unit, Pasteur Institute of Guadeloupe, 97139 Les Abymes, France
| | - Séverine Ferdinand
- Transmission, Reservoir and Diversity of Pathogens Unit, Pasteur Institute of Guadeloupe, 97139 Les Abymes, France
| | - Sylvaine Bastian
- Laboratory of Clinical Microbiology, University Hospital Center of Guadeloupe, 97159 Pointe-à-Pitre, France
| | - Tania Foucan
- Operational Hygiene Team, University Hospital Center of Guadeloupe, 97159 Pointe-à-Pitre, France
| | - Jean-David Pommier
- Division of Intensive Care, University Hospital Center of Guadeloupe, 97159 Pointe-à-Pitre, France
| | - Marc Valette
- Division of Intensive Care, University Hospital Center of Guadeloupe, 97159 Pointe-à-Pitre, France
| | - Antoine Talarmin
- Transmission, Reservoir and Diversity of Pathogens Unit, Pasteur Institute of Guadeloupe, 97139 Les Abymes, France
| | | | - Sébastien Breurec
- Transmission, Reservoir and Diversity of Pathogens Unit, Pasteur Institute of Guadeloupe, 97139 Les Abymes, France
- Faculty of Medicine Hyacinthe Bastaraud, University of the Antilles, 97157 Pointe-à-Pitre, France
- INSERM, Center for Clinical Investigation 1424, 97139 Les Abymes, France
| |
Collapse
|
9
|
Moco V, Cazenave D, Garnier M, Pot M, Marcelino I, Talarmin A, Guyomard-Rabenirina S, Breurec S, Ferdinand S, Dereeper A, Reynaud Y, Couvin D. getSequenceInfo: a suite of tools allowing to get genome sequence information from public repositories. BMC Bioinformatics 2022; 23:268. [PMID: 35804320 PMCID: PMC9264741 DOI: 10.1186/s12859-022-04809-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 06/23/2022] [Indexed: 12/02/2022] Open
Abstract
Background Biological sequences are increasing rapidly and exponentially worldwide. Nucleotide sequence databases play an important role in providing meaningful genomic information on a variety of biological organisms. Results The getSequenceInfo software tool allows to access sequence information from various public repositories (GenBank, RefSeq, and the European Nucleotide Archive), and is compatible with different operating systems (Linux, MacOS, and Microsoft Windows) in a programmatic way (command line) or as a graphical user interface. getSequenceInfo or gSeqI v1.0 should help users to get some information on queried sequences that could be useful for specific studies (e.g. the country of origin/isolation or the release date of queried sequences). Queries can be made to retrieve sequence data based on a given kingdom and species, or from a given date. This program allows the separation between chromosomes and plasmids (or other genetic elements/components) by arranging each component in a given folder. Some basic statistics are also performed by the program (such as the calculation of GC content for queried assemblies). An empirically designed nucleotide ratio is calculated using nucleotide information in order to tentatively provide a “NucleScore” for studied genome assemblies. Besides the main gSeqI tool, other additional tools have been developed to perform various tasks related to sequence analysis. Conclusion The aim of this study is to democratize the use of public repositories in programmatic ways, and to facilitate sequence data analysis in a pedagogical perspective. Output results are available in FASTA, FASTQ, Excel/TSV or HTML formats. The program is freely available at: https://github.com/karubiotools/getSequenceInfo. getSequenceInfo and supplementary tools are partly available through the recently released Galaxy KaruBioNet platform (http://calamar.univ-ag.fr/c3i/galaxy_karubionet.html). Supplementary Information The online version contains supplementary material available at 10.1186/s12859-022-04809-5.
Collapse
Affiliation(s)
- Vincent Moco
- Unité Transmission, Réservoir et Diversité des Pathogènes, Institut Pasteur de Guadeloupe, Les Abymes, Guadeloupe, France
| | - Damien Cazenave
- Unité Transmission, Réservoir et Diversité des Pathogènes, Institut Pasteur de Guadeloupe, Les Abymes, Guadeloupe, France
| | - Maëlle Garnier
- Unité Transmission, Réservoir et Diversité des Pathogènes, Institut Pasteur de Guadeloupe, Les Abymes, Guadeloupe, France
| | - Matthieu Pot
- Unité Transmission, Réservoir et Diversité des Pathogènes, Institut Pasteur de Guadeloupe, Les Abymes, Guadeloupe, France
| | - Isabel Marcelino
- Unité Transmission, Réservoir et Diversité des Pathogènes, Institut Pasteur de Guadeloupe, Les Abymes, Guadeloupe, France
| | - Antoine Talarmin
- Unité Transmission, Réservoir et Diversité des Pathogènes, Institut Pasteur de Guadeloupe, Les Abymes, Guadeloupe, France
| | - Stéphanie Guyomard-Rabenirina
- Unité Transmission, Réservoir et Diversité des Pathogènes, Institut Pasteur de Guadeloupe, Les Abymes, Guadeloupe, France
| | - Sébastien Breurec
- Unité Transmission, Réservoir et Diversité des Pathogènes, Institut Pasteur de Guadeloupe, Les Abymes, Guadeloupe, France.,Faculté de Médecine Hyacinthe Bastaraud, Université des Antilles, Pointe-à-Pitre, France.,Centre d'Investigation Clinique Antilles Guyane, Inserm CIC 1424, Pointe-à-Pitre, France
| | - Séverine Ferdinand
- Unité Transmission, Réservoir et Diversité des Pathogènes, Institut Pasteur de Guadeloupe, Les Abymes, Guadeloupe, France
| | - Alexis Dereeper
- Unité Transmission, Réservoir et Diversité des Pathogènes, Institut Pasteur de Guadeloupe, Les Abymes, Guadeloupe, France
| | - Yann Reynaud
- Unité Transmission, Réservoir et Diversité des Pathogènes, Institut Pasteur de Guadeloupe, Les Abymes, Guadeloupe, France
| | - David Couvin
- Unité Transmission, Réservoir et Diversité des Pathogènes, Institut Pasteur de Guadeloupe, Les Abymes, Guadeloupe, France.
| |
Collapse
|
10
|
Gruel G, Couvin D, Guyomard-Rabenirina S, Arlet G, Bambou JC, Pot M, Roy X, Talarmin A, Tressieres B, Ferdinand S, Breurec S. High Prevalence of bla CTXM-1/IncI1-Iγ/ST3 Plasmids in Extended-Spectrum β-Lactamase-Producing Escherichia coli Isolates Collected From Domestic Animals in Guadeloupe (French West Indies). Front Microbiol 2022; 13:882422. [PMID: 35651489 PMCID: PMC9149308 DOI: 10.3389/fmicb.2022.882422] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 04/07/2022] [Indexed: 11/13/2022] Open
Abstract
Extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-E) have been classified in the group of resistant bacteria of highest priority. We determined the prevalence of ESBL-E collected in feces from household and shelter pets in Guadeloupe (French West Indies). A single rectal swab was taken from 125 dogs and 60 cats between June and September 2019. The prevalence of fecal carriage of ESBL-E was 7.6% (14/185, 95% CI: 4.2-12.4), within the range observed worldwide. The only risk factor associated with a higher prevalence of ESBL-E rectal carriage was a stay in a shelter, suggesting that refuges could be hotspots for their acquisition. All but one (Klebsiella pneumoniae from a cat) were Escherichia coli. We noted the presence of a bla CTX-M-1/IncI1-Iγ/sequence type (ST3) plasmid in 11 ESBL-producing E. coli isolates belonging to ST328 (n = 6), ST155 (n = 4) and ST953 (n = 1). A bla CTX-M-15 gene was identified in the three remaining ESBL-E isolates. The bla CTX-M-1 and most of the antimicrobial resistance genes were present in a well-conserved large conjugative IncI1-Iγ/ST3 plasmid characterized by two accessory regions containing antibiotic resistance genes. The plasmid has been detected worldwide in E. coli isolates from humans and several animal species, such as food-producing animals, wild birds and pets, and from the environment. This study shows the potential role of pets as a reservoir of antimicrobial-resistant bacteria or genes for humans and underlines the importance of basic hygiene measures by owners of companion animals.
Collapse
Affiliation(s)
- Gaëlle Gruel
- Transmission, Reservoir and Diversity of Pathogens Unit, Pasteur Institute of Guadeloupe, Pointe-à-Pitre, France
| | - David Couvin
- Transmission, Reservoir and Diversity of Pathogens Unit, Pasteur Institute of Guadeloupe, Pointe-à-Pitre, France
| | | | | | | | - Matthieu Pot
- Transmission, Reservoir and Diversity of Pathogens Unit, Pasteur Institute of Guadeloupe, Pointe-à-Pitre, France
| | | | - Antoine Talarmin
- Transmission, Reservoir and Diversity of Pathogens Unit, Pasteur Institute of Guadeloupe, Pointe-à-Pitre, France
| | - Benoit Tressieres
- INSERM 1424, Center for Clinical Investigation, University Hospital Center of Guadeloupe, Pointe-à-Pitre, France
| | - Séverine Ferdinand
- Transmission, Reservoir and Diversity of Pathogens Unit, Pasteur Institute of Guadeloupe, Pointe-à-Pitre, France
| | - Sébastien Breurec
- Transmission, Reservoir and Diversity of Pathogens Unit, Pasteur Institute of Guadeloupe, Pointe-à-Pitre, France.,INSERM 1424, Center for Clinical Investigation, University Hospital Center of Guadeloupe, Pointe-à-Pitre, France.,Faculty of Medicine Hyacinthe Bastaraud, University of the Antilles, Pointe-à-Pitre, France
| |
Collapse
|
11
|
Pot M, Reynaud Y, Couvin D, Ducat C, Ferdinand S, Gravey F, Gruel G, Guérin F, Malpote E, Breurec S, Talarmin A, Guyomard-Rabenirina S. Wide Distribution and Specific Resistance Pattern to Third-Generation Cephalosporins of Enterobacter cloacae Complex Members in Humans and in the Environment in Guadeloupe (French West Indies). Front Microbiol 2021; 12:628058. [PMID: 34248862 PMCID: PMC8268024 DOI: 10.3389/fmicb.2021.628058] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 05/31/2021] [Indexed: 11/25/2022] Open
Abstract
Species belonging to Enterobacter cloacae complex have been isolated in numerous environments and samples of various origins. They are also involved in opportunistic infections in plants, animals, and humans. Previous prospection in Guadeloupe (French West Indies) indicated a high frequency of E. cloacae complex strains resistant to third-generation cephalosporins (3GCs) in a local lizard population (Anolis marmoratus), but knowledge of the distribution and resistance of these strains in humans and the environment is limited. The aim of this study was to compare the distribution and antibiotic susceptibility pattern of E. cloacae complex members from different sources in a “one health” approach and to find possible explanations for the high level of resistance in non-human samples. E. cloacae complex strains were collected between January 2017 and the end of 2018 from anoles, farm animals, local fresh produce, water, and clinical human samples. Isolates were characterized by the heat-shock protein 60 gene-fragment typing method, and whole-genome sequencing was conducted on the most frequent clusters (i.e., C-VI and C-VIII). The prevalence of resistance to 3GCs was relatively high (56/346, 16.2%) in non-human samples. The associated resistance mechanism was related to an AmpC overproduction; however, in human samples, most of the resistant strains (40/62) produced an extended-spectrum beta-lactamase. No relation was found between resistance in isolates from wild anoles (35/168) and human activities. Specific core-genome phylogenetic analysis highlighted an important diversity in this bacterial population and no wide circulation among the different compartments. In our setting, the mutations responsible for resistance to 3GCs, especially in ampD, were diverse and not compartment specific. In conclusion, high levels of resistance in non-human E. cloacae complex isolates are probably due to environmental factors that favor the selection of these resistant strains, and this will be explored further.
