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Desmoulin A, Sababadichetty L, Kamus L, Daniel M, Feletti L, Allou N, Potron A, Leroy AG, Jaffar-Bandjee MC, Belmonte O, Garrigos T, Miltgen G. Adaptive resistance to cefiderocol in carbapenem-resistant Acinetobacter baumannii (CRAB): Microbiological and clinical issues. Heliyon 2024; 10:e30365. [PMID: 38720704 PMCID: PMC11076957 DOI: 10.1016/j.heliyon.2024.e30365] [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: 11/15/2023] [Revised: 04/23/2024] [Accepted: 04/24/2024] [Indexed: 05/12/2024] Open
Abstract
Objectives Determining the best available therapy for carbapenem-resistant Acinetobacter baumannii (CRAB) infections is a challenge. Cefiderocol is an attractive alternative drug effective against many resistance mechanisms in Gram-negative bacteria. However, its place in the treatment of Acinetobacter baumannii infections remains unclear and much debated, with contradictory results. Methods We describe here the case of a 37-year-old man with ventilator-associated bacteraemic CRAB pneumonia in an intensive care unit. He was initially treated with a combination of colistin and tigecycline, and was then switched onto colistin and cefiderocol. We then used a new accessible protocol to test 30 CRAB isolates (OXA-23/OXA-24/OXA-58/NDM-1) for adaptive resistance to cefiderocol (ARC) after exposure to this drug. Results After clinical failure with the initial combination, we noted a significant clinical improvement in the patient on the second combination, leading to clinical cure. No ARC was detected in the two OXA-23 case-CRAB isolates. All NDM-1 CRAB isolates were resistant to cefiderocol in standard tests; the OXA-23, OXA-24 and OXA-58 CRAB isolates presented 84.2 %, 50 % and 0 % ARC, respectively. Conclusions ARC is not routinely assessed for CRAB isolates despite frequently being reported in susceptible isolates (69.2 %). Subpopulations displaying ARC may account for treatment failure, but this hypothesis should be treated with caution in the absence of robust clinical data. The two main findings of this work are that (i) cefiderocol monotherapy should probably not be recommended for OXA-23/24 CRAB infections and (ii) the characterisation of carbapenemases in CRAB strains may be informative for clinical decision-making.
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Affiliation(s)
- Anissa Desmoulin
- Laboratoire de Bactériologie, CHU Félix Guyon, Saint-Denis, La Réunion, France
| | - Loïk Sababadichetty
- UMR PIMIT, Processus Infectieux en Milieu Insulaire Tropical, CNRS 9192, INSERM U1187, IRD 249, Université de La Réunion, Sainte-Clotilde, La Réunion, France
| | - Laure Kamus
- Laboratoire de Bactériologie, CHU Félix Guyon, Saint-Denis, La Réunion, France
- UMR PIMIT, Processus Infectieux en Milieu Insulaire Tropical, CNRS 9192, INSERM U1187, IRD 249, Université de La Réunion, Sainte-Clotilde, La Réunion, France
| | - Marion Daniel
- UMR PIMIT, Processus Infectieux en Milieu Insulaire Tropical, CNRS 9192, INSERM U1187, IRD 249, Université de La Réunion, Sainte-Clotilde, La Réunion, France
| | - Lucie Feletti
- Laboratoire de Bactériologie, CHU Félix Guyon, Saint-Denis, La Réunion, France
| | - Nicolas Allou
- Service de Réanimation Polyvalente, CHU Félix Guyon, Saint-Denis, La Réunion, France
| | - Anaïs Potron
- Centre National de La Résistance Aux Antibiotiques, Laboratoire Associé Pseudomonas et Acinetobacter, CHU Jean Minjoz, Besançon, France
| | - Anne-Gaëlle Leroy
- Laboratoire de Bactériologie, Groupe Hospitalier Sud Réunion, Saint-Pierre, La Réunion, France
| | | | - Olivier Belmonte
- Laboratoire de Bactériologie, CHU Félix Guyon, Saint-Denis, La Réunion, France
| | - Thomas Garrigos
- Laboratoire de Bactériologie, CHU Félix Guyon, Saint-Denis, La Réunion, France
- UMR PIMIT, Processus Infectieux en Milieu Insulaire Tropical, CNRS 9192, INSERM U1187, IRD 249, Université de La Réunion, Sainte-Clotilde, La Réunion, France
- Centre Régional en Antibiothérapie de La Réunion, Saint-Denis, La Réunion, France
| | - Guillaume Miltgen
- Laboratoire de Bactériologie, CHU Félix Guyon, Saint-Denis, La Réunion, France
- UMR PIMIT, Processus Infectieux en Milieu Insulaire Tropical, CNRS 9192, INSERM U1187, IRD 249, Université de La Réunion, Sainte-Clotilde, La Réunion, France
- Centre Régional en Antibiothérapie de La Réunion, Saint-Denis, La Réunion, France
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Sarsiat L, Garrigos T, Houhamdi L, Dauwalder O, Kuli B, Braunberger E, Belmonte O, Fournier PE, Miltgen G. Case series of 12 Bartonella quintana endocarditis from the Southwest Indian Ocean. PLoS Negl Trop Dis 2023; 17:e0011606. [PMID: 37676863 PMCID: PMC10508605 DOI: 10.1371/journal.pntd.0011606] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 09/19/2023] [Accepted: 08/20/2023] [Indexed: 09/09/2023] Open
Abstract
BACKGROUND Bartonella spp. are fastidious bacteria frequently identified as the cause of blood culture-negative (BCN) endocarditis. However, Bartonella infections are difficult to diagnose in routine laboratory testing and their incidence is probably underestimated. We investigated the epidemiological and clinical features of Bartonella endocarditis cases diagnosed between 2009 and 2021 on Reunion Island (Southwest Indian Ocean). METHOD We retrospectively included all patients diagnosed with Bartonella endocarditis at Reunion Island University Hospital during this period. Endocarditis was diagnosed on the basis of microbiological findings, including serological tests (IFA) and PCR on cardiac valves, and the modified Duke criteria. We used then the multispacer typing (MST) method to genotype the available Bartonella strains. FINDINGS We report 12 cases of B. quintana endocarditis on Reunion Island (83.3% in men, median patient age: 32 years). All the patients originated from the Comoros archipelago. The traditional risk factors for B. quintana infection (homelessness, alcoholism, exposure to body lice) were absent in all but two of the patients, who reported head louse infestations in childhood. Previous heart disease leading to valve dysfunction was recorded in 50% of patients. All patients underwent cardiac valve surgery and antimicrobial therapy with a regimen including doxycycline. All patients presented high C-reactive protein concentrations, anemia and negative blood cultures. The titer of IgG antibodies against Bartonella sp. exceeded 1:800 in 42% of patients. Specific PCR on cardiac valves confirmed the diagnosis of B. quintana endocarditis in all patients. Genotyping by the MST method was performed on four strains detected in preserved excised valves and was contributive for three, which displayed the MST6 genotype. CONCLUSIONS Bartonella quintana is an important cause of infective endocarditis in the Comoros archipelago and should be suspected in patients with mitral valve dysfunction and BCN from this area.
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Affiliation(s)
- Ludivine Sarsiat
- Laboratoire de Bactériologie, CHU Félix Guyon, Saint-Denis, La Réunion, France
| | - Thomas Garrigos
- Laboratoire de Bactériologie, CHU Félix Guyon, Saint-Denis, La Réunion, France
- UMR Processus Infectieux en Milieu Insulaire Tropical (PIMIT), CNRS 9192, INSERM U1187, IRD 249, Université de La Réunion, Saint-Denis, La Réunion, France
| | - Linda Houhamdi
- CNR des Rickettsies, Coxiella et Bartonella, IHU-Méditerranée Infection, Marseille, France
| | - Olivier Dauwalder
- Plateau de Microbiologie Moléculaire Spécialisé et de Séquençage, Institut des Agents Infectieux, Centre de Biologie et Pathologie Nord, Hospices Civils de Lyon, Lyon, France
| | - Barbara Kuli
- Service de Maladies Infectieuses, CHU Félix Guyon, Saint-Denis, La Réunion, France
| | - Eric Braunberger
- Service de Chirurgie Cardio-thoracique, CHU Félix Guyon, Saint-Denis, La Réunion, France
| | - Olivier Belmonte
- Laboratoire de Bactériologie, CHU Félix Guyon, Saint-Denis, La Réunion, France
| | - Pierre-Edouard Fournier
- CNR des Rickettsies, Coxiella et Bartonella, IHU-Méditerranée Infection, Marseille, France
- UMR Vecteurs—Infections Tropicales et Méditerranéennes (VITROME), Université d’Aix-Marseille, IRD, AP-HM, SSA, IHU-Méditerranée Infection, Marseille, France
| | - Guillaume Miltgen
- Laboratoire de Bactériologie, CHU Félix Guyon, Saint-Denis, La Réunion, France
- UMR Processus Infectieux en Milieu Insulaire Tropical (PIMIT), CNRS 9192, INSERM U1187, IRD 249, Université de La Réunion, Saint-Denis, La Réunion, France
- Centre Régional en Antibiothérapie (CRAtb) de La Réunion, France
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Combe A, Kovacs D, de Mangou A, Miltgen G, Traversier N, Belmonte O, Simon O, Vidal C, Coolen-Allou N, Allyn J, Allou N. Impact of the COVID-19 pandemic on severe non-SARS-CoV-2 community-acquired pneumonia in Reunion Island: a multicenter retrospective observational study, 2016-2021. Sci Rep 2023; 13:14013. [PMID: 37640709 PMCID: PMC10462684 DOI: 10.1038/s41598-023-40791-5] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 08/16/2023] [Indexed: 08/31/2023] Open
Abstract
The Coronavirus 2019 (COVID-19) pandemic has had a considerable impact on the incidence of severe community-acquired pneumonia (CAP) worldwide. The aim of this study was to assess the early impact of the COVID-19 pandemic in the Reunion Island. This multicenter retrospective observational study was conducted from 2016 to 2021 in the hospitals of Reunion Island. The incidence of severe non-SARS-CoV-2 CAP, microorganisms, characteristics and outcomes of patients hospitalized in intensive care unit were compared between the pre-COVID-19 period (January 1, 2016 to February 29, 2020) and the early COVID-19 period (March 1, 2020 to October 31, 2021). Over the study period, 389 patients developed severe non-SARS-CoV-2 CAP. The incidence of severe non-SARS-CoV-2 CAP significantly decreased between the two periods (9.16 vs. 4.13 cases per 100,000 person-years). The influenza virus was isolated in 43.5% patients with severe non-SARS-CoV-2 CAP in the pre-COVID-19 period and in none of the 60 patients in the early COVID-19 period (P < 0.0001). The only virus that did not decrease was rhinovirus. Streptococcus pneumoniae was the most frequently isolated bacterial microorganism, with no significant difference between the two periods. In Reunion Island, the COVID-19 pandemic led to a significant decrease in the incidence of influenza, which likely explains the observed decrease in the incidence of severe non-SARS-CoV-2 CAP. The pandemic had no impact on the incidence of other viral and bacterial severe non-SARS-CoV-2 CAP. Monitoring influenza incidence is crucial now that COVID-19 control measures have been removed.
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Affiliation(s)
- Agathe Combe
- Intensive Care Unit, Centre Hospitalier Universitaire de La Réunion, Saint-Denis, Reunion Island, France
| | - David Kovacs
- Intensive Care Unit, Centre Hospitalier Universitaire de La Réunion, Saint-Denis, Reunion Island, France
| | - Axel de Mangou
- Intensive Care Unit, Centre Hospitalier Universitaire de La Réunion, Saint-Denis, Reunion Island, France
| | - Guillaume Miltgen
- Microbiology, Centre Hospitalier Universitaire de La Réunion, Saint-Denis, Reunion Island, France
- UMR Processus Infectieux en Milieu Insulaire Tropical, CNRS 9192, INSERM U1187, IRD 249, Centre Hospitalier Universitaire de La Réunion, Saint-Denis, Reunion Island, France
| | - Nicolas Traversier
- UMR Processus Infectieux en Milieu Insulaire Tropical, CNRS 9192, INSERM U1187, IRD 249, Centre Hospitalier Universitaire de La Réunion, Saint-Denis, Reunion Island, France
| | - Olivier Belmonte
- UMR Processus Infectieux en Milieu Insulaire Tropical, CNRS 9192, INSERM U1187, IRD 249, Centre Hospitalier Universitaire de La Réunion, Saint-Denis, Reunion Island, France
| | - Olivier Simon
- Intensive Care Unit, Centre Hospitalier Universitaire de La Réunion, Saint-Pierre, Reunion Island, France
| | - Charles Vidal
- Intensive Care Unit, Centre Hospitalier Universitaire de La Réunion, Saint-Denis, Reunion Island, France
| | - Nathalie Coolen-Allou
- Respiratory Medicine, Centre Hospitalier Universitaire de La Réunion, Saint-Denis, Reunion Island, France
| | - Jérôme Allyn
- Intensive Care Unit, Centre Hospitalier Universitaire de La Réunion, Saint-Denis, Reunion Island, France
- Clinical Informatic Department, Centre Hospitalier Universitaire Felix Guyon, Saint-Denis, Reunion Island, France
| | - Nicolas Allou
- Intensive Care Unit, Centre Hospitalier Universitaire de La Réunion, Saint-Denis, Reunion Island, France.
- Clinical Informatic Department, Centre Hospitalier Universitaire Felix Guyon, Saint-Denis, Reunion Island, France.
- Hôpital Felix Guyon, Réanimation Polyvalente, Bellepierre, 97405, Saint-Denis, France.
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Garrigos T, Grimal A, Badell E, Traversier N, Picot S, Lignereux A, Ramiandrisoa M, Ben Cimon C, Jaffar-Bandjee MC, Gbaguidi-Haore H, Toubiana J, Brisse S, Miltgen G, Belmonte O. Emerging Corynebacterium diphtheriae Species Complex Infections, Réunion Island, France, 2015-2020. Emerg Infect Dis 2023; 29:1630-1633. [PMID: 37486209 PMCID: PMC10370861 DOI: 10.3201/eid2908.230106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/25/2023] Open
Abstract
Clinical, epidemiologic, and microbiologic analyses revealed emergence of 26 cases of Corynebacterium diphtheriae species complex infections on Réunion Island, France, during 2015-2020. Isolates were genetically diverse, indicating circulation and local transmission of several diphtheria sublineages. Clinicians should remain aware of the risk for diphtheria and improve diagnostic methods and patient management.
