Emergence
and Diffusion
of Multiple Drug Resistance
against antibiotics

A better knowledge of the prevalence, risk factors, and molecular epidemiology of MDR bacteria is of utmost public health importance.

Our research is based on the participation to and/or coordination of national and international surveillance and research networks or cohorts (ONERBA , National Reference Center for Mycobacteria , AZAY-Mycobacteria , group mycobacteria of the Fench Society for Microbiology, TBnet , ESGMYC , ECDC  and WHO ) in collaboration with clinicians and national experts.

These collaborations allowed us to better assess the effectiveness of new drugs such as bedaquiline for MDR-TB, and to analyse the epidemiology of MDR-TB in France, Europe or Asia and the epidemiology of MDR Enterobacteriaceae in France (ESBL or carbapenemase-positive) or abroad (China, Vietnam).

Because Enterobacteriaceae infections (e.g Klebsiella pneumoniae (KP)) mainly result from prior colonization, we are trying to better understand the capacity of KP to colonize the gut microbiota and to identify new approaches (e.g. bacteriophages) to specifically eliminate MDR KP from the gut.

We are also developing new antibiotics and antibiotics regimens that are evaluated for their efficacy using preclinical models of mycobacteria infections (M. tuberculosis, M. avium and M. abscessus) for which we have extensive and recognized expertise.

Moreover, we are developing experimental evolution approaches to identify new mechanisms directly involved in or facilitating AMR emergence, as well as the host impact on emergence of AMR.

Multidrug resistant (MDR) tuberculosis (TB) bacteria being increasingly isolated, our goals are to (i) investigate the molecular mechanisms accounting for drug resistance in tuberculosis, (ii) provide a comprehensive assessment of MDR tuberculosis in France, (iii) improve drug-susceptibility testing and in silico predictions, and (iv) target the genetic basis underlying the spread and success of major MDR M. tuberculosis lineages.

Capitalizing on 1,300 MDR isolates longitudinally collected in France, we combine active surveillance data with advanced genomic epidemiology and phylogenetic analysis to identify mutations involved in antimicrobials resistance and the transmission dynamics of TB. Because M. tuberculosis is a slowly growing bacterium, we expect to develop faster AMR prediction tools that are essential for prescription of personalised TB patients’ treatments.

We are involved in studies evaluating new strategies to treat neglected infectious diseases such as Buruli Ulcer, and leprosy.

We also investigate how K. rhinoscleromatis, causing a chronic disease, and K. pneumoniae, causing acute infections, differently interact with and manipulate the host response during respiratory infections, focusing especially on their interaction with monocytes.