Collapse
Affiliation(s)
- Matthieu Pot
- Transmission, Reservoir and Diversity of Pathogens Unit, Pasteur Institute of Guadeloupe, Les Abymes, France
| | - Yann Reynaud
- Transmission, Reservoir and Diversity of Pathogens Unit, Pasteur Institute of Guadeloupe, Les Abymes, France
| | - David Couvin
- Transmission, Reservoir and Diversity of Pathogens Unit, Pasteur Institute of Guadeloupe, Les Abymes, France
| | - Célia Ducat
- Transmission, Reservoir and Diversity of Pathogens Unit, Pasteur Institute of Guadeloupe, Les Abymes, France
| | - Séverine Ferdinand
- Transmission, Reservoir and Diversity of Pathogens Unit, Pasteur Institute of Guadeloupe, Les Abymes, France
| | - François Gravey
- GRAM 2.0, Normandie University, UNICAEN, UNIROUEN, Caen, France
| | - Gaëlle Gruel
- Transmission, Reservoir and Diversity of Pathogens Unit, Pasteur Institute of Guadeloupe, Les Abymes, France
| | - François Guérin
- GRAM 2.0, Normandie University, UNICAEN, UNIROUEN, Caen, France.,Department of Clinical Microbiology, Caen University Hospital, Caen, France
| | - Edith Malpote
- Laboratory of Clinical Microbiology, University Hospital of Guadeloupe, Pointe-à-Pitre/Les Abymes, France
| | - Sébastien Breurec
- Transmission, Reservoir and Diversity of Pathogens Unit, Pasteur Institute of Guadeloupe, Les Abymes, France.,Faculty of Medicine Hyacinthe Bastaraud, University of the Antilles, Pointe-à-Pitre, France.,Centre for Clinical Investigation 1424, INSERM, Pointe-à-Pitre/Les Abymes, France
| | - Antoine Talarmin
- Transmission, Reservoir and Diversity of Pathogens Unit, Pasteur Institute of Guadeloupe, Les Abymes, France
| | | |
Collapse
|
12
|
Gruel G, Sellin A, Riveiro H, Pot M, Breurec S, Guyomard-Rabenirina S, Talarmin A, Ferdinand S. Antimicrobial use and resistance in Escherichia coli from healthy food-producing animals in Guadeloupe. BMC Vet Res 2021; 17:116. [PMID: 33685450 PMCID: PMC7938459 DOI: 10.1186/s12917-021-02810-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 02/19/2021] [Indexed: 12/11/2022] Open
Abstract
Background Selection pressure exerted by use of antibiotics in both human and veterinary medicine is responsible for increasing antimicrobial resistance (AMR). The objectives of this study were to better understand antimicrobial use in pigs, beef cattle, and poultry on farms on Guadeloupe, French West Indies, and to acquire data on AMR in Escherichia coli in these food-producing animals. A cross-sectional survey was conducted at 45 farms on Guadeloupe, and practical use of antimicrobials was documented in declarative interviews between March and July 2018. A total of 216 fecal samples were collected between January 2018 and May 2019, comprising 124 from pigs, 75 from beef cattle, and 17 from poultry litter. E. coli isolates were obtained for further testing by isolation and identification from field samples. Antimicrobial susceptibility testing and screening for blaCTX-M, blaTEM, tetA, and tetB resistance genes by polymerase chain reaction on extracted genomic DNA were performed. Results The study showed rational use of antimicrobials, consisting of occasional use for curative treatment by veterinary prescription. Tetracycline was the most commonly used antimicrobial, but its use was not correlated to E. coli resistance. Extended-spectrum β-lactamase (ESBL) E. coli isolates were detected in 7.3% of pigs, 14.7% of beef cattle, and 35.3% of poultry. blaCTX-M-1 was the predominant gene found in ESBL-E. coli isolates (68.8%), followed by blaCTX-M-15 (31.3%). Conclusion Despite rational use of antimicrobials, the rate of ESBL-E. coli in food-producing animals in Guadeloupe, although moderate, is a concern. Further studies are in progress to better define the genetic background of the ESBL-E. coli isolates. Graphical abstract ![]()
Collapse
Affiliation(s)
- Gaëlle Gruel
- Laboratory of Microbial Ecosystems Interactions, Transmission Reservoir and Pathogens Diversity Unit, Institut Pasteur of Guadeloupe, Morne Joliviere - B.P. 484, 97183, Les Abymes Cedex, Guadeloupe, France
| | - Arantxa Sellin
- Laboratory of Microbial Ecosystems Interactions, Transmission Reservoir and Pathogens Diversity Unit, Institut Pasteur of Guadeloupe, Morne Joliviere - B.P. 484, 97183, Les Abymes Cedex, Guadeloupe, France
| | - Hélène Riveiro
- Laboratory of Microbial Ecosystems Interactions, Transmission Reservoir and Pathogens Diversity Unit, Institut Pasteur of Guadeloupe, Morne Joliviere - B.P. 484, 97183, Les Abymes Cedex, Guadeloupe, France
| | - Matthieu Pot
- Laboratory of Microbial Ecosystems Interactions, Transmission Reservoir and Pathogens Diversity Unit, Institut Pasteur of Guadeloupe, Morne Joliviere - B.P. 484, 97183, Les Abymes Cedex, Guadeloupe, France
| | - Sébastien Breurec
- Laboratory of Microbial Ecosystems Interactions, Transmission Reservoir and Pathogens Diversity Unit, Institut Pasteur of Guadeloupe, Morne Joliviere - B.P. 484, 97183, Les Abymes Cedex, Guadeloupe, France.,Faculté de Médecine Hyacinthe Bastaraud, Université des Antilles, Pointe-à-Pitre, Guadeloupe, France.,Centre d'Investigation Clinique, INSERM CIC 1424, Pointe-à-Pitre, Guadeloupe, France
| | - Stéphanie Guyomard-Rabenirina
- Laboratory of Microbial Ecosystems Interactions, Transmission Reservoir and Pathogens Diversity Unit, Institut Pasteur of Guadeloupe, Morne Joliviere - B.P. 484, 97183, Les Abymes Cedex, Guadeloupe, France
| | - Antoine Talarmin
- Laboratory of Microbial Ecosystems Interactions, Transmission Reservoir and Pathogens Diversity Unit, Institut Pasteur of Guadeloupe, Morne Joliviere - B.P. 484, 97183, Les Abymes Cedex, Guadeloupe, France
| | - Séverine Ferdinand
- Laboratory of Microbial Ecosystems Interactions, Transmission Reservoir and Pathogens Diversity Unit, Institut Pasteur of Guadeloupe, Morne Joliviere - B.P. 484, 97183, Les Abymes Cedex, Guadeloupe, France.
| |
Collapse
|
13
|
Guyomard-Rabenirina S, Reynaud Y, Pot M, Albina E, Couvin D, Ducat C, Gruel G, Ferdinand S, Legreneur P, Le Hello S, Malpote E, Sadikalay S, Talarmin A, Breurec S. Antimicrobial Resistance in Wildlife in Guadeloupe (French West Indies): Distribution of a Single bla CTX-M-1/IncI1/ST3 Plasmid Among Humans and Wild Animals. Front Microbiol 2020; 11:1524. [PMID: 32754130 PMCID: PMC7366356 DOI: 10.3389/fmicb.2020.01524] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Accepted: 06/12/2020] [Indexed: 01/14/2023] Open
Abstract
Limited data are available on the contribution of wildlife to the spread of antibacterial resistance. We determined the prevalence of resistance to antibiotics in Escherichia coli isolates collected from wild animals in 2013 and 2014 and the genetic basis for resistance to third-generation cephalosporin in Guadeloupe. We recovered 52 antibiotic-resistant (AR) E. coli strains from 48 of the 884 (5.4%) wild animals tested (46 iguanas, 181 birds, 289 anoles, and 368 rodents at 163 sampling sites). Rodents had higher rates of carriage (n = 38, 10.3%) than reptiles and birds (2.4% and 1.1%, respectively, p < 0.001). A significant association (p < 0.001) was found between the degree of anthropization and the frequency of AR E. coli carriage for all species. The carriage rate of ciprofloxacin- and cefotaxime-resistant isolates was 0.7% (6/884) and 1.5% (13/884), respectively. Most (65.4%) AR E. coli were multi-drug resistant, and the prevalence of extended-spectrum beta-lactamase (ESBL)-producing E. coli was low (n = 7, 0.8%) in all species. Eight ESBL-producing E. coli were recovered, two genetically unrelated isolates being found in one bird. These isolates and 20 human invasive ESBL E. coli isolates collected in Guadeloupe during the same period were investigated by whole genome sequencing. blaCTX–M–1 was the only ESBL gene shared by three animal classes (humans, n = 2; birds, n = 2; rodents, n = 2). The blaCTX–M–1 gene and most of the antimicrobial resistance genes were present in a large conjugative IncI1 plasmid that was highly similar (>99% nucleotide identity) to ESBL-carrying plasmids found in several countries in Europe and in Australia. Although the prevalence of ESBL-producing E. coli isolates was very low in wild animals, it is of concern that the well-conserved IncI1 plasmid-carrying blaCTX–M–1 is widespread and occurs in various E. coli strains from animals and humans.
Collapse
Affiliation(s)
| | - Yann Reynaud
- Transmission, Reservoir and Diversity of Pathogens Unit, Institut Pasteur de la Guadeloupe, Pointe-a-Pitre, France
| | - Matthieu Pot
- Transmission, Reservoir and Diversity of Pathogens Unit, Institut Pasteur de la Guadeloupe, Pointe-a-Pitre, France
| | - Emmanuel Albina
- UMR ASTRE, CIRAD, Montpellier, France.,UMR ASTRE, F-34398, INRA, CIRAD, Université de Montpellier, Montpellier, France
| | - David Couvin
- Transmission, Reservoir and Diversity of Pathogens Unit, Institut Pasteur de la Guadeloupe, Pointe-a-Pitre, France
| | - Celia Ducat
- Transmission, Reservoir and Diversity of Pathogens Unit, Institut Pasteur de la Guadeloupe, Pointe-a-Pitre, France
| | - Gaëlle Gruel
- Transmission, Reservoir and Diversity of Pathogens Unit, Institut Pasteur de la Guadeloupe, Pointe-a-Pitre, France
| | - Severine Ferdinand
- Transmission, Reservoir and Diversity of Pathogens Unit, Institut Pasteur de la Guadeloupe, Pointe-a-Pitre, France
| | - Pierre Legreneur
- Inter-University Laboratory of Human Movement Biology-EA 7424, University of Lyon, University Claude Bernard Lyon 1, Villeurbanne, France
| | - Simon Le Hello
- Enteric Bacterial Pathogens Unit, Institut Pasteur, Paris, France.,UNICAEN, Groupe de Recherche sur l'Adaptation Microbienne, GRAM 2.0, EA2656, University of Caen Normandy, Caen, France
| | - Edith Malpote
- Laboratory of Clinical Microbiology, University Hospital of Guadeloupe, Pointe-a-Pitre/Les Abymes, France
| | - Syndia Sadikalay
- Transmission, Reservoir and Diversity of Pathogens Unit, Institut Pasteur de la Guadeloupe, Pointe-a-Pitre, France
| | - Antoine Talarmin
- Transmission, Reservoir and Diversity of Pathogens Unit, Institut Pasteur de la Guadeloupe, Pointe-a-Pitre, France
| | - Sebastien Breurec
- Transmission, Reservoir and Diversity of Pathogens Unit, Institut Pasteur de la Guadeloupe, Pointe-a-Pitre, France.,Faculty of Medicine Hyacinthe Bastaraud, University of the Antilles, Pointe-a-Pitre, France.,INSERM, Center for Clinical Investigation 1424, Pointe-a-Pitre/Les Abymes, France
| |
Collapse
|
14
|
Moussa M, Marcelino I, Richard V, Guerlotté J, Talarmin A. An Optimized Most Probable Number (MPN) Method to Assess the Number of Thermophilic Free-Living Amoebae (FLA) in Water Samples. Pathogens 2020; 9:pathogens9050409. [PMID: 32456327 PMCID: PMC7281388 DOI: 10.3390/pathogens9050409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 05/01/2020] [Accepted: 05/01/2020] [Indexed: 12/05/2022] Open
Abstract
Detection and quantification of pathogenic free-living amoebae (FLA) in water samples is critical for assessing water quality and for disease management issues. The most probable number (MPN) is commonly used to account for FLA in water. Nevertheless, this requires a high number of water replicates and working volumes, and a consequent number of non-nutrient agar (NNA)-plates seeded with Escherichia coli. Herein, we aimed at optimizing this difficult method, taking also into account key factors such as (i) the counting method, (ii) the delay between sample collection and sample processing, and (iii) the temperature during water sample transportation. To simplify the MPN method, we filtrated 1 × 1000 and 1 × 100 mL water samples, and cellulose acetate filters were cut in 10 parts and inverted on NNA-plates overlaid with E. coli. The comparison between the classical and our optimized MPN method showed that the final counts were similar, therefore validating the use of the optimized method. Our results also showed that for thermophilic FLA (such as Naegleria fowleri), water samples can be kept at around +30°C and processed within 24 h. This improved MPN method is now routinely used in our laboratory to control Naegleria sp. in the water samples in Guadeloupe.
Collapse
Affiliation(s)
- Mirna Moussa
- Unité TReD-Path (Transmission Réservoir & Diversité des Pathogènes), Institut Pasteur de la Guadeloupe, Les Abymes, 97183 Guadeloupe, France; (M.M.); (A.T.)
| | - Isabel Marcelino
- Unité TReD-Path (Transmission Réservoir & Diversité des Pathogènes), Institut Pasteur de la Guadeloupe, Les Abymes, 97183 Guadeloupe, France; (M.M.); (A.T.)
