Outbreak of IMI-1 carbapenemase-producing colistin-resistant Enterobacter cloacae on the French island of Mayotte (Indian Ocean)

Miltgen, Guillaume; Bonnin, Rémy A.; Avril, Catherine; Benoit-Cattin, T.; Martak, Daniel; Leclaire, Alexandre; Traversier, Nicolas; Roquebert, Bénédicte; Jaffar‐Bandjee, Marie‐Christine; Lugagne, Nathalie; Filleul, Laurent; Subiros, Marion; Montera, Anne-Marie de; Cholley, Pascal; Thouverez, Michelle; Dortet, Laurent; Bertrand, Xavier; Hocquet, Didier; Belmonte, Olivier

doi:10.1016/j.ijantimicag.2018.05.015

Cited by 21 publications

(15 citation statements)

References 19 publications

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“…25,26 Previous studies showed that the detection rate of CR-ECL strains in North America, Europe, the Middle East and Southeast Asia was relatively high, 7 and even outbreaks occurred in some areas. 27 In China, the molecular epidemiology of CR-ECL has been reported in Henan, Guangdong and northwestern China, and ST418 and ST78 were the predominant epidemic types of CR-ECL producing blaNDM-1 in Guangdong and northwestern China, respectively. 28,29 However, there have been no reports on the clinical molecular epidemiology of CR-ECL infection in southwestern China, and there is an urgent need to systematically analyse the epidemiological characteristics of CR-ECL infection.…”

Section: Discussionmentioning

confidence: 99%

Carbapenem-Resistant Enterobacter cloacae Causing Nosocomial Infections in Southwestern China: Molecular Epidemiology, Risk Factors, and Predictors of Mortality

Tian¹,

Huang²,

Yang³

et al. 2020

IDR

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Background: The emergence and spread of carbapenem-resistant Enterobacter cloacae (CR-ECL) have posed a serious threat to clinical management. This retrospective study assessed the epidemiological characteristics of CR-ECL to explore the risk factors and predictors of mortality in patients with CR-ECL infection. Methods: We performed a retrospective 1:2 case-control study of hospitalized patients from January 2014 to December 2017. A total of 85 consecutive unique CR-ECL strains comprised the case group, and 170 matched patients with carbapenem-susceptible Enterobacter cloacae (CS-ECL) infection at the same period as the control group. Isolates were screened for potential resistance genes by polymerase chain reaction (PCR) and molecular typing was performed by multilocus sequence typing (MLST). Results: The results of drug resistance gene detection showed that blaNDM-1 was the most common carbapenem resistance gene. The MLST results showed that ST51 was the predominant epidemic type, followed by ST88. ICU admission (P<0.001), drainage tube (P=0.002), central venous catheter (P=0.005), and carbapenem exposure (P=0.003) were independent risk factors for CR-ECL infection. Significant predictors for 28-day mortality included solid tumours (P=0.005), septic shock (P=0.019), and mechanical ventilation (P=0.027). Conclusion: Our study indicated that ST51 and ST88, which are closely related, were the predominant epidemic types of CR-ECL producing blaNDM-1 in southwestern China. Strengthening the surveillance of patients with solid tumours, septic shock and mechanical ventilation is an urgent need.

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Section: Discussionmentioning

confidence: 99%

Carbapenem-Resistant Enterobacter cloacae Causing Nosocomial Infections in Southwestern China: Molecular Epidemiology, Risk Factors, and Predictors of Mortality

Tian¹,

Huang²,

Yang³

et al. 2020

IDR

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“…The proportion of IMI carbapenemase is ten times higher in Reunion than in mainland France [35]. This high prevalence is due to an on-going outbreak of IMI-1 E. cloacae in Mayotte Island [36]. The third most prevalent resistance mechanism was bla IMP-10 (4.8%), harboured by a S. marcescens isolates.…”

Section: Discussionmentioning

confidence: 99%

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

Miltgen

Cholley

Martak

et al. 2020

Antimicrob Resist Infect Control

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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 nonsusceptible to colistin. bla NDM was the most frequent carbapenemase (79.4%), followed by bla IMI (11.1%), and bla IMP-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. bla NDM) in a polyclonal bacterial population and raises fears that Reunion Island could contribute to the influx of NDMcarbapenemase producers into the French mainland territory.

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“…The poor performance of the BD Phoenix CPO Detect in detecting IMI-1 carbapenemase in our study could account for this difference, as Thomson et al only included 1 IMI isolate in their evaluation. Despite being chromosomally encoded, IMI-1 carbapenemase-producing colistin-resistant E. cloacae has caused one outbreak on the French island of Mayotte (19). Previous studies have shown that IMI carbapenemase enzyme production can be induced when these isolates are challenged with imipenem (20,21).…”

Section: Discussionmentioning

confidence: 99%

Diagnostic Accuracy of BD Phoenix CPO Detect for Carbapenemase Production in 190 Enterobacteriaceae Isolates

et al. 2018

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The rapid and accurate detection of carbapenemase-producing (CPE) is necessary for patient management and infection control measures. We compared the performance of the BD Phoenix CPO Detect with that of a homemade Carba NP assay and a modified carbapenem inactivation method (mCIM) by challenging all 3 assays with 190 isolates of with meropenem MICs of >0.125 mg/liter. A total of 160 isolates produced KPC-, IMI-1-, NDM-, IMP-, and OXA-type carbapenemases, while 30 isolates were negative for carbapenemase production. The sensitivity and specificity were 90.6% (95% confidence interval [CI], 85.0% to 94.7%) and 100.0% (95% CI, 88.4% to 100.0%), respectively, for the Carba NP; 100.0% (95% CI, 97.7% to 100.0%) and 96.7% (95% CI, 82.7% to 99.9%), respectively, for the mCIM; and 89.4% (95% CI, 83.5% to 93.7%) and 66.7% (95% CI, 47.2% to 82.7%), respectively, for the BD Phoenix CPO Detect. In particular, the BD CPO Detect failed to detect a significant number of CPE with IMI-1. While the BD Phoenix CPO Detect is able to classify carbapenemases and is built into routine susceptibility testing with the potential to reduce the time to CPE detection, its low specificity means that a positive result will need confirmatory testing by another method.

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Outbreak of IMI-1 carbapenemase-producing colistin-resistant Enterobacter cloacae on the French island of Mayotte (Indian Ocean)

Cited by 21 publications

References 19 publications

<p>Carbapenem-Resistant <em>Enterobacter cloacae</em> Causing Nosocomial Infections in Southwestern China: Molecular Epidemiology, Risk Factors, and Predictors of Mortality</p>

<p>Carbapenem-Resistant <em>Enterobacter cloacae</em> Causing Nosocomial Infections in Southwestern China: Molecular Epidemiology, Risk Factors, and Predictors of Mortality</p>

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

Diagnostic Accuracy of BD Phoenix CPO Detect for Carbapenemase Production in 190 Enterobacteriaceae Isolates

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