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de Mangou A, Combe A, Coolen-Allou N, Miltgen G, Traversier N, Belmonte O, Vandroux D, Bohrer M, Cousty J, Caron M, Vidal C, Allyn J, Allou N. Severe community-acquired pneumonia in Reunion Island: Epidemiological, clinical, and microbiological characteristics, 2016–2018. PLoS One 2022; 17:e0267184. [PMID: 35427402 PMCID: PMC9012352 DOI: 10.1371/journal.pone.0267184] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 04/04/2022] [Indexed: 12/17/2022] Open
Abstract
Purpose No data are available on severe community-acquired pneumonia (CAP) in the French overseas department of Reunion Island. This is unfortunate as the microorganisms responsible for the disease are likely to differ from those in temperate regions due to a tropical climate and proximity to other islands of the Indian Ocean region. The aim of this study was to assess the epidemiological, clinical, prognosis, and microbiological characteristics of patients with severe CAP in Reunion Island. Materials and methods This retrospective study evaluated all patients with CAP aged >18 years and hospitalized in one of the two intensive care units of Reunion Island between 2016 and 2018. Microorganisms were identified by culture from blood and respiratory samples, multiplex polymerase chain reaction from respiratory samples, urinary antigen tests, and serology. Results Over the study period, 573 cases of severe CAP were recorded, with a mean incidence of 22 per 100,000 person-years. The most frequently isolated microorganism was influenza (21.9%) followed by Streptococcus pneumoniae (12%). The influenza virus was detected in affected patients all year round. Twenty-four patients with severe CAP came from another island of the Indian Ocean region (4.2%), mainly Madagascar (>50%). Two of these patients presented with melioidosis and 4 were infected with Acinetobacter spp. Conclusions Our findings have major implications for the management of severe CAP in tropical regions. The most frequently isolated microorganism in patients with severe CAP in Reunion Island is influenza followed by S. pneumoniae. Physicians should be aware that influenza is the main cause of severe CAP in patients living in or returning from Reunion Island, where this virus circulates all year round.
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Affiliation(s)
- Axel de Mangou
- Intensive Care Unit, Centre Hospitalier Universitaire Felix Guyon, Saint-Denis, France
| | - Agathe Combe
- Intensive Care Unit, Centre Hospitalier Universitaire Felix Guyon, Saint-Denis, France
| | - Nathalie Coolen-Allou
- Respiratory Disease, Centre Hospitalier Universitaire Felix Guyon, Saint-Denis, France
| | - Guillaume Miltgen
- Microbiology, Centre Hospitalier Universitaire Felix Guyon, Saint-Denis, France
- UMR Processus Infectieux en Milieu Insulaire Tropical, CNRS 9192, INSERM U1187, IRD 249, Université de la Réunion, Saint-Denis, France
| | - Nicolas Traversier
- Microbiology, Centre Hospitalier Universitaire Felix Guyon, Saint-Denis, France
| | - Olivier Belmonte
- Microbiology, Centre Hospitalier Universitaire Felix Guyon, Saint-Denis, France
| | - David Vandroux
- Intensive Care Unit, Centre Hospitalier Universitaire Felix Guyon, Saint-Denis, France
| | - Michel Bohrer
- Department of Medical Information, Saint-Denis University Hospital, Saint-Denis, Reunion Island, France
| | - Julien Cousty
- Intensive Care Unit, Centre Hospitalier Universitaire Sud Réunion, Saint-Pierre, France
| | - Margot Caron
- Intensive Care Unit, Centre Hospitalier Universitaire Felix Guyon, Saint-Denis, France
| | - Charles Vidal
- Intensive Care Unit, Centre Hospitalier Universitaire Felix Guyon, Saint-Denis, France
| | - Jérôme Allyn
- Intensive Care Unit, Centre Hospitalier Universitaire Felix Guyon, Saint-Denis, France
- Clinical Informatic Department, Saint-Denis University Hospital, Saint-Denis, Reunion Island, France
| | - Nicolas Allou
- Intensive Care Unit, Centre Hospitalier Universitaire Felix Guyon, Saint-Denis, France
- Clinical Informatic Department, Saint-Denis University Hospital, Saint-Denis, Reunion Island, France
- * E-mail:
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Miltgen G, Martak D, Valot B, Kamus L, Garrigos T, Verchere G, Gbaguidi-Haore H, Ben Cimon C, Ramiandrisoa M, Picot S, Lignereux A, Masson G, Jaffar-Bandjee MC, Belmonte O, Cardinale E, Hocquet D, Mavingui P, Bertrand X. OUP accepted manuscript. J Antimicrob Chemother 2022; 77:1254-1262. [PMID: 35194647 PMCID: PMC9047676 DOI: 10.1093/jac/dkac054] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [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: 08/06/2021] [Accepted: 02/01/2022] [Indexed: 11/18/2022] Open
Abstract
Background Extended-spectrum β-lactamase-producing Escherichia coli (ESBL-Ec) is a major cause of infections worldwide. An understanding of the reservoirs and modes of transmission of these pathogens is essential, to tackle their increasing frequency. Objectives We investigated the contributions of various compartments (humans, animals, environment), to human colonization or infection with ESBL-Ec over a 3 year period, on an island. Methods The study was performed on Reunion Island (Southwest Indian Ocean). We collected ESBL-Ec isolates prospectively from humans, wastewater and livestock between April 2015 and December 2018. Human specimens were recovered from a regional surveillance system representative of the island’s health facilities. These isolates were compared with those from livestock and urban/rural wastewater, by whole-genome sequencing. Results We collected 410 ESBL-Ec isolates: 161 from humans, 161 from wastewater and 88 from animals. Phylogenomic analysis demonstrated high diversity (100 STs), with different STs predominating among isolates from humans (ST131, ST38, ST10) and animals (ST57, ST156). The large majority (90%) of the STs, including ST131, were principally associated with a single compartment. The CTX-M-15, CTX-M-27 and CTX-M-14 enzymes were most common in humans/human wastewater, whereas CTX-M-1 predominated in animals. Isolates of human and animal origin had different plasmids carrying blaCTX-M genes, with the exception of a conserved IncI1-ST3 blaCTX-M-1 plasmid. Conclusions These molecular data suggest that, despite their high level of contamination, animals are not a major source of the ESBL-Ec found in humans living on this densely populated high-income island. Public health policies should therefore focus primarily on human-to-human transmission, to prevent human infections with ESBL-Ec.
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Affiliation(s)
- Guillaume Miltgen
- Laboratoire de Bactériologie, CHU Félix Guyon, Saint-Denis, La Réunion, France
- UMR Processus Infectieux en Milieu Insulaire Tropical, CNRS 9192, INSERM U1187, IRD 249, Université de La Réunion, Sainte-Clotilde, La Réunion, France
- Corresponding author. E-mail:
| | - Daniel Martak
- Service d’Hygiène Hospitalière, CHU Besançon, France
- UMR-CNRS 6249 Chrono-Environnement, Université de Bourgogne Franche-Comté, Besançon, France
| | - Benoit Valot
- UMR-CNRS 6249 Chrono-Environnement, Université de Bourgogne Franche-Comté, Besançon, France
| | - Laure Kamus
- Laboratoire de Bactériologie, CHU Félix Guyon, Saint-Denis, La Réunion, France
| | - Thomas Garrigos
- Laboratoire de Bactériologie, CHU Félix Guyon, Saint-Denis, La Réunion, France
| | - Guillaume Verchere
- UMR Processus Infectieux en Milieu Insulaire Tropical, CNRS 9192, INSERM U1187, IRD 249, Université de La Réunion, Sainte-Clotilde, La Réunion, France
| | - Houssein Gbaguidi-Haore
- Service d’Hygiène Hospitalière, CHU Besançon, France
- UMR-CNRS 6249 Chrono-Environnement, Université de Bourgogne Franche-Comté, Besançon, France
| | | | | | - Sandrine Picot
- Laboratoire de Bactériologie, Groupe Hospitalier Sud Réunion, Saint-Pierre, La Réunion, France
| | - Anne Lignereux
- Laboratoire de Biologie, Centre Hospitalier Ouest Réunion, Saint-Paul, La Réunion, France
| | - Geoffrey Masson
- Laboratoire de Biologie, Groupe Hospitalier Est Réunion, Saint-Benoit, La Réunion, France
| | | | - Olivier Belmonte
- Laboratoire de Bactériologie, CHU Félix Guyon, Saint-Denis, La Réunion, France
| | - Eric Cardinale
- Centre de Coopération International en Recherche Agronomique pour le Développement (CIRAD) Océan Indien (Réunion-Mayotte), Sainte-Clotilde, La Réunion, France
- UMR Animal, Santé, Territoires, Risques et Écosystèmes, INRAe 1309, Université de Montpellier, Montpellier, France
| | - Didier Hocquet
- Service d’Hygiène Hospitalière, CHU Besançon, France
- UMR-CNRS 6249 Chrono-Environnement, Université de Bourgogne Franche-Comté, Besançon, France
| | - Patrick Mavingui
- UMR Processus Infectieux en Milieu Insulaire Tropical, CNRS 9192, INSERM U1187, IRD 249, Université de La Réunion, Sainte-Clotilde, La Réunion, France
| | - Xavier Bertrand
- Service d’Hygiène Hospitalière, CHU Besançon, France
- UMR-CNRS 6249 Chrono-Environnement, Université de Bourgogne Franche-Comté, Besançon, France
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Miltgen G, Garrigos T, Cholley P, Deleume M, Allou N, Allyn J, Wilkinson DA, Lugagne N, Belmonte O, Bertrand X, Hocquet D, Mavingui P. Nosocomial cluster of carbapenemase-producing Enterobacter cloacae in an intensive care unit dedicated COVID-19. Antimicrob Resist Infect Control 2021; 10:151. [PMID: 34674756 PMCID: PMC8529563 DOI: 10.1186/s13756-021-01022-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 01/21/2021] [Accepted: 10/06/2021] [Indexed: 11/30/2022] Open
Abstract
Concomitant prevention of SARS-CoV-2 and extensively drug-resistant bacteria transmission is a difficult challenge in intensive care units dedicated to COVID-19 patients. We report a nosocomial cluster of four patients carrying NDM-1 plasmid-encoded carbapenemase-producing Enterobacter cloacae. Two main factors may have contributed to cross-transmission: misuse of gloves and absence of change of personal protective equipment, in the context of COVID-19-associated shortage. This work highlights the importance of maintaining infection control measures to prevent CPE cross-transmission despite the difficult context and that this type of outbreak can potentially involve several species of Enterobacterales.
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Affiliation(s)
- Guillaume Miltgen
- Laboratoire de Bactériologie, CHU Félix Guyon, Allée des Topazes, 97400, Saint-Denis, La Réunion, France. .,UMR PIMIT, Processus Infectieux en Milieu Insulaire Tropical, CNRS 9192, INSERM U1187, IRD 249, Université de La Réunion, Sainte-Clotilde, La Réunion, France.
| | - Thomas Garrigos
- Laboratoire de Bactériologie, CHU Félix Guyon, Allée des Topazes, 97400, Saint-Denis, La Réunion, France
| | - Pascal Cholley
- Service d'Hygiène Hospitalière, CHU Jean Minjoz, Besançon, France.,UMR CNRS 6249 Chrono-Environnement, Université de Bourgogne Franche-Comté, Besançon, France
| | - Marine Deleume
- Laboratoire de Bactériologie, CHU Félix Guyon, Allée des Topazes, 97400, Saint-Denis, La Réunion, France
| | - Nicolas Allou
- Service de Réanimation Polyvalente, CHU Félix Guyon, Saint-Denis, La Réunion, France
| | - Jérôme Allyn
- Service de Réanimation Polyvalente, CHU Félix Guyon, Saint-Denis, La Réunion, France
| | - David A Wilkinson
- UMR PIMIT, Processus Infectieux en Milieu Insulaire Tropical, CNRS 9192, INSERM U1187, IRD 249, Université de La Réunion, Sainte-Clotilde, La Réunion, France
| | - Nathalie Lugagne
- Service d'hygiène hospitalière, CHU Félix Guyon, Saint-Denis, La Réunion, France
| | - Olivier Belmonte
- Laboratoire de Bactériologie, CHU Félix Guyon, Allée des Topazes, 97400, Saint-Denis, La Réunion, France
| | - Xavier Bertrand
- Service d'Hygiène Hospitalière, CHU Jean Minjoz, Besançon, France.,UMR CNRS 6249 Chrono-Environnement, Université de Bourgogne Franche-Comté, Besançon, France
| | - Didier Hocquet
- Service d'Hygiène Hospitalière, CHU Jean Minjoz, Besançon, France.,UMR CNRS 6249 Chrono-Environnement, Université de Bourgogne Franche-Comté, Besançon, France
| | - Patrick Mavingui
- UMR PIMIT, Processus Infectieux en Milieu Insulaire Tropical, CNRS 9192, INSERM U1187, IRD 249, Université de La Réunion, Sainte-Clotilde, La Réunion, France
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Miltgen G, Bour M, Allyn J, Allou N, Vedani T, Vuillemenot JB, Triponney P, Martinet O, Lugagne N, Benoit-Cattin T, Dortet L, Birer A, Jaffar-Bandjee MC, Belmonte O, Plésiat P, Potron A. Molecular and epidemiological investigation of a colistin-resistant OXA-23-/NDM-1-producing Acinetobacter baumannii outbreak in the Southwest Indian Ocean Area. Int J Antimicrob Agents 2021; 58:106402. [PMID: 34293453 DOI: 10.1016/j.ijantimicag.2021.106402] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 06/29/2021] [Accepted: 07/03/2021] [Indexed: 11/29/2022]
Abstract
Dual resistance to colistin and carbapenems is a milestone reached by certain extensively-drug resistant (XDR) Gram-negative bacteria. This study describes the first outbreak of XDR colistin- and carbapenem-resistant OXA-23-/NDM-1-producing Acinetobacter baumannii (CCRAB) in the European overseas territory of Reunion Island (France, Indian Ocean). Between April 2019 and June 2020, 13 patients admitted to the University Hospital of Reunion Island were involved in the outbreak, of whom eight were infected and six died. The first case was traced to a medical evacuation from Mayotte Island (Comoros archipelago). An epidemiological link could be established for 11 patients. All of the collected CCRAB isolates showed the same resistance profile and co-produced intrinsic β-lactamases OXA-69 and ADC-191, together with acquired carbapenem-hydrolysing β-lactamases OXA-23 and NDM-1. A mutation likely involved in colistin resistance was detected in the two-component system PmrAB (D82N in PmrA). All of the isolates were found to belong to STPas1/STOx231 clonal complex and were phylogenetically indistinguishable. Their further characterization by whole-genome sequence analyses (whole-genome multi-locus sequence typing, single nucleotide polymorphisms) provided hints about the transmission pathways. This study pleads for strict application of control and prevention measures in institutions where the risk of imported XDR bacteria is high.