- Correspondence: ; Tel.: +590-590-897-664
| | | | - Jérôme Guerlotté
- Institut de Systématique, Evolution, Biodiversité (ISYEB) MNHN, CNRS, Sorbonne Université, EPHE Université des Antilles, Pointe-à-Pitre, 97110 Guadeloupe, France;
| | - Antoine Talarmin
- Unité TReD-Path (Transmission Réservoir & Diversité des Pathogènes), Institut Pasteur de la Guadeloupe, Les Abymes, 97183 Guadeloupe, France; (M.M.); (A.T.)
| |
Collapse
|
15
|
Habouria H, Pokharel P, Maris S, Garénaux A, Bessaiah H, Houle S, Veyrier FJ, Guyomard-Rabenirina S, Talarmin A, Dozois CM. Three new serine-protease autotransporters of Enterobacteriaceae (SPATEs) from extra-intestinal pathogenic Escherichia coli and combined role of SPATEs for cytotoxicity and colonization of the mouse kidney. Virulence 2020; 10:568-587. [PMID: 31198092 PMCID: PMC6592367 DOI: 10.1080/21505594.2019.1624102] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Serine protease autotransporters of Enterobacteriaceae (SPATEs) are secreted proteins that contribute to virulence and function as proteases, toxins, adhesins, and/or immunomodulators. An extra-intestinal pathogenic E. coli (ExPEC) O1:K1 strain, QT598, isolated from a turkey, was shown to contain vat, tsh, and three uncharacterized SPATE-encoding genes. Uncharacterized SPATEs: Sha (Serine-protease hemagglutinin autotransporter), TagB and TagC (tandem autotransporter genes B and C) were tested for activities including hemagglutination, autoaggregation, and cytotoxicity when expressed in E. coli K-12. Sha and TagB conferred autoaggregation and hemagglutination activities. TagB, TagC, and Sha all exhibited cytopathic effects on a bladder epithelial cell line. In QT598, tagB and tagC are tandemly encoded on a genomic island, and were present in 10% of UTI isolates and 4.7% of avian E. coli. Sha is encoded on a virulence plasmid and was present in 1% of UTI isolates and 20% of avian E. coli. To specifically examine the role of SPATEs for infection, the 5 SPATE genes were deleted from strain QT598 and tested for cytotoxicity. Loss of all five SPATEs abrogated the cytopathic effect on bladder epithelial cells, although derivatives producing any of the 5 SPATEs retained cytopathic activity. In mouse infections, sha gene-expression was up-regulated a mean of sixfold in the bladder compared to growth in vitro. Loss of either tagBC or sha did not reduce urinary tract colonization. Deletion of all 5 SPATEs, however, significantly reduced competitive colonization of the kidney supporting a cumulative role of SPATEs for QT598 in the mouse UTI model.
Collapse
Affiliation(s)
- Hajer Habouria
- a Institut national de recherche scientifique (INRS)-Institut Armand Frappier , Laval , Quebec , Canada.,b Centre de recherche en infectiologie porcine et avicole (CRIPA)
| | - Pravil Pokharel
- a Institut national de recherche scientifique (INRS)-Institut Armand Frappier , Laval , Quebec , Canada.,b Centre de recherche en infectiologie porcine et avicole (CRIPA)
| | - Segolène Maris
- a Institut national de recherche scientifique (INRS)-Institut Armand Frappier , Laval , Quebec , Canada.,b Centre de recherche en infectiologie porcine et avicole (CRIPA)
| | - Amélie Garénaux
- a Institut national de recherche scientifique (INRS)-Institut Armand Frappier , Laval , Quebec , Canada.,b Centre de recherche en infectiologie porcine et avicole (CRIPA)
| | - Hicham Bessaiah
- a Institut national de recherche scientifique (INRS)-Institut Armand Frappier , Laval , Quebec , Canada.,b Centre de recherche en infectiologie porcine et avicole (CRIPA)
| | - Sébastien Houle
- a Institut national de recherche scientifique (INRS)-Institut Armand Frappier , Laval , Quebec , Canada.,b Centre de recherche en infectiologie porcine et avicole (CRIPA)
| | - Frédéric J Veyrier
- a Institut national de recherche scientifique (INRS)-Institut Armand Frappier , Laval , Quebec , Canada.,c Institut Pasteur International Network
| | - Stéphanie Guyomard-Rabenirina
- c Institut Pasteur International Network.,d Unité Environnement Santé , Institut Pasteur de Guadeloupe , Les Abymes , Guadeloupe , France
| | - Antoine Talarmin
- c Institut Pasteur International Network.,d Unité Environnement Santé , Institut Pasteur de Guadeloupe , Les Abymes , Guadeloupe , France
| | - Charles M Dozois
- a Institut national de recherche scientifique (INRS)-Institut Armand Frappier , Laval , Quebec , Canada.,b Centre de recherche en infectiologie porcine et avicole (CRIPA).,c Institut Pasteur International Network
| |
Collapse
|
16
|
Guyomard-Rabenirina S, Weill FX, Le Hello S, Bastian S, Berger F, Ferdinand S, Legreneur P, Loraux C, Malpote E, Muanza B, Richard V, Talarmin A, Breurec S. Reptiles in Guadeloupe (French West Indies) are a reservoir of major human Salmonella enterica serovars. PLoS One 2019; 14:e0220145. [PMID: 31323053 PMCID: PMC6641201 DOI: 10.1371/journal.pone.0220145] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Accepted: 07/09/2019] [Indexed: 12/18/2022] Open
Abstract
The epidemiology of human Salmonella enterica infections in Guadeloupe (French West Indies) appears to be specific, with a higher prevalence of the subspecies enterica serovars Panama and Arechavaleta (Panama and Arechavaleta) than in other regions. A study was performed in Guadeloupe to identify the reservoir of Salmonella serovars by comparing their distribution in warm- and cold-blooded animals and in humans living in Guadeloupe and mainland France. Furthermore, a case–control study was conducted in 2012–2013 to identify the main epidemiologic risk factors for S. enterica infection among children under 15 years of age. Between June 2011 and December 2014, feces from 426 reptiles (322 anoles, 69 iguanas and 35 geckos) and 50 frogs distributed throughout Guadeloupe and nearby islands were investigated. The frequency of S. enterica carriage was 15.0% (n = 64) in reptiles but varied by species. The only significant risk factor for S. enterica infection was a more frequent presence of frogs in the houses of cases than in those of controls (P = 0.042); however, isolates were not collected. Panama and Arechavaleta were the two serovars most often recovered between 2005 and 2014 from humans living in Guadeloupe (24.5% (n = 174) and 11.5% (n = 82), respectively), which is in contrast to the low prevalence in mainland France (0.4%). Their presence at low frequencies in wild reptiles (4.6% (n = 3) and 3.1% (n = 2), respectively) and pigs (7.5% (n = 5) and 1.5% (n = 1), respectively) suggests a broad host range, and humans may be infected by indirect or direct contact with animals. These serovars are probably poorly adapted to humans and therefore cause more severe infections. The unusual subspecies houtenae serovar 43:z4,z32:- was a major subspecies in wild reptiles (24.6%, n = 16) and humans (9.4%, n = 67) but was not recovered from warm-blooded animals, suggesting that reptiles plays a key role in human infection.
Collapse
Affiliation(s)
| | - François-Xavier Weill
- Unité des Bactéries pathogènes entériques, Centre National de Référence des Escherichia coli, Shigella et Salmonella, Institut Pasteur, Paris, France
| | - Simon Le Hello
- Unité des Bactéries pathogènes entériques, Centre National de Référence des Escherichia coli, Shigella et Salmonella, Institut Pasteur, Paris, France
| | - Sylvaine Bastian
- Laboratoire de Microbiologie clinique et environnementale, Centre Hospitalier Universitaire de Pointe-à-Pitre/les Abymes, Pointe-à-Pitre, France
| | - Franck Berger
- Service de Santé des Armées, Centre d'épidémiologie et de santé publique des armées, Marseille, France.,INSERM, IRD, Sciences Economiques et Sociales de la Santé et Traitement de l'Information Médicale, Université d'Aix Marseille, Marseille, France
| | - Séverine Ferdinand
- Unité Transmission, Réservoir et Diversité des Pathogènes, Institut Pasteur de Guadeloupe, Les Abymes, France
| | | | - Cécile Loraux
- Laboratoire de Microbiologie clinique et environnementale, Centre Hospitalier Universitaire de Pointe-à-Pitre/les Abymes, Pointe-à-Pitre, France
| | - Edith Malpote
- Laboratoire de Microbiologie clinique et environnementale, Centre Hospitalier Universitaire de Pointe-à-Pitre/les Abymes, Pointe-à-Pitre, France
| | - Blandine Muanza
- Service de Pédiatrie, Centre Hospitalier Universitaire de Pointe-à-Pitre/les Abymes, Pointe-à-Pitre, France
| | - Vincent Richard
- Institut Pasteur de Nouvelle-Calédonie, Nouméa, Nouvelle-Calédonie
| | - Antoine Talarmin
- Unité Transmission, Réservoir et Diversité des Pathogènes, Institut Pasteur de Guadeloupe, Les Abymes, France
| | - Sébastien Breurec
- Unité Transmission, Réservoir et Diversité des Pathogènes, Institut Pasteur de Guadeloupe, Les Abymes, France.,Laboratoire de Microbiologie clinique et environnementale, Centre Hospitalier Universitaire de Pointe-à-Pitre/les Abymes, Pointe-à-Pitre, France.,Faculté de Médecine Hyacinthe Bastaraud, Université des Antilles, Pointe-à-Pitre, France
| |
Collapse
|
17
|
Guyomard-Rabenirina S, Muanza B, Bastian S, Malpote E, Jestin P, Guerin M, Talarmin A, Weill FX, Legrand A, Breurec S. Salmonella enterica serovars Panama and Arechavaleta: Risk Factors for Invasive Non-Typhoidal Salmonella Disease in Guadeloupe, French West Indies. Am J Trop Med Hyg 2018; 99:584-589. [PMID: 30014811 DOI: 10.4269/ajtmh.18-0192] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
A retrospective study was conducted to identify the risk factors associated with Salmonella enterica bacteremia in infants and children in Guadeloupe, French West Indies. The 171 patients with S. enterica infection seen between 2010 and 2014 included 155 (90.6%) with acute gastroenteritis, of whom 42 (27.1%) had concomitant bacteremia, and 16 (9.4%) with primary bacteremia. Most cases (97.7%) were in infants and children with no underlying health condition. Two subspecies were recovered: enterica (N = 161, 94.2%) and houtenae (N = 10, 5.8%). All but one (serovar Typhi) were non-typhoidal Salmonella. The most common serovars were Panama (N = 57, 33.3% of isolates) and Arechavaleta (N = 28, 16.4%). Univariate analysis showed a strong association only between age > 6 months and infection with the Panama or Arechavaleta serovar (P = 0.002). The rate of resistance to all classes of antibiotics during the study period was low (< 15%); however, the detection of one extended-spectrum beta-lactamase-producing S. enterica strain highlights the need for continued monitoring of antimicrobial drug susceptibility. Infection with Panama (P < 0.001) or Arechavaleta (P < 0.001) serovar was significantly associated with bacteremia in a multivariate analysis. These serovars are probably poorly adapted to humans or are more virulent. A delay between onset of symptoms and hospital admission > 5 days (P = 0.01), vomiting (P = 0.001), and increased respiratory rate (P = 0.001) contributed independently to bacteremia in the multivariate analysis. Thus, if non-typhoidal infection is suspected, blood should be cultured and antibiotic treatment initiated in all patients who meet these criteria.
