Case Report: Six New Cases of Melioidosis in the Indian Ocean Region: Comoros, Madagascar, Reunion Island

Renou, Amélie; Miltgen, Guillaume; Blondé, Renaud; Jean, Fanny; Allyn, Jérôme; Allou, Nicolas

doi:10.4269/ajtmh.20-0497

Cited by 2 publications

(3 citation statements)

References 6 publications

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“…34 To date, the etiology of CAP in R eunion Island has been investigated in only one comprehensive study. 10 As a result, severe CAP is currently managed based on French and international guidelines, 12,13 which do not specifically target microorganisms found in tropical regions (e.g., Burkholderia pseudomallei and [35][36][37] Yersinia pestis 38 ). These guidelines recommend initiating antibiotic therapy effective against all strains of S. pneumoniae and Legionella spp., namely combination therapy with cephalosporin and a SEVERE COMMUNITY-ACQUIRED ACINETOBACTER BAUMANNII PNEUMONIA macrolide or monotherapy with a respiratory fluoroquinolone.…”

Section: Discussionmentioning

confidence: 99%

Case Report: Severe Community-Acquired Pneumonia in Réunion Island due to Acinetobacter baumannii

Rotini,

de Mangou,

Combe

et al. 2024

The American Journal of Tropical Medicine and Hygiene

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Acinetobacter baumannii (Ab) is a well-known nosocomial pathogen that has emerged as a cause of community-acquired pneumonia (CAP) in tropical regions. Few global epidemiological studies of CAP-Ab have been published to date, and no data are available on this disease in France. We conducted a retrospective chart review of severe cases of CAP-Ab admitted to intensive care units in Réunion University Hospital between October 2014 and October 2022. Eight severe CAP-Ab cases were reviewed. Median patient age was 56.5 years. Sex ratio (male-to-female) was 3:1. Six cases (75.0%) occurred during the rainy season. Chronic alcohol use and smoking were found in 75.0% and 87.5% of cases, respectively. All patients presented in septic shock and with severe acute respiratory distress syndrome. Seven patients (87.5%) presented in cardiogenic shock, and renal replacement therapy was required for six patients (75.0%). Five cases (62.5%) presented with bacteremic pneumonia. The mortality rate was 62.5%. The median time from hospital admission to death was 3 days. All patients received inappropriate initial antibiotic therapy. Acinetobacter baumannii isolates were all susceptible to ceftazidime, cefepime, piperacillin-tazobactam, ciprofloxacin, gentamicin, and imipenem. Six isolates (75%) were also susceptible to ticarcillin, piperacillin, and cotrimoxazole. Severe CAP-Ab has a fulminant course and high mortality. A typical case is a middle-aged man with smoking and chronic alcohol use living in a tropical region and developing severe CAP during the rainy season. This clinical presentation should prompt administration of antibiotic therapy targeting Ab.

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Section: Discussionmentioning

confidence: 99%

Case Report: Severe Community-Acquired Pneumonia in Réunion Island due to Acinetobacter baumannii

Rotini,

de Mangou,

Combe

et al. 2024

The American Journal of Tropical Medicine and Hygiene

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“…The global melioidosis burden was predicted to be 165,000 human cases in 2015 (2). Moreover, reports of human and, occasionally, animal cases are increasing along with environmental evidence of the bacteria worldwide, highlighting the probable presence of the bacterium in all continents, including Africa and the Americas [3][4][5].…”

Section: Introductionmentioning

confidence: 99%

“…The number of farms in the table is higher than the total number of farms tested, as 10 farms included more than one animal species, i.e., appear in several columns 4…”

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confidence: 98%

Serological screening in animals combined with environmental surveys provides definite proof of the local establishment ofBurkholderia pseudomalleiin Guadeloupe

Gasqué,

Guernier-Cambert,

Manuel

et al. 2024

Preprint

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Background: Melioidosis is an emerging infectious disease caused by the soil-dwelling bacterium Burkholderia pseudomallei that affects both humans and animals. It is endemic in South and Southeast Asia, and northern Australia, causing an estimated 165,000 human cases annually worldwide. Human cases have been reported in the French West Indies (Martinique and Guadeloupe) since the 1990s. Conversely, no human cases have been reported in French Guiana, a French territory in South America. Our study aimed to investigate whether B. pseudomallei is locally established in Guadeloupe and French Guiana. We assessed animal exposure by serology and examined the presence of B. pseudomallei in the environment of seropositive animals. Methodology/Principal findings: Blood samples were collected from domestic animals in two goat farms in Les Saintes, Guadeloupe (n=31), and in 56 farms in French Guiana (n=670) and tested by ELISA. Serological follow up was performed on selected farms. Soil, water and goat rectal swabs were collected and analysed by culture and PCR. In French Guiana, the highest prevalence rates were observed in equids (24%) and cattle (16%), while in Les Saintes, a prevalence of 39% was observed in goats. The longitudinal study in Les Saintes revealed consistent high seropositivity in goats. A B. pseudomallei strain was isolated from the soil from one of the farms and detected in goat rectal swabs from the other farm. Conclusions/Significance: Our environmental investigation prompted by the serologic data confirms the presence of B. pseudomallei in Les Saintes, consistent with documented human cases of melioidosis on this island. In French Guiana, our serologic results call for environmental surveys and a re-evaluation of human infections with melioidosis-like symptoms. The approach developed in this study may help to identify high-risk areas that warrant further investigation.

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Case Report: Six New Cases of Melioidosis in the Indian Ocean Region: Comoros, Madagascar, Reunion Island

Cited by 2 publications

References 6 publications

Case Report: Severe Community-Acquired Pneumonia in Réunion Island due to Acinetobacter baumannii

Case Report: Severe Community-Acquired Pneumonia in Réunion Island due to Acinetobacter baumannii

Serological screening in animals combined with environmental surveys provides definite proof of the local establishment ofBurkholderia pseudomalleiin Guadeloupe

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