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Affiliation(s)
- Guillaume Miltgen
- Laboratoire de Bactériologie, Centre Hospitalier Universitaire La Réunion, Saint-Denis, France; UMR Processus Infectieux en Milieu Insulaire Tropical, CNRS 9192, INSERM U1187, IRD 249, Université de la Réunion, Sainte-Clotilde, France
| | - Maxime Bour
- Centre National de Référence de la Résistance aux Antibiotiques, Centre Hospitalier Universitaire de Besançon, Besançon, France
| | - Jérôme Allyn
- Réanimation polyvalente, Centre Hospitalier Universitaire La Réunion, Saint-Denis, France; Département d'informatique Clinique, Centre Hospitalier Universitaire La Réunion, Saint-Denis, France
| | - Nicolas Allou
- Réanimation polyvalente, Centre Hospitalier Universitaire La Réunion, Saint-Denis, France; Département d'informatique Clinique, Centre Hospitalier Universitaire La Réunion, Saint-Denis, France
| | - Thibaut Vedani
- Laboratoire de Bactériologie, Centre Hospitalier Universitaire La Réunion, Saint-Denis, France
| | - Jean-Baptiste Vuillemenot
- Centre National de Référence de la Résistance aux Antibiotiques, Centre Hospitalier Universitaire de Besançon, Besançon, France; Laboratoire de Bactériologie, UMR CNRS 6249 Chrono-Environnement, Faculté de Médecine-Pharmacie, Université Bourgogne Franche-Comté, Besançon, France
| | - Pauline Triponney
- Centre National de Référence de la Résistance aux Antibiotiques, Centre Hospitalier Universitaire de Besançon, Besançon, France
| | - Olivier Martinet
- Réanimation polyvalente, Centre Hospitalier Universitaire La Réunion, Saint-Denis, France
| | - Nathalie Lugagne
- Service d'Hygiène hospitalière, Centre Hospitalier Universitaire La Réunion, Saint-Denis, France
| | | | - Laurent Dortet
- Centre National de Référence de la Résistance aux Antibiotiques, Laboratoire associé, Centre Hospitalier Universitaire de Bicêtre, Le Kremlin-Bicêtre, France
| | - Aurélien Birer
- Centre National de Référence de la Résistance aux Antibiotiques, Laboratoire associé, Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, France
| | | | - Olivier Belmonte
- Laboratoire de Bactériologie, Centre Hospitalier Universitaire La Réunion, Saint-Denis, France
| | - Patrick Plésiat
- Centre National de Référence de la Résistance aux Antibiotiques, Centre Hospitalier Universitaire de Besançon, Besançon, France; Laboratoire de Bactériologie, UMR CNRS 6249 Chrono-Environnement, Faculté de Médecine-Pharmacie, Université Bourgogne Franche-Comté, Besançon, France
| | - Anaïs Potron
- Centre National de Référence de la Résistance aux Antibiotiques, Centre Hospitalier Universitaire de Besançon, Besançon, France; Laboratoire de Bactériologie, UMR CNRS 6249 Chrono-Environnement, Faculté de Médecine-Pharmacie, Université Bourgogne Franche-Comté, Besançon, France.
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9
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Ho D, Belmonte O, Andre M, Gazaille V, Perisson C, Gachelin E, Allyn J, Payet A, Coolen-Allou N. High Prevalence of Nontuberculous Mycobacteria in Cystic Fibrosis Patients in Tropical French Reunion Island. Pediatr Infect Dis J 2021; 40:e120-e122. [PMID: 33427803 DOI: 10.1097/inf.0000000000002999] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Reunion Island is a French overseas department located in a tropical area, where cystic fibrosis incidence is high. Cystic fibrosis (CF) patients are at risk of developing nontuberculous mycobacteria (NTM) infection. Epidemiologic studies are lacking in Reunion Island. METHODS From 2002 to 2015, a retrospective review was performed in university hospitals on Reunion Island. All CF patients having at least 1 positive NTM isolate were included. Clinical, radiologic, and microbiologic data were collected from patient records. RESULTS Fifty-one CF patients were included. The overall estimated prevalence of NTM was 26.4% in total CF population and 36.9% in patients over 12 years of age. Mycobacterium abscessus and Mycobacterium avium were the most frequently identified species found in 31 patients (60.8%) and 14 patients (27.4%), respectively. A rare NTM species: Mycobacterium simiae was found in 4 patients (7.8%). Twenty-nine patients (56.9%) met the American Thoracic Society (ATS) criteria for infection. They were more likely younger with a low body mass index and more frequently infected by Mycobacterium abscessus (22/29). CONCLUSION The overall prevalence of NTM in tropical Reunion Island is 3 times higher than in metropolitan France. A different environmental exposure in a tropical climate or risk factors related to cystic fibrosis or its treatment in Reunion patients could explain it.
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Affiliation(s)
| | - Olivier Belmonte
- Service de Microbiologie, CHU La Réunion site Félix Guyon, Saint Denis, Réunion
| | | | | | - Caroline Perisson
- Service de Pédiatrie, CHU La Réunion Site Sud Réunion, Saint Pierre, Réunion
| | | | - Jérôme Allyn
- Service de Réanimation Médicale, CHU La Réunion site Félix Guyon, Saint Denis, Réunion
| | - Annabelle Payet
- Service de Pneumologie, CHU La Réunion Site Sud Réunion, Saint Pierre, Réunion
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10
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Gay N, Lugagne N, Miltgen G, Belmonte O, Cardinale E. Reunion Island, a sentinel territory for antimicrobial-resistant bacteria surveillance in the South-Western Indian Ocean: a retrospective survey using hospitalized patient screening, 2015-2017. BMC Public Health 2020; 20:1488. [PMID: 33004028 PMCID: PMC7528459 DOI: 10.1186/s12889-020-09591-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 02/07/2020] [Accepted: 09/22/2020] [Indexed: 12/31/2022] Open
Abstract
Background In 2015, antimicrobial resistance was identified as a public health priority for the South-Western Indian Ocean (SWIO) (i.e. Comoros, Madagascar, Mauritius, Mayotte (France), Reunion Island (France), and Seychelles). However, in 2020, colonization rates of antimicrobial-resistant bacteria (ARB) in human populations on most islands in SWIO were still not known and neither hospital nor community colonization rates had been estimated. The aim of this study was to estimate the prevalence of colonization of six ARB groups in hospitalized patients residing in the SWIO territories. The six groups comprise extended-spectrum betalactamase producing Enterobacteriaceae (ESBL-E), carbapenem-resistant Enterobacteriaceae (CRE), methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE), and both ceftazidime and/or imipenem-resistant Acinetobacter spp. (ACB), and ceftazidime and/or imipenem-resistant Pseudomonas spp. (PSA)). Methods Based on comprehensive hospital laboratory ARB screening data, we provide the first estimation of ARB colonization rates in hospitalized patients residing in SWIO (2015–2017). Using ARB colonization rates in Reunion Island (France) as the reference for estimating odds ratio, we identified at risk patients based on their territory of residence. Results The survey pointed to significantly higher overall ARB colonization rates in patients from Comoros, Madagascar, Mayotte, and Seychelles compared to Reunion Island as the reference. Extended-spectrum betalactamase producing Enterobacteriaceae was found to be the most common ARB group colonizing patients from SWIO territories. The highest MRSA colonization rates were observed in patients from Mayotte and Seychelles. Colonization by carbapenem-resistant Enterobacteriaceae (CRE) was highest in patients from Mauritius. Conclusion These results identify high ARB colonization rates in hospitalized patients from SWIO territories that require further investigation, particularly CRE in Mauritius and MRSA in Seychelles and Mayotte. This study is the first step toward the implementation of a broader regional ARB surveillance system.
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Affiliation(s)
- Noellie Gay
- UMR Animal Santé Territoires Risque Environnement (CIRAD, INRAe, Univ Montpellier), Montpellier, France.
| | - Nathalie Lugagne
- Nosocomial infection Unit, Felix-Guyon University hospital, La Reunion, Saint-Denis, France
| | - Guillaume Miltgen
- Bacteriology laboratory, Felix-Guyon University hospital, La Reunion, Saint-Denis, France.,UMR Processus Infectieux en Milieu Insulaire Tropical (CNRS 9192, INSERM U1187, IRD 249, Univ La Réunion), La Reunion, Saint-Denis, France
| | - Olivier Belmonte
- Bacteriology laboratory, Felix-Guyon University hospital, La Reunion, Saint-Denis, France
| | - Eric Cardinale
- UMR Animal Santé Territoires Risque Environnement (CIRAD, INRAe, Univ Montpellier), Montpellier, France.,Health Monitoring Unit, Indian Ocean Commission, Port-Louis, Mauritius
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11
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Alberto C, Osdoit S, Villani AP, Bellec L, Belmonte O, Schrenzel J, Bagny K, Badell E, Brisse S, Toubiana J. Cutaneous ulcers revealing diphtheria: A re-emerging disease imported from Indian Ocean countries? Ann Dermatol Venereol 2020; 148:34-39. [PMID: 32631628 DOI: 10.1016/j.annder.2020.04.024] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Revised: 12/20/2019] [Accepted: 04/03/2020] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Diphtheria due to Corynebacteriumdiphtheriae (C. diphtheriae) has become rare in developed countries. In France only 10 cases of toxigenic diphtheria have been reported since 1989, in all cases causing pharyngitis and all emanating from endemic countries with exception of one contact case. We report herein 13 cases with cutaneous diphtheria, in 5 of which diphtheria toxin was produced, and all imported into France between 2015 and 2018. OBSERVATIONS Thirteen patients aged 4 to 77 years presented painful and rapidly progressive round ulcerations of the legs, that were superficial and in some cases purulent, with an erythematous-purple border covered with greyish membrane. Bacteriological sampling of ulcers revealed the presence of C. diphtheriae. Only 6 patients had been properly immunized over the preceding 5 years. DISCUSSION These cases underline the resurgence of cutaneous diphtheria and the circulation of toxigenic strains in France following importation from Indian Ocean countries. This may constitute an important reservoir for ongoing transmission of the disease. Re-emergence of this pathogen stems from the current migratory flow and decreased adult booster coverage. CONCLUSION Cutaneous diphtheria should be considered in cases of rapidly developing painful skin ulcers with greyish membrane, especially among patients returning from endemic areas, regardless of their vaccination status. The clinician should order specific screening for C. diphtheriae from the bacteriologist, since with routine swabbing Corynebacteriaceae may be reported simply as normal skin flora. Vaccination protects against toxigenic manifestations but not against actual bacterial infection. Early recognition and treatment of cutaneous diphtheria and up-to-date vaccination are mandatory to avoid further transmission and spread of both cutaneous and pharyngeal diphtheria.
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Affiliation(s)
- C Alberto
- Department of dermatology, Geneva university hospital, Geneva, Switzerland.
| | - S Osdoit
- Department of dermatology and internal medicine, Felix Guyon university hospital, Saint-Denis, Reunion
| | - A-P Villani
- Department of dermatology, Claude Bernard Lyon I university, Edouard Herriot hospital, Lyon, France
| | - L Bellec
- Department of infectious diseases, Felix Guyon university hospital, Saint-Denis, Reunion
| | - O Belmonte
- Laboratory of microbiology, Felix Guyon university hospital, Saint-Denis, Reunion
| | - J Schrenzel
- Laboratory of bacteriology, Geneva university hospitals, Geneva, Switzerland
| | - K Bagny
- Department of dermatology and internal medicine, Felix Guyon university hospital, Saint-Denis, Reunion
| | - E Badell
- Institut Pasteur, Biodiversity and Epidemiology of Bacterial Pathogens, 75000 Paris, France; Institut Pasteur, National Reference Center for the Corynebacteria of the diphtheriae complex, 75000 Paris, France
| | - S Brisse
- Institut Pasteur, Biodiversity and Epidemiology of Bacterial Pathogens, 75000 Paris, France; Institut Pasteur, National Reference Center for the Corynebacteria of the diphtheriae complex, 75000 Paris, France
| | - J Toubiana
- Institut Pasteur, Biodiversity and Epidemiology of Bacterial Pathogens, 75000 Paris, France; Institut Pasteur, National Reference Center for the Corynebacteria of the diphtheriae complex, 75000 Paris, France; Université de Paris, Department of General Paediatrics and Paediatric Infectious Diseases, 75000 Paris, France
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12
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Decalonne M, Dos Santos S, Gimenes R, Goube F, Abadie G, Aberrane S, Ambrogi V, Baron R, Barthelemy P, Bauvin I, Belmonte O, Benabid E, Ammar RB, Yahia SBH, Berrouane Y, Berthelot P, Beuchee A, Bille E, Bolot P, Bordes-Couecou S, Bouissou A, Bourdon S, Bourgeois-Nicolaos N, Boyer S, Cattoen C, Cattoir V, Chaplain C, Chatelet C, Claudinon A, Chautemps N, Cormier H, Coroller-Bec C, Cotte B, De Chillaz C, Dauwalder O, Davy A, Delorme M, Demasure M, Desfrere L, Drancourt M, Dupin C, Faraut-Derouin V, Florentin A, Forget V, Fortineau N, Foucan T, Frange P, Gambarotto K, Gascoin G, Gibert L, Gilquin J, Glanard A, Grando J, Gravet A, Guinard J, Hery-Arnaud G, Huart C, Idri N, Jellimann JM, Join-Lambert O, Joron S, Jouvencel P, Kempf M, Ketterer-Martinon S, Khecharem M, Klosowski S, Labbe F, Lacazette A, Lapeyre F, Larche J, Larroude P, Le Pourhiennec A, Le Sache N, Ledru S, Lefebvre A, Legeay C, Lemann F, Lesteven C, Levast-Raffin M, Leyssene D, Ligi I, Lozniewski A, Lureau P, Mallaval FO, Malpote E, Marret S, Martres P, Menard G, Menvielle L, Mereghetti L, Merle V, Minery P, Morange V, Mourdie J, Muggeo A, Nakhleh J, Noulard MN, Olive C, Patural H, Penn P, Petitfrere M, Pozetto B, Riviere B, Robine A, Ceschin CR, Ruimy R, Siali A, Soive S, Slimani S, Trentesaux AS, Trivier D, Vandenbussche C, Villeneuve L, Werner E, Le Vu S, Van Der Mee-Marquet N. Staphylococcus capitis isolated from bloodstream infections: a nationwide 3-month survey in 38 neonatal intensive care units. Eur J Clin Microbiol Infect Dis 2020; 39:2185-2194. [PMID: 32519215 PMCID: PMC7561542 DOI: 10.1007/s10096-020-03925-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 02/13/2020] [Accepted: 05/03/2020] [Indexed: 11/24/2022]
Abstract
To increase the knowledge about S. capitis in the neonatal setting, we conducted a nationwide 3-month survey in 38 neonatal intensive care units (NICUs) covering 56.6% of French NICU beds. We demonstrated 14.2% of S. capitis BSI (S.capBSI) among nosocomial BSIs. S.capBSI incidence rate was 0.59 per 1000 patient-days. A total of 55.0% of the S.capBSIs were late onset catheter-related BSIs. The S. capitis strains infected preterm babies (median gestational age 26 weeks, median birth weight 855 g). They were resistant to methicillin and aminoglycosides and belonged to the NRCS-A clone. Evolution was favorable in all but one case, following vancomycin treatment.