Collapse
Affiliation(s)
| | - Blandine Muanza
- Service de Pédiatrie, Centre Hospitalier Universitaire de Pointe-à-Pitre/les Abymes, Pointe-à-Pitre, France
| | - Sylvaine Bastian
- Laboratoire de Microbiologie Clinique et Environnementale, Centre Hospitalier Universitaire de Pointe-à-Pitre/les Abymes, Pointe-à-Pitre, France
| | - Edith Malpote
- Laboratoire de Microbiologie Clinique et Environnementale, Centre Hospitalier Universitaire de Pointe-à-Pitre/les Abymes, Pointe-à-Pitre, France
| | - Pauline Jestin
- Laboratoire de Microbiologie Clinique et Environnementale, Centre Hospitalier Universitaire de Pointe-à-Pitre/les Abymes, Pointe-à-Pitre, France
| | - Meggie Guerin
- Laboratoire de Microbiologie Clinique et Environnementale, Centre Hospitalier Universitaire de Pointe-à-Pitre/les Abymes, Pointe-à-Pitre, France
| | - Antoine Talarmin
- Unité Environnement et Santé, Institut Pasteur de Guadeloupe, Pointe-à-Pitre, France
| | - François-Xavier Weill
- Unité des Bactéries Pathogènes Entériques, Centre National de Référence des Escherichia coli, Shigella et Salmonella, Institut Pasteur, Paris, France
| | - Arnaud Legrand
- Direction de la Recherche Clinique et de L'innovation, Centre Hospitalier Universitaire de Nantes, Nantes, France
| | - Sebastien Breurec
- Faculté de Médecine Hyacinthe Bastaraud, Université des Antilles, Pointe-à-Pitre, France.,Unité des Bactéries Pathogènes Entériques, Centre National de Référence des Escherichia coli, Shigella et Salmonella, Institut Pasteur, Paris, France.,Unité Environnement et Santé, Institut Pasteur de Guadeloupe, Pointe-à-Pitre, France
| |
Collapse
|
18
|
Sadikalay S, Reynaud Y, Guyomard-Rabenirina S, Falord M, Ducat C, Fabre L, Le Hello S, Talarmin A, Ferdinand S. High genetic diversity of extended-spectrum β-lactamases producing Escherichia coli in feces of horses. Vet Microbiol 2018; 219:117-122. [PMID: 29778183 DOI: 10.1016/j.vetmic.2018.04.016] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Revised: 04/07/2018] [Accepted: 04/11/2018] [Indexed: 11/17/2022]
Abstract
Extended-spectrum beta-lactamases (ESBLs), especially those of the CTX-M type, represent a major public health problem throughout the world. Although the carriage of ESBL-producing Enterobacteriaceae (EPE) in feces of horses is now well recognized, little is known about the diversity of EPE after treatment of horses with antibiotics. We undertook this study to assess and follow the diversity of EP Escherichia coli isolated from horses after antibiotic treatment for an infection. Fecal samples from two horses treated and two that were untreated were tested for the presence of EPE on different days. All isolated E. coli strains were evaluated for antimicrobial resistance (AMR) and by whole-genome sequencing. Multi locus sequence typing, phylogrouping, resistance genes and plasmid content were extracted from genomic data. A phylogenetic analysis based on single nucleotide polymorphism (SNP) divergence was also performed on the core genome. We isolated 35 strains belonging to the A, B1 and C phylo-groups. All but one expressed SHV-12 enzymes and one expressed CTX-M-1. Intra- and inter-horse genetic diversity of E. coli strains was identified in the genome analysis and 10 AMR profiles. Two distinct EP E. coli-resistant populations (phylo-group B1: ST4164-AMR3 and ST155-AMR2) were found in one horse, and five other resistant populations were found in the second horse (phylo-group A: ST1250-AMR1; phylo-group B1: ST1250-AMR1, ST6981-AMR1 and phylo-group C: ST10-AMR4). Some persistent EP E. coli strains were detected at least 1 month after treatment. These results indicate that EP E. coli strains isolated from horse feces show intra- and inter-host genetic diversity, even in a region with low ESBL prevalence and in horses that are rarely treated with third-generation cephalosporins. These results also suggest that horizontal gene transfer and/or selection of resistance genes probably occurs in vivo within the horse gut microbiome. Follow-up of EP E. coli resistance profiles for at least 1 month after treatment is warranted to prevent persistence of EP E. coli.
Collapse
Affiliation(s)
- Syndia Sadikalay
- Unité Environnement Santé, Institut Pasteur de Guadeloupe, Les Abymes, Guadeloupe, France
| | - Yann Reynaud
- Unité Environnement Santé, Institut Pasteur de Guadeloupe, Les Abymes, Guadeloupe, France
| | | | - Mélanie Falord
- Unité Environnement Santé, Institut Pasteur de Guadeloupe, Les Abymes, Guadeloupe, France
| | - Célia Ducat
- Unité Environnement Santé, Institut Pasteur de Guadeloupe, Les Abymes, Guadeloupe, France
| | - Laetitia Fabre
- Institut Pasteur, Unité des Bactéries Pathogènes Entériques, Centre National de Réfé.rence des Escherichia coli, Shigella et Salmonella, Paris, France
| | - Simon Le Hello
- Institut Pasteur, Unité des Bactéries Pathogènes Entériques, Centre National de Réfé.rence des Escherichia coli, Shigella et Salmonella, Paris, France
| | - Antoine Talarmin
- Unité Environnement Santé, Institut Pasteur de Guadeloupe, Les Abymes, Guadeloupe, France
| | - Séverine Ferdinand
- Unité Environnement Santé, Institut Pasteur de Guadeloupe, Les Abymes, Guadeloupe, France.
| |
Collapse
|
19
|
Guyomard-Rabenirina S, Dartron C, Falord M, Sadikalay S, Ducat C, Richard V, Breurec S, Gros O, Talarmin A. Resistance to antimicrobial drugs in different surface waters and wastewaters of Guadeloupe. PLoS One 2017; 12:e0173155. [PMID: 28253356 PMCID: PMC5333909 DOI: 10.1371/journal.pone.0173155] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2016] [Accepted: 02/15/2017] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVE The first aim of this study was to evaluate the antimicrobial resistance of Enterobacteriaceae in different water environments of Guadeloupe and especially those impacted by waste water treatment plants (WWTP) effluents. The second objective was to characterize the genetic basis for antibiotic resistance of extended-spectrum beta-lactamase (ESBL) and AmpC beta-lactamase producing Enterobacteriaceae isolates (ESBLE and AmpCE). METHODS We have collected 70 surface waters (river and sea samples) impacted or not by WWTP and 18 waste waters from 2 WWTPs in 2012 and 2013. We i) determined the total and resistant bacterial counts and ii) tested isolated Enterobacteriaceae for their antimicrobial susceptibility. We also studied the genetic basis for antibiotic resistance of ESBLE and AmpCE, and the genetic background of Escherichia coli. RESULTS In rivers, contamination with Escherichia coli and antibiotic resistant coliforms (ARC) increased from the source to the mouth. Highest levels of river contamination with E. coli (9.26 x 105 MPN/100mL) and ARC (2.26 x 108 CFU/mL) were observed in surface water sampled near the discharge. A total of 246 Enterobacteriaceae strains resistant to antibiotics were isolated, mostly from waste waters and from river water collected near the discharge. Among these strains, 33 were Extended Spectrum Beta Lactamase (ESBLE) and 8 E. coli were AmpC beta-lactamase producers. All the ESBLE were isolated from waste waters or from river water collected near the discharge. The blaCTX-M gene was present in 29 of the 33 ESBLE strains, with 24 belonging to group 1. Numerous strains (68.7%) showed more than one acquired antibiotic resistance mechanism. E. coli strains belonged to different phylogenetic groups; among the B2 group, most strains belonged to the ST131 clone. CONCLUSION Our results demonstrated that many human activities can supply antibiotic-resistant bacteria in surface water. Nevertheless, WWTPs were the most important supplier of ESBLE in water environment of Guadeloupe.
Collapse
Affiliation(s)
| | - Celia Dartron
- Sorbonne Universités, UPMC Univ Paris 06, Univ Antilles, Univ Nice Sophia Antipolis, CNRS, Evolution Paris Seine—Institut de Biologie Paris Seine (EPS—IBPS), Paris, France
| | - Mélanie Falord
- Unité Environnement Santé, Institut Pasteur de la Guadeloupe, Les Abymes, Guadeloupe
| | - Syndia Sadikalay
- Unité Environnement Santé, Institut Pasteur de la Guadeloupe, Les Abymes, Guadeloupe
| | - Célia Ducat
- Unité Environnement Santé, Institut Pasteur de la Guadeloupe, Les Abymes, Guadeloupe
| | - Vincent Richard
- Institut Pasteur de Nouvelle Calédonie BP61—98845 Nouméa Cedex, Nouvelle-Calédonie
| | - Sébastien Breurec
- Unité Environnement Santé, Institut Pasteur de la Guadeloupe, Les Abymes, Guadeloupe
- Université des Antilles, Pointe à Pitre cedex, Guadeloupe
- Laboratoire de Microbiologie Clinique et Environnementale, Centre Hospitalier Universitaire de Pointe à Pitre, Guadeloupe
| | - Olivier Gros
- Sorbonne Universités, UPMC Univ Paris 06, Univ Antilles, Univ Nice Sophia Antipolis, CNRS, Evolution Paris Seine—Institut de Biologie Paris Seine (EPS—IBPS), Paris, France
| | - Antoine Talarmin
- Unité Environnement Santé, Institut Pasteur de la Guadeloupe, Les Abymes, Guadeloupe
| |
Collapse
|
20
|
Farra A, Bekondi C, Tricou V, Mbecko JR, Talarmin A. Free-living amoebae isolated in the Central African Republic: epidemiological and molecular aspects. Pan Afr Med J 2017; 26:57. [PMID: 28451034 PMCID: PMC5398892 DOI: 10.11604/pamj.2017.26.57.9021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Accepted: 12/19/2016] [Indexed: 11/11/2022] Open
Abstract
Among the many species of free-living amoebae infecting humans, only Naegleria fowleri, a few species of Acanthamoeba, Balamuthia mandrillaris recently Sappinia diploïdea and Paravahlkampfia Francina are responsible for human diseases especially deadly encephalitis outside of Acanthamoeba keratitis related. In the Central African Republic (CAR), no studies have previously been conducted about free amoebae and no suspicious cases of encephalitis or amoebic keratitis was reported even though the ecosystem supported the proliferation of these microorganisms. The objective of this study was to identify free-living amoebae present in CAR and to define the molecular characteristic. Bathing sites and cerebrospinal fluid from patients died of bacterial meningitis untagged were explored by culture and PCR and the amplicons were sequenced which allowed to characterize the species found. Only species of the genus Tetramitus, namely T. Entericus, T. waccamawensis and T.sp similar to those already described in the world and not pathogenic for humans were found in bathing sites, the cerebrospinal fluid meanwhile remained negative. Although no pathogen species such as Naegleria fowleri or species of Acanthamoeba have been isolated, this study worth pursuing because this investigation was very limited in space because of the insecurity in the country.
Collapse
Affiliation(s)
- Alain Farra
- Institut Pasteur de Bangui, Bangui, Republique Centrafricaine
| | | | - Vianney Tricou
- Institut Pasteur de Bangui, Bangui, Republique Centrafricaine
| | | | | |
Collapse
|
21
|
Guyomard-Rabenirina S, Malespine J, Ducat C, Sadikalay S, Falord M, Harrois D, Richard V, Dozois C, Breurec S, Talarmin A. Temporal trends and risks factors for antimicrobial resistant Enterobacteriaceae urinary isolates from outpatients in Guadeloupe. BMC Microbiol 2016; 16:121. [PMID: 27342199 PMCID: PMC4919840 DOI: 10.1186/s12866-016-0749-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Accepted: 06/15/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Urinary tract infections are bacterial infections most commonly encountered in the community. The resistance rate of uropathogens to commonly prescribed antibiotics has increased worldwide but there are no published data concerning the resistance of strains isolated from community-acquired UTI in Guadeloupe. To assess the susceptibility patterns of Enterobacteriaceae strains isolated from outpatients in Guadeloupe we conducted a prospective study from December 2012 to May 2014 among outpatients consulting at private and public laboratories for urine analysis. Risk factors for E. coli resistance to amoxicillin, third-generation cephalosporin, and ciprofloxacin were also determined. To study the trends of E. coli resistance rates over the past 10 years, data on the susceptibility patterns of E. coli from 2003 to 2014 were also collected from three major laboratories for a retrospective study. RESULTS During the prospective study, we isolated 1293 bacterial strains from the urine of outpatients presenting for urine analysis. The most commonly isolated bacteria were E. coli (57 %) and Klebsiella pneumoniae (15.5 %). Thirty seven per cent of the E. coli strains were resistant to amoxicillin. Resistance rates to third generation cephalosporin were low for E. coli and other Enterobacteriaceae (3.1 and 12.2 % respectively) and mostly due to the presence of an Extended Spectrum Beta-lactamase. Resistance to cotrimoxazole and ciprofloxacin was moderate (17.8 and 15.6 % respectively). However, the resistance rate of E. coli to ciprofloxacin has significantly increased during the last 10 years. Risk factors were consistent with previously reported data, especially for the increasing ciprofloxacin resistance with age. CONCLUSION General practitioners in Guadeloupe need to be better informed to favor the prescription of fosfomycin-trometamol to reduce the risk of resistance to fluoroquinolones.
