Outbreak of IMI-1 carbapenemase-producing colistin-resistant Enterobacter cloacae on the French island of Mayotte (Indian Ocean).
Fiche publication
Date publication
septembre 2018
Journal
International journal of antimicrobial agents
Auteurs
Membres identifiés du Cancéropôle Est :
Pr HOCQUET Didier
Tous les auteurs :
Miltgen G, Bonnin RA, Avril C, Benoit-Cattin T, Martak D, Leclaire A, Traversier N, Roquebert B, Jaffar-Bandjee MC, Lugagne N, Filleul L, Subiros M, de Montera AM, Cholley P, Thouverez M, Dortet L, Bertrand X, Naas T, Hocquet D, Belmonte O
Lien Pubmed
Résumé
The spread of carbapenemase-producing Enterobacteriaceae in the Southwest Indian Ocean islands is poorly known. Here we describe an outbreak of colistin-resistant Enterobacter cloacae harbouring bla in the French overseas department of Mayotte. Between October 2015 and January 2017, all isolates of imipenem-non-susceptible E. cloacae at Mayotte Medical Center and University Hospital of Reunion Island were screened for carbapenemase production. Positive isolates were typed by pulsed-field gel electrophoresis and whole-genome sequencing (WGS)-based multilocus sequence typing (MLST), and all β-lactamase genes were identified by PCR and sequencing. Resistance profiles were determined by agar diffusion and Etest. Genetic support of the bla gene was determined by WGS. A total of 18 E. cloacae isolates harbouring bla were detected in 17 patients from Mayotte. Pulsed-field gel electrophoresis (PFGE) analysis showed 16 of the 18 strains to be clonally related and belonging to ST820. Based on clinical data, this outbreak most likely had a community origin. The bla gene in the 18 isolates was carried by a new variant of an integrative mobile element involving the Xer recombinases, called EcloIMEX-8. The mcr-1-mcr-5 genes were absent from the collection. The isolates belonged to E. cloacae cluster XI, known to be colistin heteroresistant. Here we report the first outbreak of IMI-1-producing Enterobacteriaceae. IMI-1-producers may be underdetected in microbiology laboratories because of their unusual antimicrobial resistance profile (resistant to imipenem but with intermediate resistance to ertapenem and susceptible to extended-spectrum cephalosporins) and the absence of bla in the panel of genes targeted by molecular diagnostic kits.
Mots clés
Carbapenemase, Enterobacter cloacae, French overseas island, Mayotte, Outbreak, bla(IMI-1)
Référence
Int. J. Antimicrob. Agents. 2018 Sep;52(3):416-420