Waterborne Infections in Reunion Island, 2010–2017

Nicolas Allou Réanimation Polyvalente, Centre Hospitalier Universitaire Félix Guyon, Allée des Topazes, Saint Denis, France;

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Aurélien Soubeyrand Réanimation Polyvalente, Centre Hospitalier Universitaire Félix Guyon, Allée des Topazes, Saint Denis, France;

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Nicolas Traversier Bacteriologie, Centre Hospitalier Universitaire Felix Guyon, Allée des Topazes, Saint Denis, France;

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Romain Persichini Réanimation Polyvalente, Centre Hospitalier Universitaire Félix Guyon, Allée des Topazes, Saint Denis, France;

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Caroline Brulliard Réanimation Polyvalente, Centre Hospitalier Universitaire Félix Guyon, Allée des Topazes, Saint Denis, France;

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Dorothée Valance Réanimation Polyvalente, Centre Hospitalier Universitaire Félix Guyon, Allée des Topazes, Saint Denis, France;

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Olivier Martinet Réanimation Polyvalente, Centre Hospitalier Universitaire Félix Guyon, Allée des Topazes, Saint Denis, France;

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Sandrine Picot Bacteriologie, Centre Hospitalier Universitaire Sud Réunion, Saint Pierre, Saint Pierre, France

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Olivier Belmonte Bacteriologie, Centre Hospitalier Universitaire Felix Guyon, Allée des Topazes, Saint Denis, France;

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Jérôme Allyn Réanimation Polyvalente, Centre Hospitalier Universitaire Félix Guyon, Allée des Topazes, Saint Denis, France;

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Gram-negative bacilli Vibrio spp., Aeromonas spp., and Shewanella spp. are a major cause of severe waterborne infection. The aim of this study was to assess the clinical and microbiological characteristics and prognosis of patients hospitalized in Reunion Island for a waterborne infection. This retrospective study was conducted in the two university hospitals of Reunion Island between January 2010 and March 2017. Patients diagnosed with a Vibrio, Aeromonas, or Shewanella infection were evaluated. Over the study period, 112 aquatic strains were isolated at Reunion Island: Aeromonas spp. were found in 91 patients (81.3%), Shewanella spp. in 13 patients (11.6%), and Vibrio spp. in eight patients (7.2%). The in-hospital mortality rate was 11.6%. The main sites of infection were skin and soft tissue (44.6%) and the abdomen (19.6%). Infections were polymicrobial in 70 cases (62.5%). The most commonly prescribed empiric antibiotic regimen was amoxicillin–clavulanate (34.8%). Eighty-four percent of the aquatic strains were resistant to amoxicillin–clavulanate and more than > 95% were susceptible to third or fourth generation cephalosporins and fluoroquinolones. After multivariate analysis, the only independent risk factor of in-hospital mortality was the presence of sepsis (P < 0.0001). In Reunion Island, the most commonly isolated aquatic microorganisms were Aeromonas spp. Sepsis caused by aquatic microorganisms was frequent (> 50%) and associated with higher in-hospital mortality. This study suggests that empiric antibiotic regimens in patients with sepsis or septic shock caused by suspected aquatic microorganisms (tropical climate, skin lesion exposed to seawater…) should include broad-spectrum antibiotics (third or fourth generation cephalosporins).

Author Notes

Address correspondence to Nicolas Allou, Hôpital Félix Guyon, Réanimation Polyvalente, Bellepierre, Saint-Denis 97405, France. E-mail: nicolas.allou@chu-reunion.fr

Financial support: This work was internally funded.

Authors’ addresses: Nicolas Allou, Aurélien Soubeyrand, Romain Persichini, Caroline Brulliard, Dorothée Valance, Olivier Martinet, and Jérôme Allyn, Réanimation Polyvalente, Centre Hospitalier Universitaire Félix Guyon, Allée des Topazes, Saint Denis, France, E-mails: nicolas.allou@hotmail.fr, aurelien.soubeyrand@chu-reunion.fr, romain.persichini@chu-reunion.fr, caroline.brulliard@chu-reunion.fr, dorothee.valance@chu-reunion.fr, olivier.martinet@chu-reunion.fr, and jerome.allyn@chu-reunion.fr. Nicolas Traversier and Olivier Belmonte, Bacteriologie, Centre Hospitalier Universitaire Felix Guyon, Allée des Topazes, Saint Denis, France, E-mails: nicolas.traversier@chu-reunion.fr and olivier.belmonte@chu-reunion.fr. Sandrine Picot, Bacteriologie, Centre Hospitalier Universitaire Sud Réunion, Saint Pierre, Saint Pierre, France, E-mail: sandrine.picot@chu-reunion.fr.

  • 1.

    Igbinosa IH, Igumbor EU, Aghdasi F, Tom M, Okoh AI, 2012. Emerging Aeromonas species infections and their significance in public health. ScientificWorldJournal 2012: 625023.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 2.

    Vignier N, Barreau M, Olive C, Baubion E, Théodose R, Hochedez P, Cabié A, 2013. Human infection with Shewanella putrefaciens and S. algae: report of 16 cases in Martinique and review of the literature. Am J Trop Med Hyg 89: 151156.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 3.

    Chen SC, Chan KS, Chao WN, Wang PH, Lin DB, Ueng KC, Kuo SH, Chen CC, Lee MC, 2010. Clinical outcomes and prognostic factors for patients with Vibrio vulnificus infections requiring intensive care: a 10-yr retrospective study. Crit Care Med 38: 19841990.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 4.