Collapse
Affiliation(s)
| | - Joyce Malespine
- />Unité Environnement Santé, Institut Pasteur de Guadeloupe, Les Abymes, Guadeloupe France
| | - Célia Ducat
- />Unité Environnement Santé, Institut Pasteur de Guadeloupe, Les Abymes, Guadeloupe France
| | - Syndia Sadikalay
- />Unité Environnement Santé, Institut Pasteur de Guadeloupe, Les Abymes, Guadeloupe France
| | - Mélanie Falord
- />Unité Environnement Santé, Institut Pasteur de Guadeloupe, Les Abymes, Guadeloupe France
| | - Dorothée Harrois
- />Laboratoire de Biologie Clinique, Centre Hospitalier de Basse-Terre, Basse-Terre, Guadeloupe France
| | - Vincent Richard
- />Institut Pasteur de Nouvelle-Calédonie, Nouméa, Nouvelle-Calédonie France
| | | | - Sébastien Breurec
- />Unité Environnement Santé, Institut Pasteur de Guadeloupe, Les Abymes, Guadeloupe France
- />Faculté de Médecine, Université des Antilles, Pointe-à-Pitre, Guadeloupe France
- />Laboratoire de Microbiologie Clinique et Environnementale, Centre Hospitalo-Universitaire de Pointe-à-Pitre/Abymes, Pointe-à-Pitre, Guadeloupe France
| | - Antoine Talarmin
- />Unité Environnement Santé, Institut Pasteur de Guadeloupe, Les Abymes, Guadeloupe France
| |
Collapse
|
22
|
Moussa M, Tissot O, Guerlotté J, De Jonckheere JF, Talarmin A. Soil is the origin for the presence of Naegleria fowleri in the thermal recreational waters. Parasitol Res 2014; 114:311-5. [PMID: 25352239 DOI: 10.1007/s00436-014-4197-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2014] [Accepted: 10/17/2014] [Indexed: 11/25/2022]
Abstract
Naegleria fowleri is found in most geothermal baths of Guadeloupe and has been responsible for the death of a 9-year-old boy who swam in one of these baths in 2008. We wanted to determine the origin for the presence of this amoeba in the water. Water samples were taken at the origin of the geothermal sources and at the arrival in the baths. After filtration, cultures were made and the number of Naegleria present was determined using the most probable number method. Soil samples collected in the proximity of the baths were also tested for the presence of thermophilic amoebae. The species identification was obtained by PCR. During three consecutive months, no Naegleria could be found at the origin of any geothermal source tested. In contrast, N. fowleri was isolated at least once in all baths at the arrival of the water, except one. Thermophilic amoebae could be found in each soil sample, especially near the baths located at a lower altitude, but N. fowleri was only isolated near two baths, which were also the baths most often contaminated with this species. So it appears that the contamination of the water with N. fowleri occurs after emerging from the geothermal source when the water runs over the soil. Therefore, it should be possible to reduce the concentration of N. fowleri in the geothermal baths of Guadeloupe to for example less than 1 N. fowleri/10 L by installing a pipeline between the geothermal sources and the baths and by preventing flooding water from entering the baths after rainfall. By taking these measures, we were able to eliminate N. fowleri from a pool located inside a reeducation clinic.
Collapse
Affiliation(s)
- Mirna Moussa
- Unité Environnement-Santé, Institut Pasteur de la Guadeloupe, 97183, Les Abymes CEDEX, Guadeloupe, France
| | | | | | | | | |
Collapse
|
23
|
Randrianirina F, Ratsima EH, Ramparany L, Randremanana R, Rakotonirina HC, Andriamanantena T, Rakotomanana F, Rajatonirina S, Richard V, Talarmin A. Antimicrobial resistance of bacterial enteropathogens isolated from stools in Madagascar. BMC Infect Dis 2014; 14:104. [PMID: 24568189 PMCID: PMC3937528 DOI: 10.1186/1471-2334-14-104] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2013] [Accepted: 02/10/2014] [Indexed: 12/03/2022] Open
Abstract
Background Diarrheal diseases are a major public health problem in developing countries, and are one of the main causes of hospital admissions in Madagascar. The Pasteur Institute of Madagascar undertook a study to determine the prevalence and the pathogenicity of bacterial, viral and protozoal enteropathogens in diarrheal and non-diarrheal stools of children aged less than 5 years in Madagascar. We present here the results of the analysis of antimicrobial susceptibility of the bacteria isolated during this study. Methods The study was conducted in the community setting in 14 districts of Madagascar from October 2008 to May 2009. Conventional methods and PCR were used to identify the bacteria; antimicrobial susceptibility was determined using an agar diffusion method for enterobacteriaceae and MICs were measured by an agar dilution method for Campylobacter sp. In addition to the strains isolated during this study, Salmonella sp and Shigella sp isolated at the Pasteur Institute of Madagascar from 2005 to 2009 were included in the analysis to increase the power of the study. Results Twenty-nine strains of Salmonella sp, 35 strains of Shigella sp, 195 strains of diarrheagenic E. coli, 203 strains of C. jejuni and 71 strains of C. coli isolated in the community setting were tested for antibiotic resistance. Fifty-five strains of Salmonella sp and 129 strains of Shigella sp isolated from patients referred to the Pasteur Institute of Madagascar were also included in the study. Many E. coli and Shigella isolates (around 80%) but fewer Salmonella isolates were resistant to ampicillin and trimethoprim/sulfamethoxazole. A small proportion of strains of each species were resistant to ciprofloxacin and only 3% of E. coli strains presented a resistance to third generation cephalosporins due to the production of extended-spectrum beta-lactamases. The resistance of Campylobacter sp to ampicillin was the most prevalent, whereas less than 5% of isolates were resistant to each of the other antibiotics. Conclusion The highest prevalence of antimicrobial resistance was to ampicillin and trimethoprim/sulfamethoxazole. Antibiotic treatment is not recommended for children with diarrhea in Madagascar and the emphasis should be placed on oral rehydration.
Collapse
|
24
|
Rakotonirina HC, Garin B, Randrianirina F, Richard V, Talarmin A, Arlet G. Molecular characterization of multidrug-resistant extended-spectrum β-lactamase-producing Enterobacteriaceae isolated in Antananarivo, Madagascar. BMC Microbiol 2013; 13:85. [PMID: 23594374 PMCID: PMC3639105 DOI: 10.1186/1471-2180-13-85] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2012] [Accepted: 03/22/2013] [Indexed: 11/12/2022] Open
Abstract
Background We investigated the molecular characteristics of multidrug-resistant, extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae isolated in community settings and in hospitals in Antananarivo, Madagascar. Results Forty-nine E. coli, K. pneumoniae, K. oxytoca and E. cloacae ESBL-producing isolates were studied. In antimicrobial susceptibility analyses, many of the isolates exhibited resistance to aminoglycosides, fluoroquinolones and trimethoprim-sulfamethoxazole. Gene amplification analysis and sequencing revealed that 75.5% (n=37) of the isolates harbored blaCTX-M-15 and 38.7% (n=19) harbored blaSHV-12. The non-ESBLs resistance genes detected were blaTEM-1, blaOXA-1, aac(6′)-Ib,aac(6′)-Ib-cr, tetA, sul-1, sul-2, qnrA, qnrB and catB-3. We found dfrA and aadA gene cassettes in the class 1 integron variable regions of the isolates, and the combination of dfrA17-aadA5 to be the most prevalent. All blaCTX-M-15 positive isolates also contained the ISEcp1 insertion element. Conjugation and transformation experiments indicated that 70.3% of the antibiotic resistance genes resided on plasmids. Through a PCR based replicon typing method, plasmids carrying the blaSHV-12 or blaCTX-M-15 genes were assigned to either the IncFII replicon type or, rarely, to the HI2 replicon type. All isolates were subtyped by the rep-PCR and ERIC-PCR methods. Phylogenetic grouping and virulence genotyping of the E. coli isolates revealed that most of them belonged to group A1. One isolate assigned to group B2 harbored blaCTX-M-15 and five virulence genes (traT, fyuA, iutA, iha and sfa) and was related to the O25b-ST131 clone. Conclusions Our results highlight the dissemination of multidrug resistant Enterobacteriaceae isolates in Antananarivo. These findings underline the need for a rational use of antibiotic and for appropriate methods of screening ESBL in routine laboratories in Antananarivo.
Collapse
|
25
|
Moussa M, De Jonckheere JF, Guerlotté J, Richard V, Bastaraud A, Romana M, Talarmin A. Survey of Naegleria fowleri in geothermal recreational waters of Guadeloupe (French West Indies). PLoS One 2013; 8:e54414. [PMID: 23349880 PMCID: PMC3548798 DOI: 10.1371/journal.pone.0054414] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2012] [Accepted: 12/12/2012] [Indexed: 11/18/2022] Open
Abstract
In 2008 a fatal case of primary amoebic meningoencephalitis, due to the amoeboflagellate Naegleria fowleri, occurred in Guadeloupe, French West Indies, after a child swam in a bath fed with geothermal water. In order to improve the knowledge on free-living amoebae in this tropical part of France, we investigated on a monthly basis, the presence of Naegleria spp. in the recreational baths, and stream waters which feed them. A total of 73 water samples, 48 sediments and 54 swabs samples were collected from 6 sampling points between June 2011 and July 2012. The water samples were filtered and the filters transferred to non-nutrient agar plates seeded with a heat-killed suspension of Escherichia coli while sediment and swab samples were placed directly on these plates. The plates were incubated at 44°C for the selective isolation of thermophilic Naegleria. To identify the Naegleria isolates the internal transcribed spacers, including the 5.8S rDNA, were amplified by polymerase chain reaction and the sequence of the PCR products was determined. Thermophilic amoebae were present at nearly all collection sites. The pathogenic N. fowleri was the most frequently encountered thermophilic species followed by N. lovaniensis. The concentration of N. fowleri was rather low in most water samples, ranging from 0 to 22 per liter. Sequencing revealed that all N. fowleri isolates belonged to a common Euro-American genotype, the same as detected in the human case in Guadeloupe. These investigations need to be continued in order to counsel the health authorities about prevention measures, because these recreational thermal baths are used daily by local people and tourists.
Collapse
Affiliation(s)
- Mirna Moussa
- Unité Environnement-Santé, Institut Pasteur de la Guadeloupe, Les Abymes, Guadeloupe, France
| | - Johan F. De Jonckheere
- De Duve Institute, Brussels, Belgium
- Scientific Institute of Public Health, Brussels, Belgium
| | - Jérôme Guerlotté
- Unité Environnement-Santé, Institut Pasteur de la Guadeloupe, Les Abymes, Guadeloupe, France
- Université des Antilles et de la Guyane, Pointe à Pitre, Guadeloupe, France
- Muséum National d’Histoire Naturelle, UMR 7205 MNHN/CNRS, Paris, France
| | | | - Alexandra Bastaraud
- Unité Environnement-Santé, Institut Pasteur de la Guadeloupe, Les Abymes, Guadeloupe, France
| | - Marc Romana
- Inserm, U 665, Pointe-à-Pitre, Guadeloupe, France
| | - Antoine Talarmin
- Unité Environnement-Santé, Institut Pasteur de la Guadeloupe, Les Abymes, Guadeloupe, France
- * E-mail:
| |
Collapse
|
26
|
Randremanana R, Randrianirina F, Gousseff M, Dubois N, Razafindratsimandresy R, Hariniana ER, Garin B, Randriamanantena A, Rakotonirina HC, Ramparany L, Ramarokoto CE, Rakotomanana F, Ratsitorahina M, Rajatonirina S, Talarmin A, Richard V. Case-control study of the etiology of infant diarrheal disease in 14 districts in Madagascar. PLoS One 2012; 7:e44533. [PMID: 23028555 PMCID: PMC3444445 DOI: 10.1371/journal.pone.0044533] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2012] [Accepted: 08/03/2012] [Indexed: 02/04/2023] Open
Abstract
Background Acute diarrhea is a major cause of childhood morbidity and mortality worldwide. Its microbiological causes and clinico-epidemiological aspects were examined during the rainy seasons from 2008 to 2009 in 14 districts in Madagascar. Methods Stool specimens of 2196 children with acute diarrhea and 496 healthy children were collected in a community setting. Intestinal parasites were diagnosed by microscopy and bacteria by culturing methods. Rota-, astro and adenoviruses were identified using commercially available ELISA kits and rotaviruses were confirmed using reverse transcriptase polymerase chain reaction (RT-PCR). Results Intestinal microorganisms were isolated from 54.6% of diarrheal patients and 45.9% of healthy subjects (p = <0.01). The most common pathogens in diarrheic patients were intestinal parasites (36.5%). Campylobacter spp. and Rotavirus were detected in 9.7% and 6.7% of diarrheic patients. The detection rates of Entamoeba histolytica, Trichomonas intestinalis and Giardia lamblia were much greater in diarrheal patients than in non diarrheal subjects (odds ratios of 5.1, 3.2, 1.7 respectively). The abundance of other enteropathogens among the non diarrheal group may indicate prolonged excretion or limited pathogenicity. Conclusion In developing countries, where the lack of laboratory capacities is great, cross sectional studies of enteropathogens and their spatial distribution, including diarrheal and non diarrheal subjects, are interesting tools in order to advise regional policies on treatment and diarrheic patient management.
Collapse
Affiliation(s)
- Rindra Randremanana
- Epidemiologic Unit, Institut Pasteur in Madagascar, Antananarivo, Madagascar
| | | | - Marie Gousseff
- Epidemiologic Unit, Institut Pasteur in Madagascar, Antananarivo, Madagascar
| | - Natasha Dubois
- Virological Unit, Institut Pasteur in Madagascar, Antananarivo, Madagascar
| | | | | | - Benoit Garin
- Virological Unit, Institut Pasteur in Madagascar, Antananarivo, Madagascar
| | | | | | - Lovasoa Ramparany
- Molecular Biology Unit, Institut Pasteur in Madagascar, Antananarivo, Madagascar
| | | | | | | | | | | | - Vincent Richard
- Epidemiologic Unit, Institut Pasteur in Madagascar, Antananarivo, Madagascar
- * E-mail:
| |
Collapse
|
27
|
Raharimanga V, Ratovoson R, Ratsitorahina M, Ramarokoto H, Rasolofo V, Talarmin A, Richard V. Tuberculin reactivity in first-year schoolchildren in Madagascar. Trop Med Int Health 2012; 17:871-6. [PMID: 22620713 DOI: 10.1111/j.1365-3156.2012.03013.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The tuberculin skin test (TST) is an important tool in the diagnosis of tuberculosis infection in children. However, the interpretation of TST may be complicated by prior Bacillus Calmette-Guerin (BCG) vaccination. We evaluated the effect of vaccination with BCG on TST reactivity in first-year pupils attending state schools in Antananarivo. METHODS STs were performed on 376 first-year schoolchildren, aged 6 and 7, attending two state primary schools. The relationships between epidemiological information, BCG status (vaccination, BCG scars) and TST reactivity were assessed to compare TST sensitivity between children with and without BCG vaccination and between those with and without a BCG scar. RESULT The prevalence of positive TST results of ≥5, ≥10 and ≥ 15 mm was 20.2% (76/376), 18.3% (69/376) and 11.4% (43/376), respectively. BCG vaccination was not associated with TST reactivity, whatever the threshold used: ≥5 mm (odds ratio (OR, 1.2; 95% confidence interval (CI), 0.7-2.0); ≥10 mm (OR, 0.9; 95% CI, 0.6-1.7); ≥15 mm (OR, 0.6; 95% CI, 0.3-1.2). CONCLUSION These results suggest that in Madagascar, a positive TST result indicates TB infection (active or latent) rather than past BCG vaccination. Therefore, high BCG vaccination coverage does not appear to impair the usefulness of the TST as a tool for diagnosing tuberculosis.