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Affiliation(s)
- Marie Decalonne
- SPIADI, CPIAS CVDL, Hôpital Bretonneau, Centre Hospitalier Universitaire, 37044, Tours, France
| | - Sandra Dos Santos
- Cellule d'Epidémiologie Régionale des Infections Nosocomiales, CPIAS CVDL, Service de Bactériologie-Virologie-Hygiène, Hôpital Trousseau, CHRU, 37044, Tours, France
| | - Rémi Gimenes
- SPIADI, CPIAS CVDL, Hôpital Bretonneau, Centre Hospitalier Universitaire, 37044, Tours, France
| | - Florent Goube
- SPIADI, CPIAS CVDL, Hôpital Bretonneau, Centre Hospitalier Universitaire, 37044, Tours, France
| | - Géraldine Abadie
- Service de réanimation néonatale, Centre Hospitalier Universitaire Félix Guyon, 97400, Saint Denis de la Réunion, France
| | - Saïd Aberrane
- Laboratoire de Microbiologie, Centre Hospitalier Inter-Communal, 94010, Créteil, France
| | - Vanina Ambrogi
- Équipe opérationnelle d'hygiène, Centre Hospitalier Universitaire, 31059, Toulouse, France
| | - Raoul Baron
- Équipe opérationnelle d'hygiène, Centre Hospitalier Universitaire, 29609, Brest, France
| | - Patrick Barthelemy
- Équipe opérationnelle d'hygiène, Hôpital de la Conception, APHM, 13005, Marseille, France
| | - Isabelle Bauvin
- Service de réanimation néonatale, Centre Hospitalier, 64000, Pau, France
| | - Olivier Belmonte
- Laboratoire de Microbiologie, Centre Hospitalier Universitaire Félix Guyon, 97400, Saint Denis de la Réunion, France
| | - Emilie Benabid
- Équipe opérationnelle d'hygiène, Centre Hospitalier, 95300, Pontoise, France
| | - Rafik Ben Ammar
- Service de réanimation néonatale, Centre Hospitalier Universitaire Antoine-Béclère, APHP, 92140, Clamart, France
| | | | - Yasmina Berrouane
- Équipe opérationnelle d'hygiène, Centre Hospitalier Universitaire, 06200, Nice, France
| | - Philippe Berthelot
- Équipe opérationnelle d'hygiène, Centre Hospitalier Universitaire, 42055, Saint Etienne, France
| | - Alain Beuchee
- Service de réanimation néonatale, Centre Hospitalier Universitaire, 35000, Rennes, France
| | - Emmanuelle Bille
- Laboratoire de Microbiologie clinique, Hôpital universitaire Necker-Enfants malades, APHP, 75015, Paris, France
| | - Pascal Bolot
- Service de réanimation néonatale, Centre Hospitalier Delafontaine, 93205, Saint Denis, France
| | | | - Antoine Bouissou
- Service de réanimation néonatale, Centre Hospitalier Universitaire, 37044, Tours, France
| | - Sandra Bourdon
- Équipe opérationnelle d'hygiène, Centre Hospitalier du Havre, 76290, Montivilliers, France
| | - Nadège Bourgeois-Nicolaos
- Laboratoire de Microbiologie, Centre Hospitalier Universitaire Antoine-Béclère, APHP, 92140, Clamart, France
| | - Sophie Boyer
- Laboratoire de Microbiologie, Centre Hospitalier Universitaire Charles Nicolle, 76000, Rouen, France
| | - Christian Cattoen
- Laboratoire de Microbiologie, Centre Hospitalier, 59300, Valenciennes, France
| | - Vincent Cattoir
- Laboratoire de Microbiologie, Centre Hospitalier Universitaire, 35000, Rennes, France
| | - Chantal Chaplain
- Laboratoire de Microbiologie, Centre Hospitalier Delafontaine, 93205, Saint Denis, France
| | - Céline Chatelet
- Équipe opérationnelle d'hygiène, Centre Hospitalier, 62300, Lens, France
| | - Aurore Claudinon
- Laboratoire de Microbiologie, Centre Hospitalier, 95107, Argenteuil, France
| | - Nathalie Chautemps
- Service de réanimation néonatale, Centre Hospitalier Métropole Savoie-Site de Chambéry, 73 011, Chambéry, France
| | - Hélène Cormier
- UPLIN, Centre Hospitalier Universitaire, 49933, Angers, France
| | | | | | - Carole De Chillaz
- Service de Néonatalogie et Réanimation néonatale, Hôpital universitaire Necker-Enfants malades, APHP, 75015, Paris, France
| | - Olivier Dauwalder
- Laboratoire de Microbiologie, Hôpitaux Civils de Lyon, 69677, Bron, France
| | - Aude Davy
- Équipe opérationnelle d'hygiène, Centre Hospitalier, 22000, Saint Brieuc, France
| | - Martine Delorme
- Équipe opérationnelle d'hygiène, Centre Hospitalier, 79021, Niort, France
| | - Maryvonne Demasure
- Équipe opérationnelle d'hygiène, Centre Hospitalier Régional, 45100, Orléans, France
| | - Luc Desfrere
- Service de réanimation néonatale, Centre Hospitalier Universitaire, Hôpital Louis-Mourier, APHP, 92700, Colombes, France
| | - Michel Drancourt
- Laboratoire de Microbiologie, Hôpital de la Conception, APHM, 13005, Marseille, France
| | - Clarisse Dupin
- Laboratoire de Microbiologie, Centre Hospitalier, 22000, Saint Brieuc, France
| | - Véronique Faraut-Derouin
- Équipe opérationnelle d'hygiène, Centre Hospitalier Universitaire Antoine-Béclère, APHP, 92140, Clamart, France
| | - Arnaud Florentin
- Service d'hygiène et d'analyses environnementales (SHAE), Hôpitaux de Brabois, 54035, Nancy, France
| | - Virginie Forget
- Équipe opérationnelle d'hygiène, Centre Hospitalier Métropole Savoie-Site de Chambéry, 73 011, Chambéry, France
| | - Nicolas Fortineau
- Équipe opérationnelle d'hygiène, Centre Hospitalier Universitaire, Kremlin Bicêtre, APHP, 94275, Le Kremlin Bicêtre, France
| | - Tania Foucan
- Équipe opérationnelle d'hygiène, Centre Hospitalier Universitaire, 97159, Pointe-à-Pitre, France
| | - Pierre Frange
- Laboratoire de Microbiologie clinique, Hôpital universitaire Necker-Enfants malades, APHP, 75015, Paris, France.,Équipe opérationnelle d'hygiène, Hôpital universitaire Necker-Enfants malades, APHP, 75015, Paris, France
| | - Karine Gambarotto
- Équipe opérationnelle d'hygiène, Centre Hospitalier Universitaire Félix Guyon, 97400, Saint Denis de la Réunion, France
| | - Géraldine Gascoin
- Service de réanimation néonatale, Centre Hospitalier Universitaire, 49933, Angers, France
| | - Laure Gibert
- Équipe opérationnelle d'hygiène, Centre Hospitalier du Havre, 76290, Montivilliers, France
| | - Jacques Gilquin
- Équipe opérationnelle d'hygiène, Centre Hospitalier, 81100, Castres, France
| | - Audrey Glanard
- Équipe opérationnelle d'hygiène, Centre Hospitalier Delafontaine, 93205, Saint Denis, France
| | - Jacqueline Grando
- Équipe opérationnelle d'hygiène, Hôpitaux Civils de Lyon, 69677, Bron, France
| | - Alain Gravet
- Laboratoire de Microbiologie, Centre Hospitalier, 68100, Mulhouse, France
| | - Jérôme Guinard
- Laboratoire de Microbiologie, Centre Hospitalier Régional, 45100, Orléans, France
| | - Geneviève Hery-Arnaud
- Laboratoire de Microbiologie, Centre Hospitalier Universitaire, 29609, Brest, France
| | - Claire Huart
- Équipe opérationnelle d'hygiène, Centre Hospitalier, 59300, Valenciennes, France
| | - Nadia Idri
- Équipe opérationnelle d'hygiène, Hôpital Louis-Mourier, APHP, 92700, Colombes, France.,Laboratoire de Microbiologie, Hôpital Louis-Mourier, APHP, 92700, Colombes, France
| | - Jean-Marc Jellimann
- Service de réanimation néonatale, Centre Hospitalier Universitaire, Hôpitaux de Brabois, 54035, Nancy, France
| | - Olivier Join-Lambert
- Laboratoire de Microbiologie, Centre Hospitalier Universitaire, 14000, Caen, France
| | - Sylvie Joron
- Service d'hygiène, Centre Hospitalier, 62100, Calais, France
| | - Philippe Jouvencel
- Service de réanimation néonatale, Centre Hospitalier, 64100, Bayonne, France
| | - Marie Kempf
- Laboratoire de Bactériologie-Hygiène Institut de Biologie en Santé, CRCINA Inserm U1232, Université d'Angers, Centre Hospitalier Universitaire, 49933, Angers, France
| | - Sophie Ketterer-Martinon
- Service de réanimation néonatale et réanimation pédiatrique, Centre Hospitalier Universitaire de Martinique, 97261, Fort de France, France
| | - Mouna Khecharem
- Laboratoire de Bactériologie-Hygiène, Centre Hospitalier Universitaire, Kremlin Bicêtre, APHP, 94275, Le Kremlin Bicêtre, France
| | - Serge Klosowski
- Service de réanimation néonatale, Centre Hospitalier, 62300, Lens, France
| | - Franck Labbe
- Laboratoire de Microbiologie, Centre Hospitalier du Havre, 76290, Montivilliers, France
| | - Adeline Lacazette
- Service de réanimation néonatale, Centre Hospitalier Universitaire, 97159, Pointe-à-Pitre, France
| | - Fabrice Lapeyre
- Service de réanimation néonatale, Centre Hospitalier, 59300, Valenciennes, France
| | | | - Peggy Larroude
- Équipe opérationnelle d'hygiène, Centre Hospitalier, 64000, Pau, France
| | | | - Nolwenn Le Sache
- Service de réanimation néonatale, Centre Hospitalier Universitaire, Kremlin Bicêtre, APHP, 94275, Le Kremlin Bicêtre, France
| | - Sylvie Ledru
- Laboratoire de Microbiologie, Centre Hospitalier, 62300, Lens, France
| | - Annick Lefebvre
- Équipe opérationnelle d'hygiène, Université de Reims Champagne-Ardenne, 51100, Reims, France
| | - Clément Legeay
- UPLIN, Centre Hospitalier Universitaire, 49933, Angers, France
| | - Florence Lemann
- Équipe opérationnelle d'hygiène, Centre Hospitalier, 95107, Argenteuil, France
| | - Claire Lesteven
- Équipe opérationnelle d'hygiène, Centre Hospitalier Universitaire, 14000, Caen, France
| | - Marion Levast-Raffin
- Laboratoire de Biologie Médicale, Centre Hospitalier Métropole Savoie-Site de Chambéry, 73 011, Chambéry, France
| | - David Leyssene
- Laboratoire de Microbiologie, Centre Hospitalier, 64100, Bayonne, France
| | - Isabelle Ligi
- Service de réanimation néonatale, Centre Hospitalier Universitaire, Hôpital de la Conception, APHM, 13005, Marseille, France
| | - Alain Lozniewski
- Laboratoire de Microbiologie, Hôpitaux de Brabois, 54035, Nancy, France
| | - Pierre Lureau
- Laboratoire de Microbiologie, Centre Hospitalier, 79021, Niort, France
| | - Franck-Olivier Mallaval
- Équipe opérationnelle d'hygiène, Centre Hospitalier Métropole Savoie-Site de Chambéry, 73 011, Chambéry, France
| | - Edith Malpote
- Laboratoire de Microbiologie, Centre Hospitalier Universitaire, 97159, Pointe-à-Pitre, France
| | - Stéphane Marret
- Service de réanimation néonatale, Centre Hospitalier Universitaire Charles Nicolle, 76000, Rouen, France
| | - Pascale Martres
- Laboratoire de Microbiologie, Centre Hospitalier, 95300, Pontoise, France
| | - Guillaume Menard
- Équipe opérationnelle d'hygiène, Centre Hospitalier Universitaire, 35000, Rennes, France
| | - Laura Menvielle
- Service de réanimation néonatale et réanimation pédiatrique, Centre Hospitalier Universitaire, Hôpital Robert Debré, Inserm UMR-S 1250 P3Cell, Université de Reims Champagne-Ardenne, 51100, Reims, France
| | - Laurent Mereghetti
- Laboratoire de Microbiologie, Centre Hospitalier Universitaire, 37044, Tours, France
| | - Véronique Merle
- Équipe opérationnelle d'hygiène, Centre Hospitalier Universitaire Charles Nicolle, 76000, Rouen, France
| | - Pascale Minery
- Équipe opérationnelle d'hygiène, Centre Hospitalier, 68100, Mulhouse, France
| | - Virginie Morange
- Équipe opérationnelle d'hygiène, Centre Hospitalier Universitaire, 37044, Tours, France
| | - Julien Mourdie
- Service de réanimation néonatale, Centre Hospitalier du Havre, 76290, Montivilliers, France
| | - Anaelle Muggeo
- Laboratoire de Bactériologie, Université de Reims Champagne-Ardenne, 51100, Reims, France
| | - Jean Nakhleh
- Service de réanimation néonatale, Centre Hospitalier, 68100, Mulhouse, France
| | | | - Claude Olive
- Laboratoire de Microbiologie, Centre Hospitalier Universitaire de Martinique, 97261, Fort de France, France
| | - Hugues Patural
- Service de réanimation néonatale, Centre Hospitalier Universitaire, 42055, Saint Etienne, France
| | - Pascale Penn
- Laboratoire de Microbiologie, Centre Hospitalier, 72000, Le Mans, France
| | | | - Bruno Pozetto
- Laboratoire de Microbiologie, Centre Hospitalier Universitaire, 42055, Saint Etienne, France
| | - Brigitte Riviere
- Laboratoire de Microbiologie, Centre Hospitalier, 81100, Castres, France
| | - Audrey Robine
- Service de réanimation néonatale, Centre Hospitalier, 72000, Le Mans, France
| | | | - Raymond Ruimy
- Laboratoire de Microbiologie, Centre Hospitalier Universitaire, 06200, Nice, France
| | - Amine Siali
- Équipe opérationnelle d'hygiène, Centre Hospitalier Inter-Communal, 94010, Créteil, France
| | - Stéphanie Soive
- Service de réanimation néonatale, Centre Hospitalier, 22000, Saint Brieuc, France
| | - Souad Slimani
- Équipe opérationnelle d'hygiène, Centre Hospitalier Universitaire de Martinique, 97261, Fort de France, France
| | | | - Dominique Trivier
- Équipe opérationnelle d'hygiène, Centre Hospitalier, 62300, Lens, France
| | | | | | - Evelyne Werner
- Service de réanimation néonatale, Centre Hospitalier Régional, 45100, Orléans, France
| | - Stéphane Le Vu
- Agence Santé Publique France, 94415, Saint Maurice, France
| | - Nathalie Van Der Mee-Marquet
- SPIADI, CPIAS CVDL, Hôpital Bretonneau, Centre Hospitalier Universitaire, 37044, Tours, France. .,Cellule d'Epidémiologie Régionale des Infections Nosocomiales, CPIAS CVDL, Service de Bactériologie-Virologie-Hygiène, Hôpital Trousseau, CHRU, 37044, Tours, France.
