Analysis of OXA-204 carbapenemase-producing Enterobacteriaceae reveals possible endoscopy-associated transmission, France, 2012 to 2014

Anaïs Potron; Sandrine Bernabeu; Gaëlle Cuzon; Valérie Pontiès; Hervé Blanchard; Elise Seringe; Thierry Naas; Patrice Nordmann; Laurent Dortet

doi:10.2807/1560-7917.ES.2017.22.49.17-00048

Analysis of OXA-204 carbapenemase-producing Enterobacteriaceae reveals possible endoscopy-associated transmission, France, 2012 to 2014

Euro Surveill. 2017 Dec;22(49):17-00048. doi: 10.2807/1560-7917.ES.2017.22.49.17-00048.

Authors

Anaïs Potron^{1

2}, Sandrine Bernabeu^{1

3

4

5}, Gaëlle Cuzon^{1

3

4

5}, Valérie Pontiès⁶, Hervé Blanchard⁷, Elise Seringe⁷, Thierry Naas^{1

3

4

5}, Patrice Nordmann^{8

9

10

11}, Laurent Dortet^{1

3

4

5}

Affiliations

¹ National Reference Centre for Antibiotic Resistance, (division of carbapenemase-producing Enterobacteriaceae), Le Kremlin-Bicêtre, France.
² Department of Bacteriology, University Hospital of Besançon, Université of Franche-Comté, Besançon, France.
³ Bacteriology-Hygiene Unit, Assistance Publique/Hôpitaux de Paris, Bicêtre Hospital, Le Kremlin-Bicêtre, France.
⁴ EA7361 "Structure, Dynamic, Function and Expression of Broad Spectrum beta-Lactamases", Paris-Sud University, LabEx Lermit, Faculty of Medicine, Le Kremlin-Bicêtre, France.
⁵ Joint Research Unit EERA "Evolution and Ecology of Resistance to Antibiotics," Institut Pasteur-APHP-Université Paris-Sud, Paris, France.
⁶ Santé Publique France, The French Public Health Agency, Saint-Maurice, France.
⁷ Regional Coordinating Centre for Nosocomial Infection Control (C-CLIN Paris Nord), Paris, France.
⁸ National Reference Centre for Emerging Antibiotic Resistance, Fribourg, Switzerland.
⁹ Institute for Microbiology, University hospital and University of Lausanne, Lausanne, Switzerland.
¹⁰ Emerging Antibiotic Resistance Unit, Medical and Molecular Microbiology, Department of Medicine, University of Fribourg, Fribourg, Switzerland.
¹¹ Institut National de la Santé et de la Recherche Médicale (INSERM) European Unit (LEA Paris, IAME, France), University of Fribourg, Switzerland.

PMID: 29233256
PMCID: PMC5727592
DOI: 10.2807/1560-7917.ES.2017.22.49.17-00048

Abstract

OXA-48-like beta-lactamase producing bacteria are now endemic in several European and Mediterranean countries. Among this carbapenemase family, the OXA-48 and OXA-181 variants predominate, whereas other variants such as OXA-204 are rarely reported. Here, we report the molecular epidemiology of a collection of OXA-204-positive enterobacterial isolates (n = 29) recovered in France between October 2012 and May 2014. This study describes the first outbreak of OXA-204-producing Enterobacteriaceae in Europe, involving 12 isolates of an ST90 Escherichia coli clone and nine isolates of an ST147 Klebsiella pneumoniae clone. All isolates co-produced the cephalosporinase CMY-4, and 60% of them co-produced the extended-spectrum beta-lactamase CTX-M-15. The bla_OXA-204 gene was located on a 150-kb IncA/C plasmid, isolated from various enterobacterial species in the same patient, indicating a high conjugative ability of this genetic vehicle.

Keywords: OXA-48-like; antibiotic resistance; carbapenems; endoscope; nosocomial; outbreak.

MeSH terms

Anti-Bacterial Agents / therapeutic use
Endoscopes / microbiology*
Enterobacteriaceae / enzymology*
Enterobacteriaceae / genetics
Enterobacteriaceae / isolation & purification
Enterobacteriaceae Infections / epidemiology*
Enterobacteriaceae Infections / microbiology
France / epidemiology
Humans
Multilocus Sequence Typing
Plasmids / genetics*
Polymerase Chain Reaction
beta-Lactamases / genetics
beta-Lactamases / metabolism*

Substances

Anti-Bacterial Agents
beta-Lactamases