Collapse
|
28
|
Herindrainy P, Randrianirina F, Ratovoson R, Ratsima Hariniana E, Buisson Y, Genel N, Decré D, Arlet G, Talarmin A, Richard V. Rectal carriage of extended-spectrum beta-lactamase-producing gram-negative bacilli in community settings in Madagascar. PLoS One 2011; 6:e22738. [PMID: 21829498 PMCID: PMC3146483 DOI: 10.1371/journal.pone.0022738] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2010] [Accepted: 07/06/2011] [Indexed: 11/21/2022] Open
Abstract
Background Extended-spectrum ß-lactamase-producing Enterobacteria (ESBL-PE) emerged at the end of the 1980s, causing nosocomial outbreaks and/or hyperendemic situations in hospitals and long-term care facilities. In recent years, community-acquired infections due to ESBL-PE have spread worldwide, especially across developing countries including Madagascar. Objectives This study aimed to determine the prevalence and risk factors of intestinal carriage of ESBL-PE in the community of Antananarivo. Methods Non-hospitalized patients were recruited in three health centers in different socio economic settings. Fresh stool collected were immediately plated on Drigalski agar containing 3 mg/liter of ceftriaxone. Gram-negative bacilli species were identified and ESBL production was tested by a double disk diffusion (cefotaxime and ceftazidime +/− clavulanate) assay. Characterization of ESBLs were perfomed by PCR and direct sequencing . Molecular epidemiology was analysed by Rep-PCR and ERIC-PCR. Results 484 patients were screened (sex ratio = 1.03, median age 28 years). 53 ESBL-PE were isolated from 49 patients (carrier rate 10.1%). The isolates included Escherichia coli (31), Klebsiella pneumoniae (14), Enterobacter cloacae (3), Citrobacter freundii (3), Kluyvera spp. (1) and Pantoae sp.(1). In multivariate analysis, only the socioeconomic status of the head of household was independently associated with ESBL-PE carriage, poverty being the predominant risk factor. Conclusions The prevalence of carriage of ESBL in the community of Antananarivo is one of the highest reported worldwide. This alarming spread of resistance genes should be stopped urgently by improving hygiene and streamlining the distribution and consumption of antibiotics.
Collapse
Affiliation(s)
| | | | - Rila Ratovoson
- Institut Pasteur de Madagascar, Antananarivo, Madagascar
| | | | - Yves Buisson
- Institut de la Francophonie pour la Médecine Tropicale, Ventiane, Laos
| | - Nathalie Genel
- Laboratoire de Bactériologie, Faculté de Médecine Pierre et Marie Curie, UPMC, Paris France
| | - Dominique Decré
- Laboratoire de Bactériologie, Faculté de Médecine Pierre et Marie Curie, UPMC, Paris France
| | - Guillaume Arlet
- Laboratoire de Bactériologie, Faculté de Médecine Pierre et Marie Curie, UPMC, Paris France
| | | | - Vincent Richard
- Institut Pasteur de Madagascar, Antananarivo, Madagascar
- * E-mail:
| |
Collapse
|
29
|
Andriatahina T, Randrianirina F, Hariniana ER, Talarmin A, Raobijaona H, Buisson Y, Richard V. High prevalence of fecal carriage of extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella pneumoniae in a pediatric unit in Madagascar. BMC Infect Dis 2010; 10:204. [PMID: 20624313 PMCID: PMC2912907 DOI: 10.1186/1471-2334-10-204] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2009] [Accepted: 07/12/2010] [Indexed: 12/04/2022] Open
Abstract
Background Extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae have spread worldwide but there are few reports on carriage in hospitals in low-income countries. ESBL-producing Enterobacteriaceae (ESBL-PE) have been increasingly isolated from nosocomial infections in Antananarivo, Madagascar. Methods we conducted a prevalence survey in a pediatric unit from March to April 2008 Patient rectal swabs were sampled on the first and the last day of hospitalization. Medical staff and environment were also sampled. Rectal and environmental swabs were immediately plated onto Drigalski agar supplemented with 3 mg/liter of ceftriaxon. Results Fecal carriage was detected in 21.2% of 244 infants on admission and 57.1% of 154 on discharge, after more than 48 hours of hospitalization (p < 0.001). The species most frequently detected on admission were Escherichia coli and Klebsiella pneumoniae (36.9%), whereas, on discharge, K. pneumoniae was the species most frequently detected (52.7%). ESBL-associated resistances were related to trimethoprim-sulfamethoxazole (91.3%), gentamicin (76.1%), ciprofloxacin (50.0%), but not to amikacin and imipenem. The increased prevalence of carriage during hospitalization was related to standard antimicrobial therapy. Conclusion The significant emergence of multidrug-resistant enteric pathogens in Malagasy hospitals poses a serious health threat requiring the implementation of surveillance and control measures for nosocomial infections.
Collapse
|
30
|
Andriamanantena TS, Ratsima E, Rakotonirina HC, Randrianirina F, Ramparany L, Carod JF, Richard V, Talarmin A. Dissemination of multidrug resistant Acinetobacter baumannii in various hospitals of Antananarivo Madagascar. Ann Clin Microbiol Antimicrob 2010; 9:17. [PMID: 20591154 PMCID: PMC2910008 DOI: 10.1186/1476-0711-9-17] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2009] [Accepted: 06/30/2010] [Indexed: 11/10/2022] Open
Abstract
This study reports the dissemination of multidrug-resistant (MDR) OXA-23-producing Acinetobacter baumannii clones in hospitals in Antananarivo, Madagascar. A total of 53 carbapenem-resistant A. baumannii isolates were obtained from September 2006 to March 2009 in five hospitals. These resistant strains represent 44% of all A. baumannii isolates. The double disk synergy test was performed to screen for production of metallo-beta-lactamases. Polymerase chain reaction (PCR) and DNA sequencing were performed for the detection of bla(AmpC), bla(OXA-51),bla(OXA-23), bla(OXA-24), bla(IMP), bla(VIM). The presence of the insertion sequence ISAba1 relative to blaOXA-23 and blaOXA-51 was assessed by PCR. Isolates were typed by Rep-PCR. All the isolates were MDR and produced the OXA-23 carbapenemase, which was confirmed by sequencing. PCR analysis for AmpC and OXA-51 gave positive results for all strains studied. No isolates produced metallo-beta-lactamases. In all isolates ISAba1 laid upstream of blaOXA-23. The A. baumannii isolates were separated into two genotypes; genotype A had a higher prevalence (41 strains) than genotype B (12 strains). Genotype A was present in four hospitals, whilst genotype B had spread in two hospitals. The high frequency of MDR OXA-23-producing A. baumannii in various hospitals in Antananarivo is curious since carbapenems are not available in Madagascar, but it emphasises the need for infection control procedures and strict adherence to them to prevent the spread of these resistant organisms in Antananarivo and also the need to control the use of carbapenems in the future.
Collapse
|
31
|
Randrianirina F, Vaillant L, Ramarokoto CE, Rakotoarijaona A, Andriamanarivo ML, Razafimahandry HC, Randrianomenjanahary J, Raveloson JR, Hariniana ER, Carod JF, Talarmin A, Richard V. Antimicrobial resistance in pathogens causing nosocomial infections in surgery and intensive care units of two hospitals in Antananarivo, Madagascar. J Infect Dev Ctries 2010; 4:74-82. [PMID: 20212337 DOI: 10.3855/jidc.454] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2009] [Revised: 11/03/2009] [Accepted: 11/10/2009] [Indexed: 10/31/2022] Open
Abstract
BACKGROUND In developing countries, knowledge of antimicrobial resistance patterns is essential to define empirical therapy. METHODOLOGY All the surgery and intensive care wards of two hospitals in Antananarivo were included to study the antimicrobial susceptibility of the pathogenic bacteria causing nosocomial infections. A repeated cross-sectional survey was conducted between September 2006 and March 2008, one day per week. Isolates were identified using classical methods, and resistance to antibiotics was assessed according to the recommendations of the Antibiogram Committee of the French Microbiology Society. RESULTS Clinical specimens from 706 from 651 patients were collected. Of the 533 bacterial pathogens, 46.7% were Enterobacteriaceae, 19.3% were Staphylococcus aureus, and 19.1% were pathogens from the hospital environment (Pseudomonas aeruginosa and Acinetobacter baumannii).Frequencies of resistance were high, particularly in Enterobacteriaceae; however, the rate of Staphylococcus aureus isolates resistant to oxacillin (13.6 %) was moderate and all these isolates were susceptible to glycopeptids. The percentages of isolates susceptible to ceftazidim were 81.8% for E. coli, 60.9% for Klebsiella, and 52.5% for Enterobacter spp. Resistance to third-generation cephalosporins was due to extended spectrum betalactamases (ESBL). Multivariate analysis showed that diabetes (adjusted OR: 3.9) and use of an invasive procedures (adjusted OR: 3.5) were independent risk factors for resistance to third-generation cephalosporins. CONCLUSION A nationwide surveillance programme is needed to monitor the microbial trends and antimicrobial resistance in Madagascar.
Collapse
|
32
|
Randrianirina F, Vedy S, Rakotovao D, Ramarokoto CE, Ratsitohaina H, Carod JF, Ratsima E, Morillon M, Talarmin A. Role of contaminated aspiration tubes in nosocomial outbreak of Klebsiella pneumoniae producing SHV-2 and CTX-M-15 extended-spectrum beta-lactamases. J Hosp Infect 2009; 72:23-9. [PMID: 19282056 DOI: 10.1016/j.jhin.2009.02.004] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2008] [Accepted: 02/04/2009] [Indexed: 10/21/2022]
Abstract
Klebsiella pneumoniae resistant to ceftazidime was isolated from ten neonates hospitalised between February and March 2006 in two Antananarivo hospitals, Madagascar. The main environmental source, for one hospital in particular, was the liquid used to rinse aspiration tubes in the paediatric wards. The risk of contamination from aspiration tubes is very high in the hospitals of Antananarivo since tap water used to rinse the tubes is not regularly changed. Phenotypical (biotyping and antibiotyping) and genotypical (pulsed-field gel electrophoresis) analysis of all the clinical isolates indicated that nine cases were due to a single clone. This clone carried the genes encoding SHV-2 and CTX-M-15 beta-lactamases. This is the first description of an epidemic due to an ESBL-producing member of the family Enterobacteriaceae in Malagasy hospitals.
Collapse
|
33
|
Alcon-LePoder S, Sivard P, Drouet MT, Talarmin A, Rice C, Flamand M. Secretion of flaviviral non-structural protein NS1: from diagnosis to pathogenesis. Novartis Found Symp 2008; 277:233-47; discussion 247-53. [PMID: 17319166 DOI: 10.1002/0470058005.ch17] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Flaviviruses are major arthropod-borne human pathogens responsible for life-threatening encephalitis, hepatitis and haemorrhagic fevers. These enveloped, single-stranded, positive-sense RNA viruses encode a polyprotein precursor of about 3400 amino acids, processed into three structural and seven non-structural proteins. The non-structural glycoprotein NS1 is essential for flavivirus viability. During host-cell infection in vitro, NS1 is found associated with intracellular organelles as a requisite for its role in viral replication, or is transported to the cell surface where it may trigger specific signalling pathways. In addition, a secreted form of the protein is released from flavivirus-infected mammalian cells. We have previously shown that the NS1 protein circulates during the acute phase of the disease in the plasma of patients infected with dengue virus type 1 and have extended our retrospective studies to dengue type 2 and type 3 cohorts, confirming the value of the NS1 antigen as an alternative diagnostic marker. Interestingly, detection of the NS1 protein in yellow fever virus and West Nile virus infections suggests that NS1 secretion is a hallmark of human flavivirus infections. The objectives of our current studies are to define the biological properties of the secreted form of the NS1 protein, to evaluate its possible contribution to viral pathogenesis, and to validate this protein as a candidate target for passive immunoprophylaxis against flaviviruses.