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Jacquier H, Miltgen G, Hoarau D, Kumanski S, Rollot O, Bruniquet S, Ndeikoundam N, Li Pat-Yuen G, Belmonte O, Bercot B, Roquebert B. Molecular epidemiology of Neisseria gonorrhoeae clinical isolates in Reunion and Mayotte. Sex Transm Infect 2020; 96:478-479. [PMID: 32366604 DOI: 10.1136/sextrans-2019-054374] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Revised: 02/28/2020] [Accepted: 03/17/2020] [Indexed: 11/03/2022] Open
Affiliation(s)
- Hervé Jacquier
- IAME, INSERM UMR 1137, Université de Paris, Paris, France.,Department of Infectious Agents, French National Reference Center for Bacterial STI, Associated Laboratory for Gonococci, Hospital Group Saint-Louis Lariboisiere and Fernand-Widal, Paris, France
| | - Guillaume Miltgen
- CNRS 9192, INSERM U1187, IRD 249, Unité Mixte Processus Infectieux en Milieu Insulaire Tropical (PIMIT), Plateforme Technologique CYROI, Université de la Réunion, Sainte-Clotilde, Réunion.,Microbiology Laboratory, Felix Guyon University Hospital Center, Saint-Pierre, La Réunion, Réunion
| | - Damien Hoarau
- CNRS 9192, INSERM U1187, IRD 249, Unité Mixte Processus Infectieux en Milieu Insulaire Tropical (PIMIT), Plateforme Technologique CYROI, Université de la Réunion, Sainte-Clotilde, Réunion
| | - Sylvain Kumanski
- Department of Infectious Agents, French National Reference Center for Bacterial STI, Associated Laboratory for Gonococci, Hospital Group Saint-Louis Lariboisiere and Fernand-Widal, Paris, France
| | | | - Sandrine Bruniquet
- Microbiology Laboratory, Felix Guyon University Hospital Center, Saint-Pierre, La Réunion, Réunion
| | | | - Ghislaine Li Pat-Yuen
- Microbiology Laboratory, Felix Guyon University Hospital Center, Saint-Pierre, La Réunion, Réunion
| | - Olivier Belmonte
- Microbiology Laboratory, Felix Guyon University Hospital Center, Saint-Pierre, La Réunion, Réunion
| | - Beatrice Bercot
- IAME, INSERM UMR 1137, Université de Paris, Paris, France .,Department of Infectious Agents, Hospital Group Saint-Louis Lariboisiere and Fernand-Widal, Paris, France
| | - Bénédicte Roquebert
- CNRS 9192, INSERM U1187, IRD 249, Unité Mixte Processus Infectieux en Milieu Insulaire Tropical (PIMIT), Plateforme Technologique CYROI, Université de la Réunion, Sainte-Clotilde, Réunion.,Microbiology Laboratory, Felix Guyon University Hospital Center, Saint-Pierre, La Réunion, Réunion
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14
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Miltgen G, Cholley P, Martak D, Thouverez M, Seraphin P, Leclaire A, Traversier N, Roquebert B, Jaffar-Bandjee MC, Lugagne N, Cimon CB, Ramiandrisoa M, Picot S, Lignereux A, Masson G, Allyn J, Allou N, Mavingui P, Belmonte O, Bertrand X, Hocquet D. Carbapenemase-producing Enterobacteriaceae circulating in the Reunion Island, a French territory in the Southwest Indian Ocean. Antimicrob Resist Infect Control 2020; 9:36. [PMID: 32075697 PMCID: PMC7031992 DOI: 10.1186/s13756-020-0703-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [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: 08/16/2019] [Accepted: 02/14/2020] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND The spread of carbapenemase-producing Enterobacteriaceae (CPE) in the Southwest Indian Ocean area (SIOA) is poorly documented. Reunion Island is a French overseas territory located close to Madagascar and connected with Southern Africa, Indian sub-continent and Europe, with several weekly flights. Here we report the results of the CPE surveillance program in Reunion Island over a six-year period. METHODS All CPE were collected between January 2011 and December 2016. Demographics and clinical data of the carrier patients were collected. We determined their susceptibility to antimicrobials, identified the carbapenemases and ESBL by PCR and sequencing, and explored their genetic relationship using pulsed-field gel electrophoresis and multi-locus sequence typing. RESULTS A total of 61 CPEs isolated from 53 patients were retrieved in 6 public or private laboratories of the island. We found that 69.8% of CPE patients were linked to a foreign country of SIOA and that almost half of CPE cases (47.2%) reached the island through a medical evacuation. The annual number of CPE cases strongly increased over the studied period (one case in 2011 vs. 21 cases in 2016). A proportion of 17.5% of CPE isolates were non-susceptible to colistin. blaNDM was the most frequent carbapenemase (79.4%), followed by blaIMI (11.1%), and blaIMP-10 (4.8%). Autochtonous CPE cases (30.2%) harboured CPE isolates belonging to a polyclonal population. CONCLUSIONS Because the hospital of Reunion Island is the only reference healthcare setting of the SIOA, we can reasonably estimate that its CPE epidemiology reflects that of this area. Mauritius was the main provider of foreign CPE cases (35.5%). We also showed that autochthonous isolates of CPEs are mostly polyclonal, thus unrelated to cross-transmission. This demonstrates the local spread of carbapenemase-encoding genes (i.e. blaNDM) in a polyclonal bacterial population and raises fears that Reunion Island could contribute to the influx of NDM-carbapenemase producers into the French mainland territory.
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Affiliation(s)
- Guillaume Miltgen
- Laboratoire de Bactériologie, CHU Félix Guyon, Allée des Topazes, 97400, Saint-Denis, La Réunion, France. .,UMR Processus Infectieux en Milieu Insulaire Tropical, CNRS 9192, INSERM U1187, IRD 249, Université de La Réunion, Sainte-Clotilde, La Réunion, France.
| | - Pascal Cholley
- Laboratoire d'Hygiène Hospitalière, CHRU Jean Minjoz, Besançon, France.,UMR Chrono-Environnement, CNRS 6249, Université de Bourgogne Franche-Comté, Besançon, France
| | - Daniel Martak
- Laboratoire d'Hygiène Hospitalière, CHRU Jean Minjoz, Besançon, France.,UMR Chrono-Environnement, CNRS 6249, Université de Bourgogne Franche-Comté, Besançon, France
| | | | - Paul Seraphin
- Laboratoire de Bactériologie, CHU Félix Guyon, Allée des Topazes, 97400, Saint-Denis, La Réunion, France
| | - Alexandre Leclaire
- Laboratoire de Bactériologie, CHU Félix Guyon, Allée des Topazes, 97400, Saint-Denis, La Réunion, France
| | - Nicolas Traversier
- Laboratoire de Bactériologie, CHU Félix Guyon, Allée des Topazes, 97400, Saint-Denis, La Réunion, France
| | - Bénédicte Roquebert
- Laboratoire de Bactériologie, CHU Félix Guyon, Allée des Topazes, 97400, Saint-Denis, La Réunion, France.,UMR Processus Infectieux en Milieu Insulaire Tropical, CNRS 9192, INSERM U1187, IRD 249, Université de La Réunion, Sainte-Clotilde, La Réunion, France
| | - Marie-Christine Jaffar-Bandjee
- Laboratoire de Bactériologie, CHU Félix Guyon, Allée des Topazes, 97400, Saint-Denis, La Réunion, France.,UMR Processus Infectieux en Milieu Insulaire Tropical, CNRS 9192, INSERM U1187, IRD 249, Université de La Réunion, Sainte-Clotilde, La Réunion, France
| | - Nathalie Lugagne
- Service d'hygiène hospitalière, CHU Félix Guyon, Saint-Denis, La Réunion, France
| | | | | | - Sandrine Picot
- Laboratoire de Bactériologie, Groupe Hospitalier Sud Réunion, Saint-Pierre, La Réunion, France
| | - Anne Lignereux
- Laboratoire de biologie, Centre Hospitalier Gabriel Martin, Saint-Paul, La Réunion, France
| | - Geoffrey Masson
- Laboratoire de biologie, Groupe Hospitalier Est Réunion, Saint-Benoit, La Réunion, France
| | - Jérôme Allyn
- Service de Réanimation polyvalente. Département d'Informatique clinique, CHU Félix Guyon, Saint-Denis, La Réunion, France
| | - Nicolas Allou
- Service de Réanimation polyvalente. Département d'Informatique clinique, CHU Félix Guyon, Saint-Denis, La Réunion, France
| | - Patrick Mavingui
- UMR Processus Infectieux en Milieu Insulaire Tropical, CNRS 9192, INSERM U1187, IRD 249, Université de La Réunion, Sainte-Clotilde, La Réunion, France
| | - Olivier Belmonte
- Laboratoire de Bactériologie, CHU Félix Guyon, Allée des Topazes, 97400, Saint-Denis, La Réunion, France
| | - Xavier Bertrand
- Laboratoire d'Hygiène Hospitalière, CHRU Jean Minjoz, Besançon, France.,UMR Chrono-Environnement, CNRS 6249, Université de Bourgogne Franche-Comté, Besançon, France
| | - Didier Hocquet
- Laboratoire d'Hygiène Hospitalière, CHRU Jean Minjoz, Besançon, France.,UMR Chrono-Environnement, CNRS 6249, Université de Bourgogne Franche-Comté, Besançon, France
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Allou N, Soubeyrand A, Traversier N, Persichini R, Brulliard C, Valance D, Martinet O, Picot S, Belmonte O, Allyn J. Waterborne Infections in Reunion Island, 2010-2017. Am J Trop Med Hyg 2018; 99:578-583. [PMID: 30039783 PMCID: PMC6169186 DOI: 10.4269/ajtmh.17-0981] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Accepted: 04/11/2018] [Indexed: 11/07/2022] Open
Abstract
Gram-negative bacilli Vibrio spp., Aeromonas spp., and Shewanella spp. are a major cause of severe waterborne infection. The aim of this study was to assess the clinical and microbiological characteristics and prognosis of patients hospitalized in Reunion Island for a waterborne infection. This retrospective study was conducted in the two university hospitals of Reunion Island between January 2010 and March 2017. Patients diagnosed with a Vibrio, Aeromonas, or Shewanella infection were evaluated. Over the study period, 112 aquatic strains were isolated at Reunion Island: Aeromonas spp. were found in 91 patients (81.3%), Shewanella spp. in 13 patients (11.6%), and Vibrio spp. in eight patients (7.2%). The in-hospital mortality rate was 11.6%. The main sites of infection were skin and soft tissue (44.6%) and the abdomen (19.6%). Infections were polymicrobial in 70 cases (62.5%). The most commonly prescribed empiric antibiotic regimen was amoxicillin-clavulanate (34.8%). Eighty-four percent of the aquatic strains were resistant to amoxicillin-clavulanate and more than > 95% were susceptible to third or fourth generation cephalosporins and fluoroquinolones. After multivariate analysis, the only independent risk factor of in-hospital mortality was the presence of sepsis (P < 0.0001). In Reunion Island, the most commonly isolated aquatic microorganisms were Aeromonas spp. Sepsis caused by aquatic microorganisms was frequent (> 50%) and associated with higher in-hospital mortality. This study suggests that empiric antibiotic regimens in patients with sepsis or septic shock caused by suspected aquatic microorganisms (tropical climate, skin lesion exposed to seawater…) should include broad-spectrum antibiotics (third or fourth generation cephalosporins).
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Affiliation(s)
- Nicolas Allou
- Réanimation Polyvalente, Centre Hospitalier Universitaire Félix Guyon, Allée des Topazes, Saint Denis, France
| | - Aurélien Soubeyrand
- Réanimation Polyvalente, Centre Hospitalier Universitaire Félix Guyon, Allée des Topazes, Saint Denis, France
| | - Nicolas Traversier
- Bacteriologie, Centre Hospitalier Universitaire Felix Guyon, Allée des Topazes, Saint Denis, France
| | - Romain Persichini
- Réanimation Polyvalente, Centre Hospitalier Universitaire Félix Guyon, Allée des Topazes, Saint Denis, France
| | - Caroline Brulliard
- Réanimation Polyvalente, Centre Hospitalier Universitaire Félix Guyon, Allée des Topazes, Saint Denis, France
| | - Dorothée Valance
- Réanimation Polyvalente, Centre Hospitalier Universitaire Félix Guyon, Allée des Topazes, Saint Denis, France
| | - Olivier Martinet
- Réanimation Polyvalente, Centre Hospitalier Universitaire Félix Guyon, Allée des Topazes, Saint Denis, France
| | - Sandrine Picot
- Bacteriologie, Centre Hospitalier Universitaire Sud Réunion, Saint Pierre, Saint Pierre, France
| | - Olivier Belmonte
- Bacteriologie, Centre Hospitalier Universitaire Felix Guyon, Allée des Topazes, Saint Denis, France
| | - Jérôme Allyn
- Réanimation Polyvalente, Centre Hospitalier Universitaire Félix Guyon, Allée des Topazes, Saint Denis, France
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Abstract
RATIONALE Patients repatriated from foreign hospitals are sources of extensively drug-resistant (XDR) bacteria outbreaks. Thus, an individual benefit potential for the patient opposes a collective ecological risk potential. These ethical issues have not been well studied. PATIENT CONCERNS We report the case of a 74-year-old patient repatriated from Mauritius to the French island of Reunion who presented mesenteric infarction evolving over several days, and who suffered a cardiac arrest before transfer. DIAGNOSES In Reunion Island, a CT-scan revealed a multisegmental enlarged parietal enlargement associated with free peritoneal effusion and a suboccluded aspect of the superior mesenteric artery. INTERVENTIONS Surgical exploration showed a severe mesenteric infarction with peritonitis, and a resection of 120cm of the small intestine was conducted. This patient was infected with a vanA glycopeptide-resistant Enterococcus faecium and a carbapenem-resistant Klebsiella pneumoniae which produced carbapenemases NDM-1 and OXA-181, which required specific care and could have led to a local epidemic. OUTCOMES The patient died after 9 days after being admitted to the ICU. LESSONS Repatriation of critically ill patients from abroad should be considered according to ethical criteria, evaluating, if possible, the expected benefits, and ecological risks incurred. Limiting unnecessary transfers could be an effective measure to limit the spread of XDR bacteria.