    Hoel S, Vadstein O, Jakobsen AN, 2017. Species distribution and prevalence of putative virulence factors in mesophilic Aeromonas spp. isolated from fresh retail sushi. Front Microbiol 8: 931.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 5.

    Araujo VS, Pagliares VA, Queiroz ML, Freitas-Almeida AC, 2002. Occurrence of Staphylococcus and enteropathogens in soft cheese commercialized in the city of Rio de Janeiro, Brazil. J Appl Microbiol 92: 11721177.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 6.

    Praveen PK, Debnath C, Shekhar S, Dalai N, Ganguly S, 2016. Incidence of Aeromonas spp. infection in fish and chicken meat and its related public health hazards: a review. Vet World 9: 611.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 7.

    Klontz KC, Lieb S, Schreiber M, Janowski HT, Baldy LM, Gunn RA, 1988. Syndromes of Vibrio vulnificus infections: clinical and epidemiologic features in Florida cases, 1981–1987. Ann Intern Med 109: 318323.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 8.

    Levine WC, Griffin PM, 1993. Vibrio infections on the Gulf Coast: results of first year of regional surveillance Gulf Coast Vibrio working group. J Infect Dis 167: 479483.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 9.

    Diaz JH, 2014. Skin and soft tissue infections following marine injuries and exposures in travelers. J Travel Med 21: 207213.

  • 10.

    McAuliffe GN, Hennessy J, Baird RW, 2015. Relative frequency, characteristics, and antimicrobial susceptibility patterns of Vibrio spp., Aeromonas spp., Chromobacterium violaceum, and Shewanella spp. in the northern territory of Australia, 2000–2013. Am J Trop Med Hyg 92: 605610.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 11.

    Singer et al. 2016. The third international consensus definitions for sepsis and septic shock (sepsis-3). JAMA 315: 801810.

  • 12.

    EUCAST, 2017. European Committee on Antimicrobial Susceptibility Testing 2017. Available at: http://www.eucast.org/clinical_breakpoints/.

    • PubMed
    • Export Citation
  • 13.

    Hou CC, Lai CC, Liu WL, Chao CM, Chiu YH, Hsueh PR, 2011. Clinical manifestation and prognostic factors of non-cholerae Vibrio infections. Eur J Clin Microbiol Infect Dis 30: 819824.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 14.

    Lamy B, Kodjo, A, Laurent, F; colBVH Study Group, 2009. Prospective nationwide study of Aeromonas infections in France. J Clin Microbiol 47: 12341237.

  • 15.

    Qamar FN et al. 2016. Aeromonas-associated diarrhea in children under 5 years: the GEMS experience. Am J Trop Med Hyg 95: 774780.

  • 16.

    Aravena-Román M, Inglis TJ, Henderson B, Riley TV, Chang BJ, 2012. Antimicrobial susceptibilities of Aeromonas strains isolated from clinical and environmental sources to 26 antimicrobial agents. Antimicrob Agents Chemother 56: 11101112.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 17.

    Chen PL, Ko WC, Wu CJ, 2012. Complexity of β-lactamases among clinical Aeromonas isolates and its clinical implications. J Microbiol Immunol Infect 45: 398403.

  • 18.

    Héritier C, Poirel L, Nordmann P, 2004. Genetic and biochemical characterization of a chromosome-encoded carbapenem-hydrolyzing ambler class D beta-lactamase from Shewanella algae. Antimicrob Agents Chemother 48: 16701675.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 19.

    Kim DM, Kang CI, Lee CS, Kim HB, Kim EC, Kim NJ, Oh MD, Choe KW, 2006. Treatment failure due to emergence of resistance to carbapenem during therapy for Shewanella algae bacteremia. J Clin Microbiol 44: 11721174.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 20.

    Lamy B, Laurent F, Kodjo A, Roger F, Jumas-Bilak E, Marchandin H; colBVH Study Group, 2012. Which antibiotics and breakpoints should be used for Aeromonas susceptibility testing? Considerations from a comparison of agar dilution and disk diffusion methods using Enterobacteriaceae breakpoints. Eur J Clin Microbiol Infect Dis 31: 23692377.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 21.

    Baron S, Granier SA, Larvor E, Jouy E, Cineux M, Wilhelm A, Gassilloud B, Le Bouquin S, Kempf I, Chauvin C, 2017. Aeromonas diversity and antimicrobial susceptibility in freshwater—an attempt to set generic epidemiological cut-off values. Front Microbiol 8: 503.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 22.

    Brulliard C, Traversier N, Allyn J, Schaeffer C, Bouchet B, Allou N, 2017. Case report: disseminated Shewanella algae infection with meningoencephalitis in a traveler secondary to marine injury in Madagascar. Am J Trop Med Hyg 97: 10431044.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 23.

    Wu CJ, Chen PL, Hsueh PR, Chang MC, Tsai PJ, Shih HI, Wang HC, Chou PH, Ko WC, 2015. Clinical implications of species identification in monomicrobial Aeromonas bacteremia. PLoS One 10: e0117821.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 24.

    Wong KC, Brown AM, Luscombe GM, Wong SJ, Mendis K, 2015. Antibiotic use for Vibrio infections: important insights from surveillance data. BMC Infect Dis 15: 226.

  • 25.

    Holt HM, Gahrn-Hansen B, Bruun B, 2005. Shewanella algae and Shewanella putrefaciens: clinical and microbiological characteristics. Clin Microbiol Infect 11: 347352.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 26.

    Jacob-Kokura S, Chan CY, Kaplan L, 2014. Bacteremia and empyema caused by Shewanella algae in a trauma patient. Ann Pharmacother 48: 128136.

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