Collapse
Affiliation(s)
- S Alcon-LePoder
- Institut Pasteur, Virology Department, 25 Rue du Dr Roux, 75015 Paris, France
| | | | | | | | | | | |
Collapse
|
34
|
Ratsitorahina M, Harisoa J, Ratovonjato J, Biacabe S, Reynes JM, Zeller H, Raoelina Y, Talarmin A, Richard V, Louis Soares J. Outbreak of dengue and Chikungunya fevers, Toamasina, Madagascar, 2006. Emerg Infect Dis 2008; 14:1135-7. [PMID: 18598641 PMCID: PMC2600361 DOI: 10.3201/eid1407.071521] [Citation(s) in RCA: 108] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
An outbreak of dengue-like syndrome occurred in Toamasina from January through March 2006. Dengue type l or chikungunya viruses were detected in 38 of 55 patients sampled. Aedes albopictus was the only potential vector collected. Of 4,242 randomly selected representative residents interviewed retrospectively, 67.5% reported a dengue-like syndrome during this period.
Collapse
|
35
|
Raharimanga V, Carod JF, Ramarokoto CE, Chrétien JB, Rakotomanana F, Talarmin A, Richard V. Age-specific seroprevalence of hepatitis A in Antananarivo (Madagascar). BMC Infect Dis 2008; 8:78. [PMID: 18538023 PMCID: PMC2435538 DOI: 10.1186/1471-2334-8-78] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2008] [Accepted: 06/06/2008] [Indexed: 11/19/2022] Open
Abstract
Background Hepatitis A virus (HAV) is an enteric, viral, infectious disease endemic in many developing countries such as Madagascar. Infection is often subclinical or asymptomatic in children; however, symptomatic acute infections become more common with increasing age. In some developing countries, improvements in living conditions have led to changes in the epidemiological pattern of HAV infection. There are very few reports on the prevalence of HAV in Madagascar. This study was to determine the seroprevalence of hepatitis A virus antibodies in relation to age in the city of Antananarivo, Madagascar. Methods Serum samples collected in 2004 during a cross-sectional survey of individuals aged between two and 24 years from Antananarivo were tested for anti-HAV antibody using a commercial enzyme immunoassay kit. Subjects were investigated using a standardized social and medical history questionnaire. Results 926 subjects were enrolled including 406 males and 520 females. There were 251 children under 10 years old and 675 subjects between 10 and 24 years old. Of the 926 serum samples tested, 854 (92.2%) were positive for anti-HAV antibodies. The number of seropositive samples was similar for males and females. The overall seroprevalence was 83.7% (210/251) for children under 10 years old and 95.5% (644/675) for subjects aged between 10 and 24 years (p < 0.001). Conclusion Despite improvements in sanitary conditions and hygiene over the last few years, the prevalence of HAV in Antananarivo is high. Only children under five years old remain susceptible to HAV infection. Immunization against HAV is not needed at the present time in the Madagascan population, but should be recommended for travellers.
Collapse
Affiliation(s)
- Vaomalala Raharimanga
- Unité d'Epidémiologie, Institut Pasteur de Madagascar, BP 1274, Antananarivo 101, Madagascar.
| | | | | | | | | | | | | |
Collapse
|
36
|
Randrianirina F, Carod JF, Ratsima E, Chrétien JB, Richard V, Talarmin A. Evaluation of the performance of four rapid tests for detection of hepatitis B surface antigen in Antananarivo, Madagascar. J Virol Methods 2008; 151:294-297. [PMID: 18462816 DOI: 10.1016/j.jviromet.2008.03.019] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2007] [Revised: 03/18/2008] [Accepted: 03/19/2008] [Indexed: 12/17/2022]
Abstract
Four rapid immunochromatographic assays--Determine HBsAg, Virucheck HBsAg, Cypress HBsAg Dipstick and Hexagon HBsAg--for human hepatitis B surface antigen (HBsAg) detection in human serum were evaluated. A collection of reference serum samples (91 HBsAg positive and 109 HBsAg negative) stored at -80 degrees C was used. Sensitivity and positive predictive value (PPV) exceeded 95%, and specificity and negative predictive value (NPV) exceeded 96% for all tests. The Determine HBsAg test performed best in this study, with a sensitivity of 97.8%, a specificity and PPV of 100%, a NPV of 98.2% and an accuracy rate of 99.0%. However, the differences between the tests were not significant. Other factors should therefore also be taken into account by the Ministry of Health in its decision to recommend a particular test: price, availability, delivery time and feasibility of whole-blood testing. The Determine test appears to be the most suitable for Madagascar, based on all these criteria. The use of this test, despite its lower sensitivity, could prevent blood-borne transmission of hepatitis B virus (HBV) in areas with limited resources.
Collapse
|
37
|
Bekondi C, Olinger CM, Boua N, Talarmin A, Muller CP, Le Faou A, Venard V. Central African Republic is part of the West-African hepatitis B virus genotype E crescent. J Clin Virol 2007; 40:31-7. [PMID: 17689139 DOI: 10.1016/j.jcv.2007.05.009] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2007] [Revised: 04/25/2007] [Accepted: 05/21/2007] [Indexed: 12/12/2022]
Abstract
BACKGROUND Recent studies have shown that Hepatitis B virus (HBV) genotype E predominates in a vast crescent in West-Africa spanning from Senegal to Angola. OBJECTIVES To determine whether HBV strains in the Central African Republic (CAR) belong predominately to the homogeneous West-African genotype E or whether they are more closely related to genotypes found in East Africa. STUDY DESIGN Serum samples were randomly collected from 196 patients admitted with symptoms of acute or chronic hepatitis to the Central Hospital in Bangui. Thirty complete and 36 partial sequences of HBV strains were obtained. RESULTS Ninety-four percent (62/66) of the strains belonged to genotype E, while genotype A1, most closely related to a strain from Tanzania and genotype D were detected in only one and three samples, respectively. One strain presented a recombination between the S and X gene of a genotype E precursor and a partial PreC/C gene of a genotype D precursor. CONCLUSIONS Genotype E is predominant in CAR with little overlap with genotypes from Eastern Africa, extending the West-African HBV genotype E crescent further to the East.
Collapse
Affiliation(s)
- Claudine Bekondi
- Laboratoire de Virologie, Unité des Rétrovirus et des Hépatites virales, Institut Pasteur de Bangui, rue Pasteur, BP 923 Bangui, République Centrafricaine
| | | | | | | | | | | | | |
Collapse
|
38
|
Randrianirina F, Soares JL, Ratsima E, Carod JF, Combe P, Grosjean P, Richard V, Talarmin A. In vitro activities of 18 antimicrobial agents against Staphylococcus aureus isolates from the Institut Pasteur of Madagascar. Ann Clin Microbiol Antimicrob 2007; 6:5. [PMID: 17521424 PMCID: PMC1891307 DOI: 10.1186/1476-0711-6-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2007] [Accepted: 05/23/2007] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Staphylococcus aureus, one of the most frequently isolated pathogens in both hospitals and the community, has been particularly efficient at developing resistance to antimicrobial agents. In developed countries, as methicillin-resistant S. aureus (MRSA) has prevailed and, furthermore, as S. aureus with reduced susceptibility to vancomycin has emerged, the therapeutic options for the treatment of S. aureus infections have become limited. In developing countries and especially African countries very little is known concerning the resistance of S. aureus to antibiotics. In Madagascar no data exist concerning this resistance. OBJECTIVE To update the current status of antibiotic resistance of S. aureus in Antananarivo, Madagascar. METHODS Clinical S. aureus isolates were collected from patients at the Institut Pasteur of Madagascar from January 2001 to December 2005. Susceptibility tests with 18 antibiotics were performed by the disk diffusion method. RESULTS Among a total of 574 isolates, 506 were from community-acquired infections and 68 from nosocomial infections. There was no significant difference in the methicillin resistance rate between community-acquired strains (33 of 506; 6.5%) and nosocomial strains (3 of 68, 4.4%). Many MRSA isolates were resistant to multiple classes of antibiotics. Resistance to tetracyclin, trimethoprim-sulfamethoxazole and erythromycin was more common. Among MRSA isolates resistance rates to rifampicin, fusidic acid, gentamicin and ciprofloxacin were lower than that observed with other drugs easily available in Madagascar. No isolates were resistant to glycopeptides. CONCLUSION The rate of methicillin-resistant S. aureus is not different between community-acquired and nosocomial infections and is still rather low in Madagascar.
Collapse
Affiliation(s)
| | - Jean-Louis Soares
- Institut Pasteur de Madagascar, BP 1274, Antananarivo 101, Madagascar
| | - Elisoa Ratsima
- Institut Pasteur de Madagascar, BP 1274, Antananarivo 101, Madagascar
| | | | - Patrice Combe
- Institut Pasteur de Madagascar, BP 1274, Antananarivo 101, Madagascar
| | - Pierre Grosjean
- Institut Pasteur de Madagascar, BP 1274, Antananarivo 101, Madagascar
| | - Vincent Richard
- Institut Pasteur de Madagascar, BP 1274, Antananarivo 101, Madagascar
| | - Antoine Talarmin
- Institut Pasteur de Madagascar, BP 1274, Antananarivo 101, Madagascar
| |
Collapse
|
39
|
Frank T, Gautier V, Talarmin A, Bercion R, Arlet G. Characterization of sulphonamide resistance genes and class 1 integron gene cassettes in Enterobacteriaceae, Central African Republic (CAR). J Antimicrob Chemother 2007; 59:742-5. [PMID: 17350987 DOI: 10.1093/jac/dkl538] [Citation(s) in RCA: 71] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES The aim of this study was to characterize genes encoding sulphonamide resistance and gene cassettes associated with class 1 integrons in trimethoprim-sulphamethoxazole resistant Enterobacteriaceae recovered from Bangui, Central African Republic (CAR). METHODS We studied 78 clinical Enterobacteriaceae isolates, including 16 extended-spectrum beta-lactamases producers, 10 Salmonella and 9 Shigella, resistant to trimethoprim-sulphamethoxazole as assessed by the disc diffusion method. PCR was used to test for sul1 and sul2 genes. Class 1 integron resistance gene cassettes were characterized by directly sequencing PCR products obtained with primers recognising 5' and 3' conserved regions. RESULTS The sul1 gene was found in 67 isolates, the sul2 gene in 72 isolates and both genes in 62 isolates, while the int1 gene was found in 74 isolates. The most prevalent dfr genes were dfrA7 (49%), dfrA1 (17%) and dfrA2d (13%). CONCLUSION These results illustrate the wide distribution of sulphonamide and trimethoprim resistance genes among Enterobacteriaceae in Bangui (CAR).
Collapse
Affiliation(s)
- Thierry Frank
- Institut Pasteur de Bangui, Bangui, Central African Republic
| | | | | | | | | |
Collapse
|
40
|
Nouvel LX, Kassa-Kelembho E, Dos Vultos T, Zandanga G, Rauzier J, Lafoz C, Martin C, Blazquez J, Talarmin A, Gicquel B. Multidrug-resistant Mycobacterium tuberculosis, Bangui, Central African Republic. Emerg Infect Dis 2006; 12:1454-6. [PMID: 17073103 PMCID: PMC3298286 DOI: 10.3201/eid1209.060361] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
We investigated multidrug-resistant (MDR) Mycobacterium tuberculosis strains in Bangui, Central African Republic. We found 39.6% with the same spoligotype and synonymous single nucleotide polymorphism in the mutT1 gene. However, strains had different rpoB mutations responsible for rifampin resistance. MDR strains in Bangui may emerge preferentially from a single, MDR-prone family.
Collapse
|
41
|
Randrianirina F, Soares JL, Carod JF, Ratsima E, Thonnier V, Combe P, Grosjean P, Talarmin A. Antimicrobial resistance among uropathogens that cause community-acquired urinary tract infections in Antananarivo, Madagascar. J Antimicrob Chemother 2006; 59:309-12. [PMID: 17138569 DOI: 10.1093/jac/dkl466] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Urinary tract pathogens obtained from patients in Madagascar are becoming increasingly resistant to commonly used antibiotics that are readily available at a low price. This poses a real problem for the treatment of community-acquired urinary tract infections (UTIs) in Madagascar. OBJECTIVES To obtain data on the pathogens responsible for community-acquired UTIs in Antananarivo and on their susceptibility patterns to the antimicrobial agents that are currently used to treat UTIs. METHODS We conducted a retrospective study on bacteria isolated from the urine of patients at the Institut Pasteur of Madagascar between January 2004 and April 2006. RESULTS We isolated 903 pathogens from 673 women and 213 men. The most commonly isolated bacteria were Escherichia coli (607 strains), Klebsiella pneumoniae (87 strains), Staphylococcus aureus (35 strains) and Proteus mirabilis (32 strains). Seventy-seven per cent of Gram-negative bacilli were resistant to amoxicillin, 65.7% were resistant to trimethoprim/sulfamethoxazole and more than 15% were resistant to ciprofloxacin. Strains were rarely resistant to more expensive antibiotics (ceftriaxone 5.9%, fosfomycin 4.6%). Most bacteria showed intermediate susceptibility to nitroxolin. Resistance rates of E. coli to ceftriaxone and gentamicin increased significantly between 2005 and 2006, due to the increase in strains harbouring an extended-spectrum beta-lactamase. Gram-positive bacteria, Streptococcaceae and Staphylococcus spp. were rarely resistant, but 9.5% of streptococci were resistant to penicillin A and 8% of staphylococci were resistant to oxacillin. CONCLUSIONS The rate of amoxicillin- and trimethoprim/sulfamethoxazole-resistant Enterobacteriaceae implies that another antibiotic should be used for empirical treatment and that there is a need for new generic drugs in developing countries, especially in Madagascar.
