Review of Antibiotic Resistance in the Indian Ocean Commission: A Human and Animal Health Issue

Abstract

Antimicrobial resistance (AMR) is a major threat to human, animal health, and environment worldwide. For human, transmission occurred through a variety of routes both in health-care settings and community. In animals, AMR was reported in livestock, pets, and wildlife; transmission of AMR can be zoonotic with the probably most important route being foodborne transmission. The Indian Ocean Commission (IOC), composed of Comoros, Madagascar, Mauritius, Reunion (France), and Seychelles recognized the surveillance of AMR in both animal and human as a main public health priority for the region. Mayotte, French overseas territory, located in Comoros archipelago, was also included in this review. This review summarized our best epidemiological knowledge regarding AMR in Indian Ocean. We documented the prevalence, and phenotypic and genotypic profiles of prone to resistance Gram-positive and Gram-negative bacteria both in animals and humans. Our review clearly pointed out extended-spectrum β-lactamase and carbapenemase-producing Enterobacteriaceae as main human and animal health issue in IOC. However, publications on AMR are scarce, particularly in Comoros, Mayotte, and Seychelles. Thus, research and surveillance priorities were recommended (i) estimating the volume of antimicrobial drugs used in livestock and human medicine in the different territories [mainly third generation cephalosporin (3GC)]; (ii) developing a “One Health” surveillance approach with epidemiological indicators as zoonotic foodborne pathogen (i.e., couple Escherichia coli resistance to 3GC/carbapenems); (iii) screening travelers with a history of hospitalization and consumption of antibiotic drug returning from at risk areas (e.g., mcr-1 transmission with China or hajj pilgrims) allowing an early warning detection of the emergence for quick control measures implementation in IOC.

Risk Factors of Extended-Spectrum β-Lactamase Producing Enterobacteriaceae Occurrence in Farms in Reunion, Madagascar and Mayotte Islands, 2016–2017

“…No phenotypic resistance to ertapenem in ESBL-E isolates was identified, which is in accordance with the absence of carbapenemase producing Enterobacteriacae (CPE) detection in IO livestock in 2018 [ 1 ]. However, use of CPE selective media would be more suitable for CPE detection.…”

“…Main ESBL-E co-resistance were observed in Madagascar (i.e., ofloxacin, tetracyclin, nalidixic acid and gentamicin) and Reunion (i.e., ofloxacin, nalidixic acid and trimethoprime/sulfamethoxazole). High ESBL-E co-resistance observed in Madagascar could point out a drug overuse, particularly for widely available oral agents [ 1 ]. Nalidixic acid resistant isolates were resistant to ofloxacin in Reunion and Madagascar pig productions as observed in majority of cases [ 27 ].…”

“…This diversity of ESBL genes in poultry could be related to close contact with poultry house surrounding environment. Interestingly, bla CTX-M-15 was observed in pig production, beef cattle and poultry from Mayotte and Madagascar; It is the main enzyme observed in humans in IO [ 1 , 20 , 21 ] and circulation of ESBL-E between human and livestock could be suspected.…”

“…Extended-spectrum β-Lactamase producing Enterobacteriaceae (ESBL-E) is a public and veterinary health burden worldwide and particularly in West Indian ocean countries [ 1 ]. These multi-resistant bacteria have been identified as a priority in terms of epidemiological surveillance in humans and animals from the Indian Ocean Commission (IOC) state members (i.e., Comoros, Madagascar, Mauritius, Reunion and Seychelles) and Mayotte (French oversea territory) [ 1 ].…”

Reunion, a sentinel island for multidrug-resistant bacteria surveillance in South-western Indian ocean: a retrospective survey using hospitalised patients screening, 2015-2017

“…Based on literature, extended-spectrum betalactamase producing Enterobacteriaceae (ESBL-E) and carbapenemase producing Enterobacteriaceae (CPE) were identified as a main public and veterinary health issue for SWIO. 3 Antimicrobial resistance was considered as a main public health priority for the area since 2015.…”