Melioidosis in New Caledonia: a dominant strain in a transmission hotspot

Melot, Bénédicte; Colot, Julien; Lacassin, F.; Tardieu, S; Lapisardi, E; Mayo, Mark; Price, Erin P.; Sarovich, Derek S.; Currie, Bart J.; Goarant, Cyrille

doi:10.1017/s0950268815002770

Cited by 4 publications

(10 citation statements)

References 29 publications

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Section: Discussionsupporting

confidence: 52%

“…Theirprovenances are as follows: An isolate from Romania in 1966, two Australian isolates respectively from 2013 and 2016, two mainland France isolates from 2011 and 2021, an isolate from Wallis and Futuna from 2012, and three isolates from French Polynesia, isolated in 2017, 2019 and 2020. As observed for other pathogens, e.g., Burkholderia pseudomallei(43), the predominant sublineages seem to be linked either to geographically close territories (Polynesia, Australia) or from metropolitan France, consistent with human transmission and dissemination.In this study, cases with C. diphtheriae had an uneven geographic repartition across New Caledonia. This observation can in part be explained by the geographical distribution of the population: high population density in the main city of Nouméa (34.7% of the population) and in the South Province (74.9 % of the population), but low density in the North Province and the Islands, with respectively 18.4 % and 6.8% of the population(15).…”

supporting

confidence: 56%

“…Of all the published data available worldwide (876 genomes), nine strains outside New Caledonia belong to this sublineage (Table S3). (43), the predominant sublineages seem to be linked either to geographically close territories (Polynesia, Australia) or from metropolitan France, consistent with human transmission and dissemination.…”

Section: Discussionmentioning

confidence: 76%

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Genomic epidemiology ofCorynebacterium diphtheriaein New Caledonia

Tessier

Hennart

Badell-Ocando

et al. 2022

Preprint

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Objectives: An increasing number of isolations of Corynebacterium diphtheriae has been observed in recent years in the archipelago of New Caledonia. We aimed to analyze the clinical and microbiological features of samples with C. diphtheriae. Methods: All C. diphtheriae isolates identified in New Caledonia from May 2015 to May 2019 were included. For each case, a retrospective consultation of the patient files was conducted. Antimicrobial susceptibility phenotypes, tox gene and diphtheria toxin expression, biovar and the genomic sequence were determined. Core genome multilocus sequence typing (cgMLST), 7-gene MLST and search of genes of interest were performed from genomic assemblies. Results: 58 isolates were included, with a median age of patients of 28 years (range: 9 days to 78 years). Cutaneous origin accounted for 51 of 58 (87.9%) isolates, and C. diphtheriae was associated with Staphylococcus aureus and/or Streptococcus pyogenes in three quarters of cases. Half of cases came either from the main city Noumea (24%, 14/58) or from the sparsely populated island of Lifou (26%, 15/58). Six tox-positive isolates were identified, associated with recent travel to Vanuatu; 5 of these cases were linked and cgMLST confirmed recent transmission. Two cases of endocarditis in young female patients with a history of rheumatic fever involved tox-negative isolates. The 58 isolates were mostly susceptible to commonly used antibiotics. In particular, no isolate was resistant to the first-line molecules amoxicillin or erythromycin. Resistance to tetracycline was found in a genomic cluster of 17 (29%) isolates, 16 of which carried the tetO gene. There were 13 cgMLST sublineages, most of which were also observed in the neighboring country Australia. Conclusions: Cutaneous infections may harbor non-toxigenic C. diphtheriae isolates, which circulate largely silently in non-specific wounds. The possible introduction of tox-positive strains from a neighboring island illustrates that diphtheria surveillance should be maintained in New Caledonia, and that immunization in neighboring islands must be improved. Genomic sequencing uncovers how genotypes circulate locally and across neighboring countries.

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Section: Discussionsupporting

confidence: 52%

supporting

confidence: 56%

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Genomic epidemiology ofCorynebacterium diphtheriaein New Caledonia

Tessier

Hennart

Badell-Ocando

et al. 2022

Preprint

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“…Similar to in PNG, the first melioidosis studies in New Caledonia were conducted and reported by animal health workers [ 8 ]. The first human case was reported in 1999 [ 9 ]; since then, 19 melioidosis cases have been reported and studied [ 23 , 24 , 25 ]. As seems the case in PNG, melioidosis in New Caledonia is mostly restricted to one regional province, although whether there are biogeographic, demographic, or simply healthcare access factors at play can be only determined through a thorough and structured epidemiological and environmental study across the dispersed islands of that nation.…”

Section: Review Of Confirmed Human Melioidosis Casesmentioning

confidence: 99%

“…As is the case in the Balimo region of PNG, there is evidence in New Caledonia of a persistent, dominant clonal strain as defined by MLST, with ST292 being the most common in the highly-endemic east coast region. All isolates analysed with MLST were shown to cluster—along with the other isolates from Melanesia—within the Australian clade rather than the Asian clade [ 25 ].…”

Section: Review Of Confirmed Human Melioidosis Casesmentioning

confidence: 99%

Melioidosis in Papua New Guinea and Oceania

Warner

Currie

2018

TropicalMed

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Melioidosis has only been sporadically reported throughout Melanesia and the Pacific region since the first report from Guam in 1946; therefore, its contribution to the disease burden in this region is largely unknown. However, the outcome of a small number of active surveillance programs, serological surveys, and presumptive imported cases identified elsewhere provide an insight into its epidemiology and potential significance throughout the region. Both clinical cases and environmental reservoirs have been described from the rural district of Balimo in the Western Province of Papua New Guinea and from the Northern Province of New Caledonia. In both these locations the incidence of disease is similar to that described in tropical Australia and Burkholderia pseudomallei isolates are also phylogenetically linked to Australian isolates. Serological evidence and presumptive imported cases identified elsewhere suggest that melioidosis exists in other countries throughout the Pacific. However, the lack of laboratory facilities and clinical awareness, and the burden of other infections of public health importance such as tuberculosis, contribute to the under-recognition of melioidosis in this region.

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