title: French regional surveillance program of carbapenemase-producing Gram-negative bacilli: results from a 2-year period.
abstract: In February 2011, the CARB-LR group was created as a sentinel laboratory-based surveillance network to control the emergence of carbapenem-resistant Gram-negative bacilli (CR GNB) in a French Southern Region. We report the epidemiological results of a 2-year study. All the Gram-negative bacilli isolates detected in the different labs (hospital and community settings) of a French Southern Region and with reduced susceptibility to ertapenem and/or imipenem were characterised with regard to antibiotic resistance, bla genes content, repetitive sequence-based polymerase chain reaction (rep-PCR) profiles and multilocus sequence typing (MLST). A total of 221 strains were analysed. Acinetobacter baumannii was the most prevalent carbapenemase-producing bacteria, with a majority of OXA-23 producers (n = 37). One isolate co-produced OXA-23 and OXA-58 enzymes. Klebsiella pneumoniae was the most frequent carbapenemase-producing Enterobacteriaceae (CPE) (OXA-48 producer: n = 29, KPC producer: n = 1), followed by Escherichia coli (OXA-48 producer: n = 8, KPC producer: n = 1) and Enterobacter cloacae (OXA-48 producer, n = 1). One isolate of Pseudomonas aeruginosa produced a VIM-1 carbapenemase. A clonal diversity of carbapenemase-producing K. pneumoniae and E. coli was noted with different MLSTs. On the other hand, almost all OXA-23-producing A. baumannii strains belonged to the widespread ST2/international clone II. The link between the detection of CR GNB and a foreign country was less obvious, suggesting the beginning of a local cross-transmission. The number of CR GNB cases in our French Southern Region has sharply increased very recently due to the diffusion of OXA-48 producers.
authors.affiliation: Service de Microbiologie, CHU Carémeau, Place du Professeur Robert Debré, Nîmes Cedex 09, 30029, France.
authors.forename: A
authors.initials: A
authors.lastname: Pantel
authors.forename: A
authors.initials: A
authors.lastname: Boutet-Dubois
authors.forename: H
authors.initials: H
authors.lastname: Jean-Pierre
authors.forename: H
authors.initials: H
authors.lastname: Marchandin
authors.forename: A
authors.initials: A
authors.lastname: Sotto
authors.forename: J-P
authors.initials: JP
authors.lastname: Lavigne
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology; D001426:Bacterial Proteins / Q000096:biosynthesis*; D024881:Drug Resistance, Bacterial; D004755:Enterobacteriaceae / Q000187:drug effects / Q000201:enzymology* / Q000235:genetics / Q000302:isolation & purification; D004756:Enterobacteriaceae Infections / Q000453:epidemiology* / Q000382:microbiology*; D005602:France / Q000453:epidemiology; D006801:Humans; D062486:Public Health Surveillance; D001618:beta-Lactamases / Q000096:biosynthesis*
chemical_list: D000900:Anti-Bacterial Agents; D001426:Bacterial Proteins; D001618:beta-Lactamases; C063912:carbapenemase