Gay Noellie, Belmonte Olivier, Collard Jean-Marc, Halifa Mohamed, Issack Mohammad Iqbal, Mindjae Saindou, Palmyre Philippe, Ibrahim Abdul Aziz, Rasamoelina Harena, Flachet Loïc, Filleul Laurent, Cardinale Eric
Animals, Health, Territories, Risks and Ecosystems Unit, Department of Animal Health, French Agricultural Research Center for International Development (CIRAD), Montpellier, France.
Bacteriology Laboratory, Félix Guyon Hospital, Saint-Denis, Reunion.
Front Public Health. 2017 Jul 6;5:162. doi: 10.3389/fpubh.2017.00162. eCollection 2017.
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 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.
抗菌药物耐药性（AMR）是全球人类、动物健康和环境面临的重大威胁。对人类而言，耐药性在医疗机构和社区中通过多种途径传播。在动物中，牲畜、宠物和野生动物均有抗菌药物耐药性的报道；抗菌药物耐药性的传播可能是人畜共患病，其中最重要的传播途径可能是食源性传播。由科摩罗、马达加斯加、毛里求斯、留尼汪（法国）和塞舌尔组成的印度洋委员会（IOC）认识到对动物和人类抗菌药物耐药性的监测是该地区主要的公共卫生重点。位于科摩罗群岛的法国海外领地马约特也被纳入此次综述。本综述总结了我们关于印度洋抗菌药物耐药性的最佳流行病学知识。我们记录了动物和人类中易产生耐药性的革兰氏阳性菌和革兰氏阴性菌的流行情况以及表型和基因型特征。我们的综述明确指出，产超广谱β-内酰胺酶和碳青霉烯酶的肠杆菌科细菌是印度洋委员会地区主要的人类和动物健康问题。然而，关于抗菌药物耐药性的出版物很少，特别是在科摩罗、马约特和塞舌尔。因此，建议了研究和监测重点：（i）估计不同地区（主要是第三代头孢菌素（3GC））在兽用和人用抗菌药物的使用量；（ii）制定一种“同一健康”监测方法，以人畜共患病食源性病原体的流行病学指标（即对3GC/碳青霉烯类药物的耐药性组合）为依据；（iii）对有住院史和曾在高危地区（如与中国的mcr-1传播或朝觐朝圣者）服用抗生素药物的旅行者进行筛查，以便早期预警检测到耐药性的出现，从而在印度洋委员会地区迅速实施控制措施。