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Affiliation(s)
| | | | | | | | - Olivier Belmonte
- Laboratoire de bactériologie, Centre Hospitalier Universitaire La Réunion, Site Félix Guyon, Bellepierre
| | | | - Guillaume Miltgen
- Laboratoire de bactériologie, Centre Hospitalier Universitaire La Réunion, Site Félix Guyon, Bellepierre
- UMR Processus Infectieux en Milieu Insulaire Tropical (PIMIT), CNRS 9192, INSERM U1187, IRD 249, Université de La Réunion, Sainte-Clotilde, Saint-Denis cedex, France
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17
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Allain-Jeannic G, Traversier N, Belmonte O, Valance D, Bekkar S, Allou N, Allyn J. Delayed surgery in a patient with pneumococcal peritonitis and bacteremia secondary to perforation of gastroduodenal ulcer: A case report. Medicine (Baltimore) 2018; 97:e11323. [PMID: 29995767 PMCID: PMC6076138 DOI: 10.1097/md.0000000000011323] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
RATIONALE Very few cases of secondary peritonitis caused by Streptococcus pneumoniae have been described in the literature, and they have been found to occur mostly in patients with predisposing factors. Here, we report the case of an elderly patient who developed pneumococcal peritonitis secondary to perforation of gastroduodenal ulcer. PATIENT CONCERNS An 82-year-old man was admitted to intensive care unit (ICU) for septic shock with cardiac impairment 1 day after arriving in the Emergency Department. DIAGNOSES The patient presented with pneumococcal bacteremia and pneumococcal antigenuria. No abdominal defense was found on examination. A computed tomography scan revealed pneumoperitoneum and peritoneal effusions. INTERVENTIONS The patient was treated with effective empiric antibiotic therapy, and delayed surgery. OUTCOMES The patient gradually improved and was discharged from ICU on day 14. The ultimate outcome was unfavorable, with death occurring on day 28. LESSONS This rare infection can occur in elderly patients even in the absence of other predisposing factors. Secondary peritonitis may be suspected in patients with positive pneumococcal antigenuria or unexplained pneumococcal bacteremia, especially if an asthenic form is possible.
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Affiliation(s)
| | | | | | | | - Sarah Bekkar
- Service de chirurgie digestive, Centre hospitalier universitaire Félix-Guyon, Allée des Topazes, Saint Denis, France
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18
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Rakotondrasoa A, Issack MI, Garin B, Biot F, Valade E, Wattiau P, Allou N, Belmonte O, Bibi J, Price EP, Collard JM. Melioidosis in the Western Indian Ocean and the Importance of Improving Diagnosis, Surveillance, and Molecular Typing. Trop Med Infect Dis 2018; 3:tropicalmed3010030. [PMID: 30274427 PMCID: PMC6136609 DOI: 10.3390/tropicalmed3010030] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [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: 01/18/2018] [Revised: 02/26/2018] [Accepted: 03/02/2018] [Indexed: 02/04/2023] Open
Abstract
Melioidosis, caused by the bacterium Burkholderia pseudomallei, is an infectious disease of humans or animals, and the specific environmental conditions that are present in western Indian Ocean islands are particularly suitable for the establishment/survival of B. pseudomallei. Indeed, an increasing number of new cases have been reported in this region (Madagascar, Mauritius, Réunion (France), and Seychelles, except Comoros and Mayotte (France)), and are described in this review. Our review clearly points out that further studies are needed in order to investigate the real incidence and burden of melioidosis in the western Indian Ocean and especially Madagascar, since it is likely to be higher than currently reported. Thus, research and surveillance priorities were recommended (i) to improve awareness of melioidosis in the population and among clinicians; (ii) to improve diagnostics, in order to provide rapid and effective treatment; (iii) to implement a surveillance and reporting system in the western Indian Ocean; and (iv) to investigate the presence of B. pseudomallei in environmental samples, since we have demonstrated its presence in soil samples originating from the yard of a Madagascan case.
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Affiliation(s)
| | | | - Benoît Garin
- Laboratoire Immuno-Hématologie, CHU Pointe-à-Pitre/Abymes 97159, Guadeloupe.
| | - Fabrice Biot
- Unité de Bactériologie/UMR_MD1, Institut de Recherche Biomédicale des Armées, Brétigny sur Orge, Ecole du Val-de-Grâce, 91223 Paris, France.
| | - Eric Valade
- Unité de Bactériologie/UMR_MD1, Institut de Recherche Biomédicale des Armées, Brétigny sur Orge, Ecole du Val-de-Grâce, 91223 Paris, France.
| | - Pierre Wattiau
- Unit of Foodborne, Highly Pathogenic Bacterial Zoonoses & Antibiotic Resistance, Veterinary and Agrochemical Research Center, Brussels 1180, Belgium.
| | - Nicolas Allou
- Réanimation polyvalente, Centre Hospitalier Universitaire Félix Guyon, 97499 Saint Denis, France.
| | - Olivier Belmonte
- Bactériologie, Centre Hospitalier Universitaire Félix Guyon, 97499 Saint Denis, France.
| | - Jastin Bibi
- Ministry of Health, Public Health Department, Victoria, Seychelles.
| | - Erin P Price
- Faculty of Science, Health, Education and Engineering, University of the Sunshine Coast, Sippy Downs, QLD 4556, Australia.
| | - Jean-Marc Collard
- Unité de Bactériologie Expérimentale, Institut Pasteur de Madagascar, Antananarivo 101, Madagascar.
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Gay N, Leclaire A, Laval M, Miltgen G, Jégo M, Stéphane R, Jaubert J, Belmonte O, Cardinale E. Risk Factors of Extended-Spectrum β-Lactamase Producing Enterobacteriaceae Occurrence in Farms in Reunion, Madagascar and Mayotte Islands, 2016-2017. Vet Sci 2018; 5:vetsci5010022. [PMID: 29473906 PMCID: PMC5876575 DOI: 10.3390/vetsci5010022] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Revised: 02/12/2018] [Accepted: 02/19/2018] [Indexed: 12/11/2022] Open
Abstract
In South Western Indian ocean (IO), Extended-Spectrum β-Lactamase producing Enterobacteriaceae (ESBL-E) are a main public health issue. In livestock, ESBL-E burden was unknown. The aim of this study was estimating the prevalence of ESBL-E on commercial farms in Reunion, Mayotte and Madagascar and genes involved. Secondly, risk factors of ESBL-E occurrence in broiler, beef cattle and pig farms were explored. In 2016-2017, commercial farms were sampled using boot swabs and samples stored at 4 °C before microbiological analysis for phenotypical ESBL-E and gene characterization. A dichotomous questionnaire was performed. Prevalences observed in all production types and territories were high, except for beef cattle in Reunion, which differed significantly. The most common ESBL gene was blaCTX-M-1. Generalized linear models explaining ESBL-E occurrence varied between livestock production sectors and allowed identifying main protective (e.g., water quality control and detergent use for cleaning) and risk factors (e.g., recent antibiotic use, other farmers visiting the exploitation, pet presence). This study is the first to explore tools for antibiotic resistance management in IO farms. It provides interesting hypothesis to explore about antibiotic use in IO territories and ESBL-E transmission between pig, beef cattle and humans in Madagascar.
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Affiliation(s)
- Noellie Gay
- Animals, Health, Territories, Risks and Ecosystems, Avenue Agropolis, 34398 Montpellier CEDEX 5, France.
| | - Alexandre Leclaire
- Bacteriology laboratory, Félix Guyon Hospital, Saint-Denis, 97400 Reunion, France.
| | - Morgane Laval
- Animals, Health, Territories, Risks and Ecosystems, Avenue Agropolis, 34398 Montpellier CEDEX 5, France.
| | - Guillaume Miltgen
- Bacteriology laboratory, Félix Guyon Hospital, Saint-Denis, 97400 Reunion, France.
- UMR PIMIT, CNRS 9192, INSERM U1187, IRD 249, F-97418 Sainte-Clotilde, La Réunion, France.
| | - Maël Jégo
- Animals, Health, Territories, Risks and Ecosystems, Avenue Agropolis, 34398 Montpellier CEDEX 5, France.
| | - Ramin Stéphane
- Animals, Health, Territories, Risks and Ecosystems, Avenue Agropolis, 34398 Montpellier CEDEX 5, France.
| | - Julien Jaubert
- Bacteriology laboratory, Félix Guyon Hospital, Saint-Denis, 97400 Reunion, France.
| | - Olivier Belmonte
- Bacteriology laboratory, Félix Guyon Hospital, Saint-Denis, 97400 Reunion, France.
| | - Eric Cardinale
- Animals, Health, Territories, Risks and Ecosystems, Avenue Agropolis, 34398 Montpellier CEDEX 5, France.
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Allou N, Martinet O, Allyn J, Bouchet B, Jaffar-Bandjee MC, Galas T, Traversier N, Belmonte O. Emergence of melioidosis in the Indian Ocean region: Two new cases and a literature review. PLoS Negl Trop Dis 2017; 11:e0006018. [PMID: 29240770 PMCID: PMC5730118 DOI: 10.1371/journal.pntd.0006018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [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: 12/03/2022] Open
Abstract
Melioidosis is a disease caused by bacteria called B. pseudomallei. Infections can develop after contact with standing water. This disease can reach all the organs and especially the lungs. It is associated with a high mortality rate (up to 50%). Melioidosis is endemic in northern Australia and in Southeast Asia. Nevertheless, B. pseudomallei may be endemic in the Indian Ocean region and in Madagascar in particular, so clinicians and microbiologists should consider acute melioidosis as a differential diagnosis in the Indian Ocean region, in particular from Madagascar.
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Affiliation(s)
- Nicolas Allou
- Réanimation Polyvalente, Centre Hospitalier Universitaire Félix Guyon, Saint Denis, France
- * E-mail:
| | - Olivier Martinet
- Réanimation Polyvalente, Centre Hospitalier Universitaire Félix Guyon, Saint Denis, France
| | - Jérôme Allyn
- Réanimation Polyvalente, Centre Hospitalier Universitaire Félix Guyon, Saint Denis, France
| | - Bruno Bouchet
- Réanimation Polyvalente, Centre Hospitalier Universitaire Félix Guyon, Saint Denis, France
| | | | - Thomas Galas
- Réanimation Polyvalente, Centre Hospitalier Universitaire Félix Guyon, Saint Denis, France
| | - Nicolas Traversier
- Bacteriologie, Centre Hospitalier Universitaire Felix Guyon, Saint Denis, France
| | - Olivier Belmonte
- Bacteriologie, Centre Hospitalier Universitaire Felix Guyon, Saint Denis, France
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Coolen-Allou N, Belmonte O, Andre M, Gazaille V. [Hydropneumothorax revealing Mycobacterium intracellulare pleural infection]. Med Mal Infect 2017; 48:215-217. [PMID: 28993032 DOI: 10.1016/j.medmal.2017.09.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2017] [Revised: 08/15/2017] [Accepted: 09/12/2017] [Indexed: 11/25/2022]
Affiliation(s)
- N Coolen-Allou
- Service de pneumologie, CHU de La Réunion site Félix-Guyon, allée des Topazes, 97400 Saint-Denis, La Réunion.
| | - O Belmonte
- Service de microbiologie, CHU de La Réunion site Félix-Guyon, allée des Topazes, 97400 Saint-Denis, La Réunion
| | - M Andre
- Service de pneumologie, CHU de La Réunion site Félix-Guyon, allée des Topazes, 97400 Saint-Denis, La Réunion
| | - V Gazaille
- Service de pneumologie, CHU de La Réunion site Félix-Guyon, allée des Topazes, 97400 Saint-Denis, La Réunion
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Gay N, Belmonte O, Collard JM, Halifa M, Issack MI, Mindjae S, Palmyre P, Ibrahim AA, Rasamoelina H, Flachet L, Filleul L, Cardinale E. Review of Antibiotic Resistance in the Indian Ocean Commission: A Human and Animal Health Issue. Front Public Health 2017; 5:162. [PMID: 28730149 PMCID: PMC5498788 DOI: 10.3389/fpubh.2017.00162] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Accepted: 06/21/2017] [Indexed: 01/21/2023] Open
Abstract
Antimicrobial resistance (AMR) is a major threat to human, animal health, and environment worldwide. For human, transmission occurred through a variety of routes both in health-care settings and community. In animals, AMR was reported in livestock, pets, and wildlife; transmission of AMR can be zoonotic with the probably most important route being foodborne transmission. The Indian Ocean Commission (IOC), composed of Comoros, Madagascar, Mauritius, Reunion (France), and Seychelles recognized the surveillance of AMR in both animal and human as a main public health priority for the region. Mayotte, French overseas territory, located in Comoros archipelago, was also included in this review. This review summarized our best epidemiological knowledge regarding AMR in Indian Ocean. We documented the prevalence, and phenotypic and genotypic profiles of prone to resistance Gram-positive and Gram-negative bacteria both in animals and humans. Our review clearly pointed out extended-spectrum β-lactamase and carbapenemase-producing Enterobacteriaceae as main human and animal health issue in IOC. However, publications on AMR are scarce, particularly in Comoros, Mayotte, and Seychelles. Thus, research and surveillance priorities were recommended (i) estimating the volume of antimicrobial drugs used in livestock and human medicine in the different territories [mainly third generation cephalosporin (3GC)]; (ii) developing a “One Health” surveillance approach with epidemiological indicators as zoonotic foodborne pathogen (i.e., couple Escherichia coli resistance to 3GC/carbapenems); (iii) screening travelers with a history of hospitalization and consumption of antibiotic drug returning from at risk areas (e.g., mcr-1 transmission with China or hajj pilgrims) allowing an early warning detection of the emergence for quick control measures implementation in IOC.
