Homme, animal, environnement : quel est le principal réservoir d’Entérobactéries productrices de bêta-lactamases à spectre étendu dans le Sud-Ouest de l’océan Indien ?

Abstract : Bacterial antibiotic drug resistance is a worldwide health issue affecting human, animal, and agriculture. Extended-spectrum bêta-lactamase-producing Enterobacteriaceae (ESBL-E), mutidrug-resistant bacteria, are a main health priority for the South-western Indian Ocean (SWIO) composed of islands (i.e. Madagascar, Maurice, Mayotte, Les Seychelles, l’Union des Comores et La Réunion). The main objective of this PhD thesis was estimating the ESBL-E prevalence in the three « One Heath approach » compartments (human, animal, environment) in order to identify the main ESBL-E reservoir in IO. This prevalence was independently estimated for each compartment by a sectorial approach and by a holistic approach connecting all compartments spatially and temporally.Both approaches suggest that livestock could be the main ESBL-E reservoir in IO and point out permeability between these three compartments in Madagascar. If the idea of a main reservoir of ESBL-E in livestock seems plausible, its contribution to human colonisation could differ between SWIO territories. Indeed, human direct and/or undirect exposure to this reservoir could be reduced in high-income countries (i.e. Seychelles, La Réunion) but significant for low-income countries (i.e. Madagascar, Union des Comores). In the absence, or reduced application, of food safety, sanitation, and drinking water access, the exposure to ESBL-E from livestock could be substantial in SWIO low-income countries. Consequently, the relative contribution of livestock in human ESBL-E subsequent colonisation could be significant in low-income countries but currently understudied. Research on that topic should strengthen antibiotic drug resistance control measures in low sanitation contexts.
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Noellie Gay. Homme, animal, environnement : quel est le principal réservoir d’Entérobactéries productrices de bêta-lactamases à spectre étendu dans le Sud-Ouest de l’océan Indien ?. Médecine humaine et pathologie. Université de la Réunion, 2019. Français. ⟨NNT : 2019LARE0024⟩. ⟨tel-02477381⟩

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