Molecular Epidemiology of resistant bacteria isolated from food in Algeria

L’émergence des bactéries à Gram négatif (BGN) productrices de carbapénémases et/ou résistantes à la colistine, provoquée par la consommation irrationnelle de ces antibiotiques, est en forte augmentation. Les pressions politiques se multiplient à l’égard de ce problème et il est de plus en plus urgent de mettre en place des mesures pour empêcher la dissémination de ces bactéries multi-résistantes et/ou des éléments génétiques mobiles qu’elles contiennent à l’homme, l’animal et dans l’environnement, pouvant alors être responsable d’infections dont les options thérapeutiques sont particulièrement limitées. Certains antibiotiques utilisés comme dernier recours pour le traitement des infections à BGN en médecine humaine, sont également fortement utilisés chez les animaux d’élevage pour le traitement et la prévention des maladies bactériennes dues à ces BGN, mais également pour favoriser la croissance et augmenter la rentabilité et les revenus des éleveurs. Cet usage non régulé des antibiotiques n’est pas sans inconvénients, pouvant entraîner la dissémination des bactéries et/ou le transfert des éléments génétiques mobiles portant les résistances aux antibiotiques à l’homme. Récemment, des résistances aux β-lactamines, aux carbapénèmes et à la colistine ont été largement rapportées chez les animaux et les aliments d’origine animale destinés à la consommation humaine, parmi les bactéries pathogènes, les bactéries zoonotiques mais aussi les bactéries commensales. En Algérie, des pratiques peu judicieuses concernant l'achat des antibiotiques par des agriculteurs sans avis des vétérinaires ont conduit à leur utilisation inappropriée. Cette pratique semble être très répandue dans les élevages, en particulier chez les volailles où les antibiotiques sont utilisés à titre prophylactique, mais aussi comme facteur de croissance rendant le risque de contamination humaine majeur. Pour contrôler l'administration rationnelle de colistine et des carbapénèmes dans le traitement des maladies animales, préserver leur efficacité et diminuer le risque d'émergence d'une résistance à un des ces antibiotiques, il est essentiel de connaître l’épidémiologie actuelle des BGN résistants à ces antibiotiques. Ainsi, ce travail de Thèse s’inscrivait dans ces objectifs : i) Caractérisation moléculaire des entérobactéries résistantes aux carbapénèmes isolées de la viande de poulet dans l'ouest de l'Algérie (Chapitre I)ii)Caractérisation moléculaire d'entérobactéries résistantes à la colistine isolées dans la viande de poulet dans l'ouest de l'Algérie (Chapitre II)Une revue de la littérature (Chapitre II) sur le rôle des animaux et en particulier des animaux producteurs d'aliments comme réservoirs de la résistance à la colistine induite par les plasmides (mcr) a été utilisée comme introduction de ce manuscrit de thèse et a permis de comparer nos résultats avec ceux préalablement obtenus.The emergence of carbapenemase-producing Gram negative bacteria (GNB) and/or colistinresistant bacteria, due to the irrational use of these antibiotic, is on the rise. It is becoming an urgent priority for policy-makers, there is an emergency to tackle the problem by developing measures to prevent the large dissemination of multidrug-resistant (MDR) bacteria and/or their genetic mobile elements to human, animal and environment. This is of importance because of the few therapeutic options remaining active to treat infections caused by MDR organisms. In veterinary settings, some common antibiotics used inhuman infections are frequently consumpted in livestock for the treatment and prevention of bacterial diseases (dueto these GNB) but also as growth promotion and to increase the farmers’ profitability and income. This unregulated use of antibiotics is not without drawbacks, which can lead to the spread of MDR bacteria and/or the transfer of the mobile genetic elements bearing the antibiotic resistance to humans. Recently, resistance to b-lactams, carbapenems and colistin has been widely reported in animals and food of animal origin intended for human consumption, among pathogenic bacteria, zoonotic bacteria but also commensal bacteria. However, little is known about the dissemination of MDR strains in food producing animals In Algeria, unwise practices concerning the purchase of antibiotics by farmers without veterinary advice led to their inappropriate use. This practice seems to be widespread infarms, especially in poultry where antibiotics are used prophylactically, but also as a growth factor, inducing the risk of major human contamination. In this way, polymyxins are widely used and poultry was identified to be an important source of colistin resistance mediated by the new transferable plasmid (mcr) among commensal GNB. To control the rational administration of antibiotics in the treatment of animal diseases, to preserve their effectiveness and to reduce the risk of the emergence of colistin/carbapenem resistance, it is essential to know the current epidemiology of the resistance of GNB to these antibiotics.Thus, the different objectives of this thesis were:The molecular characterisation of carbapenem-resistant Enterobacterales isolated from chicken meat in Western Algeria (Chapter I), The molecular characterisation of colistin-resistant Enterobacterales isolated from chicken meat in Western Algeria (Chapter III). A review of the literature (Chapter II) on the role of animals and particularly food-producing animals as reservoirs of the colistin resistance mediated plasmid (mcr) was conducted as an introduction to this thesis manuscript and was allowed to compare our results with those previously obtained

