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Carbapenemase-producing Enterobacteriaceae circulating in the Reunion Island, a French territory in the Southwest Indian Ocean

Authors
  • Miltgen, Guillaume1, 2
  • Cholley, Pascal3, 4
  • Martak, Daniel3, 4
  • Thouverez, Michelle3
  • Seraphin, Paul1
  • Leclaire, Alexandre1
  • Traversier, Nicolas1
  • Roquebert, Bénédicte1, 2
  • Jaffar-Bandjee, Marie-Christine1, 2
  • Lugagne, Nathalie5
  • Cimon, Céline Ben6
  • Ramiandrisoa, Mahery7
  • Picot, Sandrine8
  • Lignereux, Anne9
  • Masson, Geoffrey10
  • Allyn, Jérôme11
  • Allou, Nicolas11
  • Mavingui, Patrick2
  • Belmonte, Olivier1
  • Bertrand, Xavier3, 4
  • And 1 more
  • 1 CHU Félix Guyon, Allée des Topazes, Saint-Denis, La Réunion, 97400, France , Saint-Denis (France)
  • 2 Université de La Réunion, Sainte-Clotilde, La Réunion, France , Sainte-Clotilde (France)
  • 3 CHRU Jean Minjoz, Besançon, France , Besançon (France)
  • 4 Université de Bourgogne Franche-Comté, Besançon, France , Besançon (France)
  • 5 Service d’hygiène hospitalière, CHU Félix Guyon, Saint-Denis, La Réunion, France , Saint-Denis (France)
  • 6 Laboratoires Réunilab, Sainte-Clotilde, La Réunion, France , Sainte-Clotilde (France)
  • 7 Laboratoires Cerballiance, Le Port, La Réunion, France , Le Port (France)
  • 8 Groupe Hospitalier Sud Réunion, Saint-Pierre, La Réunion, France , Saint-Pierre (France)
  • 9 Centre Hospitalier Gabriel Martin, Saint-Paul, La Réunion, France , Saint-Paul (France)
  • 10 Groupe Hospitalier Est Réunion, Saint-Benoit, La Réunion, France , Saint-Benoit (France)
  • 11 Service de Réanimation polyvalente. Département d’Informatique clinique, CHU Félix Guyon, Saint-Denis, La Réunion, France , Saint-Denis (France)
Type
Published Article
Journal
Antimicrobial Resistance & Infection Control
Publisher
BioMed Central
Publication Date
Feb 19, 2020
Volume
9
Issue
1
Identifiers
DOI: 10.1186/s13756-020-0703-3
Source
Springer Nature
Keywords
License
Green

Abstract

BackgroundThe 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.MethodsAll 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.ResultsA 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.ConclusionsBecause 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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