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Affiliation(s)
- Noellie Gay
- Animals, Health, Territories, Risks and Ecosystems Unit, Department of Animal Health, French Agricultural Research Center for International Development (CIRAD), Montpellier, France
| | - Olivier Belmonte
- Bacteriology Laboratory, Félix Guyon Hospital, Saint-Denis, Reunion
| | - Jean-Marc Collard
- Experimental Bacteriology Unit, Pasteur Institute of Madagascar, Antananarivo, Madagascar
| | | | | | | | | | | | | | - Loïc Flachet
- Health Monitoring Unit, Indian Ocean Commission, Port-Louis, Mauritius
| | - Laurent Filleul
- Regional Unit of Indian Ocean, Santé Publique France, Saint-Denis, Reunion
| | - Eric Cardinale
- Animals, Health, Territories, Risks and Ecosystems Unit, Department of Animal Health, French Agricultural Research Center for International Development (CIRAD), Montpellier, France.,Health Monitoring Unit, Indian Ocean Commission, Port-Louis, Mauritius
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Holman AM, Allyn J, Miltgen G, Lugagne N, Traversier N, Picot S, Lignereux A, Oudin C, Belmonte O, Allou N. Surveillance of carbapenemase-producing Enterobacteriaceae in the Indian Ocean Region between January 2010 and December 2015. Med Mal Infect 2017; 47:333-339. [PMID: 28602387 DOI: 10.1016/j.medmal.2017.04.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Accepted: 04/12/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND The aim of this study was to trace the emergence of carbapenemase-producing Enterobacteriaceae (CPE) on Reunion Island, a French overseas territory well suited for the surveillance of CPE emergence in patients from the entire Indian Ocean Region. METHODS This retrospective multicenter study was conducted on Reunion Island between 2010 and 2015. RESULTS A total of 43 CPEs were isolated during the course of the study, in 36 patients (50% in the last year alone). Among these patients, 21 had a link with a foreign country (58%), mainly Mauritius (47.6%). Over the same period, CPEs were isolated from 13 of 1735 (0.7%) repatriated patients to Reunion Island from another country of the Indian Ocean Region. The incidence of isolation of CPEs in the repatriated patients treated in Mauritius was higher (9.2%) than in patients treated in Madagascar or the Comoros Islands (<1%, P<0.001). The most commonly isolated microorganism was Klebsiella pneumoniae (39.5%). The most frequently identified carbapenemase was NDM-1 (81.4%); 100% and 56% of the NDM-1 strains were susceptible to tigecycline and colistin, respectively. In-hospital mortality rate was higher in patients presenting with CPE infection than in patients without CPE infection (75% vs. 25%, P=0.04). CONCLUSION As elsewhere in the world, the number of CPE cases on Reunion Island is on the rise. Most cases involve patients from Mauritius, which justifies screening and isolating CPE in patients from that country.
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Affiliation(s)
- A M Holman
- Réanimation polyvalente, centre hospitalier universitaire Felix-Guyon, allée des Topazes, 97405 Saint-Denis, Réunion
| | - J Allyn
- Réanimation polyvalente, centre hospitalier universitaire Felix-Guyon, allée des Topazes, 97405 Saint-Denis, Réunion
| | - G Miltgen
- Bacteriologie, centre hospitalier universitaire Felix-Guyon, allée des Topazes, 97405 Saint-Denis, Réunion
| | - N Lugagne
- Unité d'hygiène et de lutte contre les infections hospitalières, centre hospitalier universitaire Felix-Guyon, allée des Topazes, 97405 Saint-Denis, Réunion
| | - N Traversier
- Bacteriologie, centre hospitalier universitaire Felix-Guyon, allée des Topazes, 97405 Saint-Denis, Réunion
| | - S Picot
- Bactériologie, centre hospitalier universitaire Sud Réunion, 97410 Saint-Pierre, Réunion
| | - A Lignereux
- Biologie, centre hospitalier Gabriel-Martin, 97460 Saint-Paul, Réunion
| | - C Oudin
- Comité de lutte contre les infections nosocomiales, groupe hospitalier Est Réunion, 97470 Saint-Benoît, Réunion
| | - O Belmonte
- Bacteriologie, centre hospitalier universitaire Felix-Guyon, allée des Topazes, 97405 Saint-Denis, Réunion
| | - N Allou
- Réanimation polyvalente, centre hospitalier universitaire Felix-Guyon, allée des Topazes, 97405 Saint-Denis, Réunion.
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Alberto C, Osdoit S, Bellec L, Belmonte O, Yvin JL, Bagny K. La diphtérie existe encore ! Ann Dermatol Venereol 2016. [DOI: 10.1016/j.annder.2016.09.163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Allyn J, Angue M, Corradi L, Traversier N, Belmonte O, Belghiti M, Allou N. Epidemiology of 62 patients admitted to the intensive care unit after returning from Madagascar. J Travel Med 2016; 23:taw023. [PMID: 27147730 DOI: 10.1093/jtm/taw023] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/29/2016] [Indexed: 11/14/2022]
Abstract
BACKGROUND To our knowledge, there is no data on the epidemiology of patients hospitalized in intensive care unit (ICU) after a stay in Madagascar or other low-income countries. It is possible that such data may improve transfer delays and care quality for these patients. METHODS In a retrospective study, we reviewed the charts of all patients admitted to ICU of the Reunion Island Felix Guyon University Hospital from January 2011 through July 2013. We identified all patients who had stayed in Madagascar during the 6 months prior to ICU admission. RESULTS Of 1842 ICU patients, 62 (3.4%) had stayed in Madagascar during the 6 months prior to ICU admission. Patients were 76% male and the median age was 60.5 (48.25-64.75) years; patients were more frequently residents of Madagascar than travellers (56.5%). In most cases, patients were not hospitalized or given antibiotics in Madagascar. The most frequent causes of hospitalization were infections including malaria (21%) and lower respiratory infection (11%). Carriage and infection with multidrug resistant (MDR) bacteria on ICU admission were frequent (37% and 9.7%, respectively). The mortality rate in ICU was 21%, and severity acute physiological Score II was 53.5 (37-68). CONCLUSIONS Patients admitted to ICU after a stay to Madagascar are mainly elderly patients with chronic illnesses, and often foreign residents. The admission causes are specific of the country like malaria, or specific to the population concerned such as cardiovascular accidents that could be prevented.
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Affiliation(s)
| | | | | | - Nicolas Traversier
- Bacteriology laboratory, CHU Félix Guyon, La Réunion, Bellepierre 97405 Saint-Denis cedex, France
| | - Olivier Belmonte
- Bacteriology laboratory, CHU Félix Guyon, La Réunion, Bellepierre 97405 Saint-Denis cedex, France
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Gonzalez C, Coolen-Allou N, Allyn J, Estève JB, Belmonte O, Allou N. [Severe sepsis and pulmonary abscess with bacteremia due to Elizabethkingia miricola]. Med Mal Infect 2015; 46:49-51. [PMID: 26607230 DOI: 10.1016/j.medmal.2015.10.011] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2015] [Revised: 10/06/2015] [Accepted: 10/21/2015] [Indexed: 12/16/2022]
Affiliation(s)
- C Gonzalez
- Service de réanimation polyvalente, centre hospitalier universitaire Félix-Guyon, allée des Topazes, 97400 Saint-Denis, France
| | - N Coolen-Allou
- Service de pneumologie, centre hospitalier universitaire Félix-Guyon, allée des Topazes, 97400 Saint-Denis, France
| | - J Allyn
- Service de réanimation polyvalente, centre hospitalier universitaire Félix-Guyon, allée des Topazes, 97400 Saint-Denis, France
| | - J-B Estève
- Service de cardiologie, centre hospitalier universitaire Félix-Guyon, allée des Topazes, 97400 Saint-Denis, France
| | - O Belmonte
- Service de bactériologie, centre hospitalier universitaire Félix-Guyon, allée des Topazes, 97400 Saint-Denis, France
| | - N Allou
- Service de réanimation polyvalente, centre hospitalier universitaire Félix-Guyon, allée des Topazes, 97400 Saint-Denis, France.
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Angue M, Allou N, Belmonte O, Lefort Y, Lugagne N, Vandroux D, Montravers P, Allyn J. Risk Factors for Colonization With Multidrug-Resistant Bacteria Among Patients Admitted to the Intensive Care Unit After Returning From Abroad. J Travel Med 2015; 22:300-5. [PMID: 26081076 DOI: 10.1111/jtm.12220] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2015] [Revised: 04/23/2015] [Accepted: 04/28/2015] [Indexed: 11/29/2022]
Abstract
BACKGROUND Few national recommendations exist on management of patients returning from abroad and all focus on hospitalized patients. Our purpose was to compare, in an intensive care unit (ICU), the admission prevalence and acquisition of multidrug-resistant (MDR) bacteria carriage in patients with ("Abroad") or without ("Local") a recent stay abroad, and then identify the risk factors in "Abroad" patients. METHODS In this retrospective study, we reviewed charts of all the patients hospitalized in the ICU unit from January 2011 through July 2013 with hygiene samplings performed. We identified all patients who had stayed abroad ("Abroad") within 6 months prior to ICU admission. RESULTS Of 1,842 ICU patients, 129 (7%) "Abroad" patients were reported. In the "Abroad" group, the rate of MDR strain carriage was higher at admission (33% vs 6.7%, p < 0.001) and also more often diagnosed during the ICU stay (acquisition rate: 17% vs 5.2%, p < 0.001) than in "Local" patients. Risk factors associated with MDR bacteria carriage at admission in "Abroad" patients were diabetes mellitus [odds ratio (OR) 5.1 (1.7-14.8), p = 0.003] and "hospitalization abroad with antibiotic treatment" [OR 10.7 (4.2-27.3), p < 0.001]. Hospitalization abroad without antibiotic treatment was not identified as a risk factor. CONCLUSIONS The main factor associated with MDR bacteria carriage after a stay abroad seems to be a hospitalization abroad only in case of antibiotic treatment abroad. Screening and isolation of "Abroad" patients should be recommended, even in case of a first negative screening.
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Affiliation(s)
- Marion Angue
- Intensive Care Unit, CHU Félix Guyon, Saint-Denis, France
| | - Nicolas Allou
- Intensive Care Unit, CHU Félix Guyon, Saint-Denis, France
| | | | - Yannick Lefort
- Intensive Care Unit, CHU Félix Guyon, Saint-Denis, France
| | | | - David Vandroux
- Intensive Care Unit, CHU Félix Guyon, Saint-Denis, France
| | - Philippe Montravers
- Département Anesthésie Réanimation, AP-HP, Hop Bichat-Claude Bernard, Paris, France.,Université Paris Diderot, Sorbonne Paris Cité, Paris, France
| | - Jérôme Allyn
- Intensive Care Unit, CHU Félix Guyon, Saint-Denis, France
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Allyn J, Angue M, Belmonte O, Lugagne N, Traversier N, Vandroux D, Lefort Y, Allou N. Delayed diagnosis of high drug-resistant microorganisms carriage in repatriated patients: three cases in a French intensive care unit. J Travel Med 2015; 22:215-7. [PMID: 25728976 DOI: 10.1111/jtm.12194] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2014] [Revised: 01/07/2015] [Accepted: 01/12/2015] [Indexed: 12/27/2022]
Abstract
We report three cases of high drug-resistant microorganisms (HDRMO) carriage by patients repatriated from a foreign country. National recommendations suggest systematic screening and contact isolation pending results of admission screening of all patients recently hospitalized abroad. HDRMO carriage (carbapenem-resistant Acinetobacter baumanii and carbapenemase-producing Enterobacteriaceae) was not isolated on admission screening swabs, but later between 3 and 8 days after admission. In absence of cross-transmission, two hypotheses seem possible: a false-negative test on admission, or a late onset favored by antibiotic pressure. Prolonged isolation may be discussed even in case of negative screening on admission from high-risk patients.
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Robert J, Pantel A, Merens A, Lavigne JP, Nicolas-Chanoine MH, Brieu N, Vrain A, Scanvic A, Porcheret H, Garnier P, Bertrand X, Descamps D, Hombrouck C, Soullie B, Heym B, de Montclos H, Garrec H, Levast M, Mendes-Martins L, Decousser JW, Huet C, Bert F, Herzig V, Klein JP, Nebbad B, Hendricx S, Verhaeghe A, Lafaurie C, Lanselle C, Elsayed F, Carrer A, Drieux-Rouzet L, Evreux F, Varache C, Wallet F, Martin C, Le-Bris JM, Moulhade MC, Deville E, Menouni O, Jean-Pierre H, Pierrot P, Delarbre JM, Coude B, Foca M, Degand N, Prots L, Pantel A, Adam MN, Laurens E, Raskine L, Laouira S, Arlet G, Sanchez R, Peuchant O, Grau V, Laurent C, De-Champs C, Vachee A, Harriau P, Merens A, Belmonte O, Michel G, Henry C, Picot S, Glatz I, Gueudet T, Honderlick P, Cavalie L, Galinier JL, Patoz P, van-der-Mee-Marquet N, Haguenoer E, Canis F, Kassis-Chikhany N, Le-Garrec Y. Incidence rates of carbapenemase-producing Enterobacteriaceae clinical isolates in France: a prospective nationwide study in 2011-12. J Antimicrob Chemother 2014; 69:2706-12. [DOI: 10.1093/jac/dku208] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
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Bellec L, Moiton MP, Lagrange M, Kuli B, Belmonte O. F-06: Épidémiologie des endocardites à La Réunion. Med Mal Infect 2014. [DOI: 10.1016/s0399-077x(14)70163-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Fernandez C, Gazaille V, Werbrouck-Chiraux A, Belmonte O, Sultan-Bichat N, Agape P, Chretien F, Schlossmacher P. Histoplasmose : aspects clinicopathologiques chez l’immunocompétent et l’immunodéprimé. À propos de deux cas d’infection à Histoplasma capsulatum sur l’Île de la Réunion. Rev Mal Respir 2014; 31:447-53. [DOI: 10.1016/j.rmr.2013.10.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2013] [Accepted: 09/19/2013] [Indexed: 01/02/2023]
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Belmonte O, Pailhoriès H, Kempf M, Gaultier MP, Lemarié C, Ramont C, Joly-Guillou ML, Eveillard M. High prevalence of closely-related Acinetobacter baumannii in pets according to a multicentre study in veterinary clinics, Reunion Island. Vet Microbiol 2014; 170:446-50. [PMID: 24613079 DOI: 10.1016/j.vetmic.2014.01.042] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2013] [Revised: 01/28/2014] [Accepted: 01/31/2014] [Indexed: 10/25/2022]
Abstract
Our objective was to study the carriage of Acinetobacter baumannii (AB) in pets in Reunion Island (RI), a French territory in Indian Ocean. Overall, 138 pets were sampled (rectum, mouth, wounds if applicable) in 9 veterinary clinics (VC). The prevalence of AB carriage was 6.5% (95%CI; 2.4, 10.6) and 9 carriers were identified from 4 VC. Hospitalization in a VC and antimicrobial treatment administered within the 15 preceding days were significantly associated with AB carriage (P<0.01 and P<0.05, respectively). Despite the VC in which animals have been sampled were located all around RI, most isolates (8/9) were closely-related (>90% similarity by pulsed-field gel electrophoresis). Additional studies are needed to improve the understanding about interactions between the different reservoirs of AB in RI.
