Vedani Thibaut, Pot Matthieu, Garrigos Thomas, Sababadichetty Loïk, Daniel Marion, Wilkinson David, Benoit-Cattin Thierry, Belmonte Olivier, Mavingui Patrick, Dortet Laurent, Miltgen Guillaume
Laboratoire de Bactériologie, CHU Félix Guyon, Allée des Topazes, 97400, 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.
Ann Clin Microbiol Antimicrob. 2025 Jan 29;24(1):8. doi: 10.1186/s12941-025-00778-8.
Located in the Southwest Indian Ocean area (SIOA), the two French overseas territories (FOTs) of Reunion and Mayotte islands are heavily impacted by antimicrobial resistance. The aim of this study was to investigate all cases of NDM-5 and OXA-181 carbapenemase-producing Escherichia coli (CPEc) in these two FOTs between 2015 and 2020, to better understand the regional spread of these last-line treatment resistant bacteria.
All E. coli isolates not susceptible to ertapenem from various public and private hospitals on Reunion and Mayotte islands were screened for carbapenemase production. Clinical and microbiological data were collected for each case. Genotypic analysis of the isolates was carried out using WGS to determine the clonality relationship between the isolates and the genetic support of the carbapenemase-encoding genes.
A total of 92 isolates of NDM-5 (n = 67) and OXA-181 (n = 25) CPEc was collected from Reunion (n = 55) and Mayotte (n = 37) islands. Whole-genome sequencing identified 4 majors STs (ST58, ST167, ST405 and ST410). Genotypic analysis demonstrated numerous intra-ST possible cross transmission events, including strains isolated in both islands. Finally, all isolates (100%) carried the bla or bla genes on plasmids (IncF2, IncX3), most of which were conserved and identified in various STs.
We highlighted the dual dissemination of successful plasmids and the worrying circulation of high-risk clones via patients transfer between these two FOTs. It is therefore essential to effectively screen these patients for CPEc carriage on admission and to take these plasmids into account when investigating intra- or inter-hospital CPEc outbreaks.
留尼汪岛和马约特岛这两个法国海外领地位于西南印度洋地区（SIOA），深受抗菌药物耐药性的影响。本研究的目的是调查2015年至2020年间这两个法国海外领地中所有产NDM-5和OXA-181碳青霉烯酶的大肠杆菌（CPEc）病例，以更好地了解这些耐最后一线治疗细菌的区域传播情况。
对留尼汪岛和马约特岛各公立和私立医院中对厄他培南不敏感的所有大肠杆菌分离株进行碳青霉烯酶产生情况筛查。收集每个病例的临床和微生物学数据。使用全基因组测序（WGS）对分离株进行基因分型分析，以确定分离株之间的克隆关系以及碳青霉烯酶编码基因的遗传载体。
从留尼汪岛（n = 55）和马约特岛（n = 37）共收集到92株产NDM-5（n = 67）和OXA-181（n = 25）的CPEc。全基因组测序鉴定出4个主要序列型（ST58、ST167、ST405和ST410）。基因分型分析显示在序列型内有许多可能的交叉传播事件，包括在两个岛屿分离到的菌株。最后，所有分离株（100%）在质粒（IncF2、IncX3）上携带bla或bla基因，其中大多数是保守的且在不同序列型中被鉴定出来。
我们强调了成功质粒的双重传播以及通过患者在这两个法国海外领地之间转移导致的高风险克隆令人担忧的传播情况。因此，至关重要的是在患者入院时有效筛查其是否携带CPEc，并在调查医院内或医院间CPEc暴发时考虑这些质粒。