Collapse
|
42
|
Affiliation(s)
- Thierry Frank
- Institut Pasteur de Bangui, Bangui, Central African Republic
| | - Guillaume Arlet
- Université Pierre et Marie Curie (Paris VI), Paris, France
- Hôpital Tenon AP-HP, Paris, France
| | | | | | - Raymond Bercion
- Institut Pasteur de Bangui, Bangui, Central African Republic
| |
Collapse
|
43
|
Menard D, Yapou F, Manirakiza A, Djalle D, Matsika-Claquin MD, Talarmin A. Polymorphisms in pfcrt, pfmdr1, dhfr genes and in vitro responses to antimalarials in Plasmodium falciparum isolates from Bangui, Central African Republic. Am J Trop Med Hyg 2006; 75:381-7. [PMID: 16968910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/11/2023] Open
Abstract
Drug resistance is probably the greatest challenge to most malaria-control programs. Given the limited resources for other malarial-control measures, rational drug used is crucial. Molecular markers for parasite resistance such as pfcrt, pfmdr-1, and dhfr have the potential to be used in an integrated fashion to provide timely information that is useful to policy makers. Therefore, we evaluated polymorphisms in these genes from Plasmodium falciparum and their association with in vitro antimalarial drug resistance to 135 parasites samples collected in Bangui in 2004. For the dhfr gene, we found a strong association between the dhfr genotype and chemosensitivity to pyrimethamine. For the pfcrt gene, we found that haplotypes with mutant-type alleles led to significant changes in the IC50 values for chloroquine, monodesethylamodiaquine, and quinine. We found no correlations for the pfmdr1 gene. These findings suggest that a regular monitoring and screening for resistance markers for antifolates and for chloroquine could act as an adjunct to in vivo trials.
Collapse
Affiliation(s)
- Didier Menard
- Pasteur Institute of Bangui, Bangui, Central African Republic.
| | | | | | | | | | | |
Collapse
|
44
|
Kassa-Kelembho E, Kassa E, Zandanga G, Service YB, Ignaleamoko A, Talarmin A. Poor performance of a novel serological test for diagnosis of pulmonary tuberculosis in Bangui, Central African Republic. Clin Vaccine Immunol 2006; 13:702-3. [PMID: 16760330 PMCID: PMC1489549 DOI: 10.1128/cvi.00194-05] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
We assessed the performance of a serological test for tuberculosis (SDHO Laboratories Inc., Canada) in our setting. Among 68 of 99 suspected pulmonary tuberculosis patients who were scored as having tuberculosis on the basis of Mycobacterium tuberculosis-positive culture, the sensitivity of the serological test was lower than that of sputum smear microscopic examination (20.6% versus 80.9%, respectively; P < 0.000001).
Collapse
|
45
|
Matsika-Claquin MD, Ménard D, Fontanet AL, Ngwhotue A, Sarda J, Talarmin A. Efficacy of chloroquine–proguanil malaria prophylaxis in a non-immune population in Bangui, Central African Republic: a case–control study. Trans R Soc Trop Med Hyg 2006; 100:381-6. [PMID: 16313935 DOI: 10.1016/j.trstmh.2005.07.022] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2004] [Revised: 06/28/2005] [Accepted: 07/15/2005] [Indexed: 10/25/2022] Open
Abstract
A case-control study was conducted to evaluate the efficacy of the combination of chloroquine plus proguanil as malaria prophylaxis in a non-immune population living in the Central African Republic. Cases were patients presenting with a malaria attack confirmed by a positive blood film and/or an HRP2 positive antigen test at the Pasteur Institute of Bangui. Two control subjects were included per case: one was a relative or close friend and the other was matched to the patient with respect to the length of stay. A questionnaire assessing malaria prophylaxis habits and malarial risk factors over the 2-month period prior to inclusion in the study was given to 48 cases and 96 controls. A conditional logistic regression was used to identify risk factors. The efficacy of the chloroquine plus proguanil regimen was found to be high (95.5%, 95% CI 74.0-99.2%) in this country known for high chloroquine resistance. Our data lend some support to the use of chloroquine plus proguanil in Bangui, and the protective efficacy of chloroquine plus proguanil should now be studied prospectively as part of a randomised controlled trial of various prophylactic drugs.
Collapse
Affiliation(s)
- M D Matsika-Claquin
- Epidemiology Unit, Pasteur Institute of Bangui, Central African Republic, Ambassade de France à Bangui (RCA), 75351 Paris 07 SP, France.
| | | | | | | | | | | |
Collapse
|
46
|
Menard D, Djalle D, Yapou F, Manirakiza A, Talarmin A. Frequency distribution of antimalarial drug-resistant alleles among isolates of Plasmodium falciparum in Bangui, Central African Republic. Am J Trop Med Hyg 2006; 74:205-10. [PMID: 16474071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/06/2023] Open
Abstract
We determined the baseline frequency distribution of mutant alleles of genes associated with resistance to chloroquine and sulfadoxine-pyrimethamine in Plasmodium falciparum isolates in Bangui, Central African Republic. Mutant alleles of the P. falciparum chloroquine resistance transporter (pfcrt) gene were found in all samples and the frequency of the deduced CIET pfcrt haplotype was high (45%). The most common allele of the P. falciparum multidrug resistance 1 (pfmdr1) gene among the field isolates of P. falciparum was 86Y (21.9%). The 1246Y allele was also common (18.0%). Of the 167 P. falciparum isolates in which the dihydrofolate reductase gene was studied, only 11 carried the wild-type allele (6.6%) whereas many (50.3%) were quadruple mutants (50R, 51I, 59R, 108N). The frequency of the 436A mutant allele of the dihydropteroate synthase gene was high (74.3%), but the frequencies of the 437G (18.6%) and 540E (5.2%) mutant alleles were low. Molecular analyses of antimalarial drug-resistant alleles of P. falciparum isolates in Bangui strongly suggest the widespread distribution of chloroquine and pyrimethamine resistance and to a lesser extent sulfadoxine resistance.
Collapse
Affiliation(s)
- Didier Menard
- Pasteur Institute of Bangui, Bangui, Central African Republic
| | | | | | | | | |
Collapse
|
47
|
Lavergne A, de Thoisy B, Lacoste V, Pascalis H, Pouliquen JF, Mercier V, Tolou H, Dussart P, Morvan J, Talarmin A, Kazanji M. Mayaro virus: complete nucleotide sequence and phylogenetic relationships with other alphaviruses. Virus Res 2005; 117:283-90. [PMID: 16343676 DOI: 10.1016/j.virusres.2005.11.006] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2005] [Revised: 11/08/2005] [Accepted: 11/08/2005] [Indexed: 11/23/2022]
Abstract
Mayaro (MAY) virus is a member of the genus Alphavirus in the family Togaviridae. Alphaviruses are distributed throughout the world and cause a wide range of diseases in humans and animals. Here, we determined the complete nucleotide sequence of MAY from a viral strain isolated from a French Guianese patient. The deduced MAY genome was 11,429 nucleotides in length, excluding the 5' cap nucleotide and 3' poly(A) tail. Nucleotide and amino acid homologies, as well as phylogenetic analyses of the obtained sequence confirmed that MAY is not a recombinant virus and belongs to the Semliki Forest complex according to the antigenic complex classification. Furthermore, analyses based on the E1 region revealed that MAY is closely related to Una virus, the only other South American virus clustering with the Old World viruses. On the basis of our results and of the alphaviruses diversity and pathogenicity, we suggest that alphaviruses may have an Old World origin.
Collapse
Affiliation(s)
- Anne Lavergne
- Laboratoire de Rétrovirologie, Institut Pasteur de la Guyane, 23 avenue Pasteur, BP6010, 97306 Cayenne cedex, French Guiana
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
48
|
Kazanji M, Dussart P, Duprez R, Tortevoye P, Pouliquen JF, Vandekerkhove J, Couppié P, Morvan J, Talarmin A, Gessain A. Serological and molecular evidence that human herpesvirus 8 is endemic among Amerindians in French Guiana. J Infect Dis 2005; 192:1525-9. [PMID: 16206066 DOI: 10.1086/491744] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2005] [Accepted: 05/25/2005] [Indexed: 11/04/2022] Open
Abstract
We evaluated the presence of human herpesvirus 8 (HHV-8) infection among groups of Amerindians in French Guiana. The overall prevalence of antibodies against lytic HHV-8 antigens was 23.0% (180/781), increasing from 18.4% in children <6 years old to approximately 30% in older persons (>45 years). Seroprevalence was higher in Amerindians living in remote localities than it was in those living in the coastal region. Analysis of a 725-base pair fragment of the K1 gene amplified from DNA from a Wayampi Amerindian showed that the virus belonged to molecular subtype E, which has hitherto been found in only a few Amerindians in Brazil and Ecuador.
Collapse
Affiliation(s)
- Mirdad Kazanji
- Laboratoire de Retrovirologie, Institut Pasteur de la Guyane, Cayenne, French Guiana.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
49
|
Menard D, Matsika-Claquin MD, Djalle D, Yapou F, Manirakiza A, Dolmazon V, Sarda J, Talarmin A. Association of failures of seven-day courses of artesunate in a non-immune population in Bangui, Central African Republic with decreased sensitivity of Plasmodium falciparum. Am J Trop Med Hyg 2005; 73:616-21. [PMID: 16172492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/04/2023] Open
Abstract
We assessed the efficacy and safety of a seven-day course of artesunate for the treatment of uncomplicated Plasmodium falciparum malaria in 55 non-immune patients living in Bangui, Central African Republic. The parasitologic cure rates were 100%, 95%, and 85% on days 14, 28, and 42, respectively. There were no significant differences in parasitemia density, 50% inhibitory concentration of dihydroartemisinin, and frequency of mutant P. falciparum multidrug resistance 1 codon 86 between patients who were cured and those who displayed recrudescence. However, the 90% inhibitory concentration for dihydroartemisinin and the number of genotypes isolated were both higher in the recrudescent patients (five- and two-fold, respectively). We found an association between recrudescence and decreased sensitivity. This suggests that the use of artemisinin compounds alone will select resistant strains. We conclude that artesunate should not be used in monotherapy even in seven-day courses, but only in combination with other anti-malarials to prevent the emergence of resistant P. falciparum.
Collapse
Affiliation(s)
- Didier Menard
- Institut Pasteur de Bangui, Bangui, Central African Republic.
| | | | | | | | | | | | | | | |
Collapse
|
50
|
Menard D, Djalle D, Manirakiza A, Yapou F, Siadoua V, Sana S, Matsika-Claquin MD, Nestor M, Talarmin A. Drug-resistant malaria in Bangui, Central African Republic: an in vitro assessment. Am J Trop Med Hyg 2005; 73:239-43. [PMID: 16103582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/04/2023] Open
Abstract
We used an in vitro isotopic drug sensitivity assay to assess the sensitivity of Plasmodium falciparum isolates collected in Bangui, Central African Republic between March and July 2004. We tested antimalarials that are currently in use in this country (chloroquine, amodiaquine, quinine, and pyrimethamine), antimalarials that will become available in this region in the future (artemisinin and halofantrine), and prophylactic antimalarials (mefloquine, doxycycline, and atovaquone). The proportions of resistant isolates were 37% for chloroquine, 15.9% for amodiaquine, 0% for quinine, 0% for dihydroartemisinin, 1.6% for mefloquine, 3.8% for halofantrine, 4.0% for atovaquone, and 38.3% for pyrimethamine. No multi-resistant isolates (showing resistance to more than three drugs) were found. A positive correlation was found between the 50% inhibitory concentrations values for the following drugs: chloroquine and amodiaquine; quinine and halofantrine; chloroquine and dihydroartemisinin; chloroquine and halofantrine; amodiaquine and dihydroartemisinin; dihydroartemisinin and mefloquine; chloroquine and quinine; and quinine and dihydroartemisinin. These findings suggest that the Ministry of Health should recommend a interim policy with the amodiaquine plus sulfadoxine-pyrimethamine combination as the first-line antimalarial drug in Bangui until better alternative treatments such as artemisinin-based combination therapies become available at low prices in the Central African Republic.
Collapse
Affiliation(s)
- Didier Menard
- Pasteur Institute of Bangui, Bangui, Central African Republic.
| | | | | | | | | | | | | | | | | |
Collapse
|