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Affiliation(s)
- O Belmonte
- Laboratoire de Bactériologie, CHU Saint-Denis, La Réunion, Saint-Denis, France
| | - H Pailhoriès
- Laboratoire de Bactériologie, CHU Angers, Angers, France; Groupe d'étude des interactions hôtes pathogènes (GEIHP, EA 3142), UFR Médecine, Université Angers, Angers, France
| | - M Kempf
- Laboratoire de Bactériologie, CHU Angers, Angers, France; Groupe d'étude des interactions hôtes pathogènes (GEIHP, EA 3142), UFR Médecine, Université Angers, Angers, France
| | - M P Gaultier
- Laboratoire de Bactériologie, CHU Angers, Angers, France
| | - C Lemarié
- Laboratoire de Bactériologie, CHU Angers, Angers, France
| | - C Ramont
- Laboratoire de Bactériologie, CHU Angers, Angers, France
| | - M L Joly-Guillou
- Laboratoire de Bactériologie, CHU Angers, Angers, France; Groupe d'étude des interactions hôtes pathogènes (GEIHP, EA 3142), UFR Médecine, Université Angers, Angers, France
| | - M Eveillard
- Laboratoire de Bactériologie, CHU Angers, Angers, France; Groupe d'étude des interactions hôtes pathogènes (GEIHP, EA 3142), UFR Médecine, Université Angers, Angers, France.
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Eveillard M, Kempf M, Belmonte O, Pailhoriès H, Joly-Guillou ML. Reservoirs of Acinetobacter baumannii outside the hospital and potential involvement in emerging human community-acquired infections. Int J Infect Dis 2013; 17:e802-5. [PMID: 23672981 DOI: 10.1016/j.ijid.2013.03.021] [Citation(s) in RCA: 111] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2012] [Revised: 03/08/2013] [Accepted: 03/19/2013] [Indexed: 11/30/2022] Open
Abstract
The objective of the present report was to review briefly the potentially community-acquired Acinetobacter baumannii infections, to update information on the reservoirs of A. baumannii outside the hospital, and to consider their potential interactions with human infections. Most reports on potentially community-acquired A. baumannii have been published during the last 15 years. They concern community-acquired pneumonia, infections in survivors from natural disasters, and infected war wounds in troops from Iraq and Afghanistan. Although the existence of extra-hospital reservoirs of A. baumannii has long been disputed, the recent implementation of molecular methods has allowed the demonstration of the actual presence of this organism in various environmental locations, in human carriage, in pets, slaughter animals, and human lice. Although the origin of the A. baumannii infections in soldiers injured in Southwestern Asia is difficult to determine, there are some arguments to support the involvement of extra-hospital reservoirs in the occurrence of community-acquired infections. Overall, the emergence of community-acquired A. baumannii infections could be associated with interactions between animals, environment, and humans that are considered to be potentially involved in the emergence or re-emergence of some infectious diseases.
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Affiliation(s)
- Matthieu Eveillard
- Laboratoire de Bactériologie - Hygiene, Centre Hospitalier Universitaire, 4 rue Larrey, 49000 Angers, France; Groupe d'Etude des Interactions Hôtes Pathogènes (GEIHP), Université d'Angers, France.
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Potron A, Rondinaud E, Poirel L, Belmonte O, Boyer S, Camiade S, Nordmann P. Genetic and biochemical characterisation of OXA-232, a carbapenem-hydrolysing class D β-lactamase from Enterobacteriaceae. Int J Antimicrob Agents 2013; 41:325-9. [PMID: 23305656 DOI: 10.1016/j.ijantimicag.2012.11.007] [Citation(s) in RCA: 126] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2012] [Revised: 10/25/2012] [Accepted: 11/13/2012] [Indexed: 11/16/2022]
Abstract
Three enterobacterial isolates (two Klebsiella pneumoniae and one Escherichia coli) were recovered from three patients transferred from India to France in 2011. All three isolates were resistant or of intermediate susceptibility to all β-lactams and of decreased susceptibility to carbapenems. These three isolates expressed a novel carbapenem-hydrolysing β-lactamase, OXA-232, differing from OXA-181 and OXA-48 by one and five amino acid substitutions, respectively. Compared with OXA-181, OXA-232 had a lower ability to hydrolyse carbapenems but conversely possessed higher hydrolytic activities against penicillins. The bla(OXA-232) gene was located on a 6.1-kb ColE-type non-conjugative plasmid.
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Affiliation(s)
- Anaïs Potron
- Service de Bactériologie-Virologie, INSERM U914 Emerging Resistance to Antibiotics, Hôpital de Bicêtre, Assistance Publique/Hôpitaux de Paris, Faculté de Médecine et Université Paris-Sud, K. Bicêtre, France
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Hocquet D, Colomb M, Dehecq B, Belmonte O, Courvalin P, Plésiat P, Meziane-Cherif D. Ceftazidime-hydrolysing β-lactamase OXA-145 with impaired hydrolysis of penicillins in Pseudomonas aeruginosa. J Antimicrob Chemother 2011; 66:1745-50. [PMID: 21665906 DOI: 10.1093/jac/dkr187] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVES To describe a novel extended-spectrum oxacillinase, named OXA-145, differing from narrow-spectrum OXA-35 (from the OXA-10 group) by deletion of residue Leu-165. The genetic environment of bla(OXA-145) and the biochemical properties of OXA-145 are reported. We also assessed the impact of the Leu-165 deletion on the hydrolysis spectrum of the ancestor OXA-10. METHODS Extended-spectrum β-lactamase OXA-145 was identified in the multidrug-resistant clinical Pseudomonas aeruginosa 08-056, and characterized by isoelectric focusing, PCR and DNA sequencing. Antibiotic susceptibility tests were performed by agar dilution. The resistance profiles conferred by cloned bla(OXA-10), bla(OXA-35), bla(OXA-145) and a bla(OXA-10) derivative obtained by site-directed mutagenesis were determined in Escherichia coli. Kinetic parameters of OXA-35 and OXA-145 were established after purification of His-tagged proteins. RESULTS The sequence of OXA-145, encoded by a class 1 integron-borne gene in strain 08-056, differed from that of narrow-spectrum penicillinase OXA-35 by a single amino acid deletion (Leu-165) located in the highly conserved omega loop. Deletion of Leu-165 from OXA-35 (yielding OXA-145) or OXA-10 (the progenitor of OXA-35) extended the hydrolysis spectrum to third-generation cephalosporins and to monobactams, while reducing that for penicillins. OXA-145 showed biphasic hydrolysis curves for all the substrates tested. Its activity against nitrocefin was 10-fold higher in the presence of sodium hydrogen carbonate. CONCLUSIONS OXA-145 is a new extended-spectrum β-lactamase from the OXA-10 group. The deletion of Leu-165 is responsible for a shift in the hydrolysis spectrum from penicillins to third-generation cephalosporins, as well as monobactams. The loss of penicillin hydrolysis was due to a non-carboxylated Lys-73.
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Affiliation(s)
- Didier Hocquet
- Centre National de Référence de Résistance aux Antibiotiques, Laboratoire associé Pseudomonas aeruginosa, Centre Hospitalier Universitaire, Besançon, France
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Gaüzère BA, Bussienne F, Bouchet B, Jabot J, Roussiaux A, Drouet D, Djourhi S, Leauté B, Belcour D, Bossard G, Champion S, Jaffar-Bandjee MC, Belmonte O, Vilain P, Brottet E, Hoang L, Vandroux D. [Severe cases of A(H1N1)v2009 infection in Réunion Island in 2009 and 2010]. ACTA ACUST UNITED AC 2011; 104:97-104. [PMID: 21509522 PMCID: PMC7097782 DOI: 10.1007/s13149-011-0147-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [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: 11/12/2010] [Accepted: 02/21/2011] [Indexed: 11/21/2022]
Abstract
Dans l’hémisphère sud, La Réunion est la sentinelle des infections survenant préférentiellement au cours de l’hiver austral, susceptibles de gagner quelques mois plus tard l’hémisphère nord, telle l’infection à A(H1N1)v2009. Nous rapportons les caractéristiques des patients admis en 2009 et 2010 dans notre service de réanimation principalement pour détresse respiratoire aiguë, à la suite d’une infection à A(H1N1)v2009. Les données démographiques, cliniques, biologiques, ainsi que les traitements et le devenir des patients admis pour infection virale à A(H1N1)v2009 exclusivement confirmée par RT-PCR ont été recueillis de façon prospective. Au cours des années 2009 et 2010, 25 patients ont répondu aux critères définis d’infection à A(H1N1)v2009. L’âge médian était de 40,4 (±17,4) ans. La plupart d’entre eux (22/25) présentaient des facteurs de comorbidité: pathologies chroniques, surpoids ou obésité, grossesse, trisomie. Les principaux motifs d’admission en réanimation ont été les pneumonies virales avec tableau de syndrome de détresse respiratoire aiguë. Le recours à la ventilation artificielle a été nécessaire chez 22 des 25 patients, avec recours à des méthodes sophistiquées et réservées à quelques centres au niveau national, telles que les techniques d’oxygénation extracorporelle (ECMO) ou ventilation à haute fréquence (HFO). Au cours des deux années, 12 décès (48 %) sont survenus essentiellement dans des tableaux de défaillance multiviscérale. Au cours des hivers et automnes australs 2009 et 2010 et pendant une période de plusieurs semaines, l’infection à A(H1N1) v2009 a entraîné une surcharge d’activité notable dans les services de réanimation de La Réunion. L’échec de la campagne de vaccination, notamment des personnes à risques, a eu pour conséquence la survenue de nouveaux cas graves en 2010, notamment parmi les personnes à risques. Le recueil de ces données peut aider à la planification et à l’anticipation de la prise en charge d’autres épidémies grippales.
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Affiliation(s)
- B-A Gaüzère
- Service De Réanimation Polyvalente, Centre Hospitalier Félix-guyon, Chr Réunion, F-97405, Saint-Denis, France.
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Belmonte O, Drouet D, Alba J, Moiton MP, Kuli B, Lugagne-Delpon N, Mourlan C, Jaffar-Bandjee MC. [Evolution of Enterobacteriaceae resistance to antibiotics in Reunion Island: emergence of extended-spectrum beta-lactamases]. ACTA ACUST UNITED AC 2009; 58:18-24. [PMID: 19864085 DOI: 10.1016/j.patbio.2009.07.021] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2009] [Accepted: 07/12/2009] [Indexed: 11/28/2022]
Abstract
AIM OF THE STUDY The antibiotic resistance of enterobacteriacae knows a worldwide worrying evolution with an increase of the extended spectrum betalactamases (ESBL) that spread into the community. Few publications describe this problem in the Indian Ocean area. The aim of this study is first to identify in Félix Guyon Hospital (Reunion Island) the emergent antibiotics resistance for enterobacteriaceae between 1997/1998 and 2006/2007 periods, at second, to update the prophylactic and therapeutic measures for handling the risk linked to multiresistant enterobacteriaceae in our hospital and third, to assess the risk in Reunion Island and especially at the community level. METHODS The antibiotic susceptibility of 7814 enterobacteriaceae strains collected among patients, during 1997/1998 and 2006/2007 periods, were analysed as well as the consumption of the third generation cephalosporins, imipenem and fluoroquinolones. RESULTS Within a span of time of 10 years, an important increase (+57 %) of the resistance prevalence of enterobacteriaceae is observed. The resistance by the ESBL production mechanism is predominant especially for Enterobacter cloacae and Escherichia coli. An important use of broad spectrum antibiotics is correlated with this resistance evolution. CONCLUSION The emergence of ESBL-producing enterobacteriaceae in our hospital is impairing both therapeutic and health care. It requires a much better control of antibiotics prescriptions and therefore, an important multidisciplinary implication. A proof molecular analysis would allow to evaluate the risk more precisely, especially at the community level.
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Affiliation(s)
- O Belmonte
- Laboratoire de Microbiologie et d'Hématologie, Centre Hospitalier Régional de La Réunion, Site Félix-Guyon, Route de Bellepierre, 97405 Saint-Denis, France.
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Bencimon C, Belmonte O, Randrianarivelojosia M, Grosjean P, Pfister P, Combe P. [Diagnosis of malaria in Antananarivo City: examination of the results obtained at the Institut Pasteur de Madagascar from 2001 to 2004]. Bull Soc Pathol Exot 2006; 99:198-9. [PMID: 16983826] [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] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Malaria diagnosis is part of the daily activities of the Clinical Biology Center (CBC) of the Institut Pasteur de Madagascar in Antananarivo. Over a period of four years (2001-2004), regardless the methods being used, out of 6537 blood samples examined, 159 (2.43%) tests were positive. All four species of Plasmodium infecting human. were detected with a high prevalence of P. falciparum (87.2%). 49/159 patients were foreigners, but their files did not allow us to distinguish imported from locally acquired malaria cases. Also, among Malagasy patients, there was no possibility to recognize introduced malaria cases (contracted in coastal areas). In Madagascar malaria remains a public health problem. But fever and recent history of fever are often considered and treated as malaria. Our results demonstrated that confirmed malaria rate was very low. Reporting malaria on the basis of clinical signs overestimates malaria cases at the national level. The importance of malaria biological diagnosis is discussed in this article.
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Affiliation(s)
- C Bencimon
- Centre de biologie clinique, BP 1274, Antananarivo (101), Institut Pasteur de Madagascar
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Randrianarivelojosia M, Fidock DA, Belmonte O, Valderramos SG, Mercereau-Puijalon O, Ariey F. First evidence of pfcrt mutant Plasmodium falciparum in Madagascar. Trans R Soc Trop Med Hyg 2006; 100:826-30. [PMID: 16442577 PMCID: PMC2944659 DOI: 10.1016/j.trstmh.2005.10.009] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2005] [Revised: 10/03/2005] [Accepted: 10/26/2005] [Indexed: 11/28/2022] Open
Abstract
The island of Madagascar, lying in the Indian Ocean approximately 250 miles from the African coast, has so far remained one of the few areas in the world without noticeable Plasmodium falciparum high-grade chloroquine (CQ) resistance. Here we report genotyping data on pfcrt in Madagascar. The pfcrt K76T mutation, which is critical for resistance to CQ, was detected in six (3.3%) of 183 P. falciparum isolates screened, within the mutant haplotypes CVIET and CVIDT. This is the first observation of pfcrt mutant parasites on the island. The current massive distribution of CQ for in-home management of fever in children will promote the dissemination of these mutant CQ-resistant parasites. In this context, genotyping of pfcrt remains a useful tool for CQ resistance surveillance as the prevalence of pfcrt mutations is far from saturation in Madagascar.
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