Characterization of Staphylococcus aureus Isolated from Food Products in Western Algeria

International audienceThe current study aimed to characterize Staphylococcus aureus isolates from foodstuffs collected from western Algeria. A total of 153 S. aureus isolates from various raw and processed foods were obtained and identified using matrix-assisted laser desorption and ionization time-of-flight mass spectrometry. Isolates were characterized by antimicrobial susceptibility testing and toxin gene detection. Methicillin-resistant Staphylococcus aureus (MRSA) isolates were identified by detection of the mecA gene and characterized by staphylococcal cassette chromosome mec (SCCmec) typing. We found that 30.9% (153/495) of food samples were contaminated with S. aureus. Thirty-three (21.5%) S. aureus isolates were identified as MRSA, and 16.9% (26/153) carried the mecA gene. Three SCCmec types were identified of which type IV was the most common (69.2%) followed by type V (15.3%) and type II (7.6%). Two MRSA isolates were not typable with SCCmec typing. None of the examined isolates harbored mecC. Furthermore, 14.3% (22/153) of the isolates were toxigenic S. aureus. The cytotoxin gene pvl was detected in 11.1% of the S. aureus isolates. This gene was more commonly detected (76.4%) in MRSA isolates than in methicillin-suceptible Staphylococcus aureus (MSSA) isolates. The tsst-1 gene coding for toxic shock syndrome toxin was isolated rarely (3.2%) and only in MSSA isolates. According to disk diffusion test results, 70 isolates were resistant to only one antimicrobial drug, and 51 (33.3%) isolates were multidrug resistant. Other 32 isolates were susceptible to all antibiotics. Our study highlights, for the first time, a high prevalence of multidrug-resistant S. aureus isolates carrying pvl or tsst-1 found in food products in Algeria. The risk of MRSA transmission through the food chain cannot be disregarded, particularly in uncooked foods

First occurrence of NDM-1 in Acinetobacter baumannii ST85 isolated from ă Algerian dairy farms

International audienceno abstrac

Spread of OXA-48 and NDM-1-Producing Klebsiella pneumoniae ST48 and ST101 in Chicken Meat in Western Algeria

International audienc

Type 1 Diabetes in People Hospitalized for COVID-19: New Insights From the CORONADO Study

International audienc

The association between macrovascular complications and intensive care admission, invasive mechanical ventilation, and mortality in people with diabetes hospitalized for coronavirus disease-2019 (COVID-19)

International audienceAbstract Background It is not clear whether pre-existing macrovascular complications (ischemic heart disease, stroke or peripheral artery disease) are associated with health outcomes in people with diabetes mellitus hospitalized for COVID-19. Methods We conducted cohort studies of adults with pre-existing diabetes hospitalized for COVID-19 infection in the UK, France, and Spain during the early phase of the pandemic (between March 2020—October 2020). Logistic regression models adjusted for demographic factors and other comorbidities were used to determine associations between previous macrovascular disease and relevant clinical outcomes: mortality, intensive care unit (ICU) admission and use of invasive mechanical ventilation (IMV) during the hospitalization. Output from individual logistic regression models for each cohort was combined in a meta-analysis. Results Complete data were available for 4,106 (60.4%) individuals. Of these, 1,652 (40.2%) had any prior macrovascular disease of whom 28.5% of patients died. Mortality was higher for people with compared to those without previous macrovascular disease (37.7% vs 22.4%). The combined crude odds ratio (OR) for previous macrovascular disease and mortality for all four cohorts was 2.12 (95% CI 1.83–2.45 with an I 2 of 60%, reduced after adjustments for age, sex, type of diabetes, hypertension, microvascular disease, ethnicity, and BMI to adjusted OR 1.53 [95% CI 1.29–1.81]) for the three cohorts. Further analysis revealed that ischemic heart disease and cerebrovascular disease were the main contributors of adverse outcomes. However, proportions of people admitted to ICU (adjOR 0.48 [95% CI 0.31–0.75], I 2 60%) and the use of IMV during hospitalization (adjOR 0.52 [95% CI 0.40–0.68], I 2 37%) were significantly lower for people with previous macrovascular disease. Conclusions This large multinational study of people with diabetes mellitus hospitalized for COVID-19 demonstrates that previous macrovascular disease is associated with higher mortality and lower proportions admitted to ICU and treated with IMV during hospitalization suggesting selective admission criteria. Our findings highlight the importance correctly assess the prognosis and intensive monitoring in this high-risk group of patients and emphasize the need to design specific public health programs aimed to prevent SARS-CoV-2 infection in this subgroup