OXA-48 Carbapenemase-Producing Salmonella enterica Serovar Kentucky Isolate of Sequence Type 198 in a Patient Transferred from Libya to Switzerland

Abstract

e Here, we report a case of OXA-48-producing Salmonella enterica serovar Kentucky of sequence type 198 (ST198) from perianal screening cultures of a patient transferred from Libya to Switzerland. The bla OXA-48 gene was carried by Tn1999.2 and located on an ϳ60-kb IncL/M plasmid. This Salmonella strain also possessed the bla VEB-8 , aac(6)-Ib, tet(A), sul1, and mphA resistance genes and substitutions in GyrA (Ser83Phe and Asp87Asn) and ParC (Ser80Ile). This finding emphasizes that prompt screening strategies are essential to prevent the dissemination of carbapenemase producers imported from countries where they are endemic.

Intestinal Carriage of Carbapenemase-Producing Organisms: Current Status of Surveillance Methods

“…Most recently, OXA-48 was detected in the United States, Canada, and South Africa (20,(48)(49)(50). Many of these reports involve patients previously treated in Middle Eastern and North African countries (51). Nonetheless, an early outbreak of OXA-48-producing K. pneumoniae in England was not linked to known regions of endemicity (52).…”

“…More concerning, however, was a retrospective analysis that uncovered an outbreak of OXA-48-producing Enterobacteriaceae in a Dutch hospital that had been ongoing for 2 years (53). OXA-48 has disseminated to a wide variety of Enterobacteriaceae species, including Klebsiella spp., E. coli, Citrobacter spp., Serratia marcescens (54)(55)(56), Enterobacter spp., Morganella morganii (55), Providencia stuartii (57), Raoultella planticola (56), and Salmonella enterica (51).…”

Trends in Serotype Distribution and Antimicrobial Susceptibility in Salmonella enterica Isolates from Humans in Belgium, 2009 to 2013

“…These ESBLs are capable of hydrolyzing penicillins, cephalosporins (except cephamycins), and monobactams and are inhibited by clavulanic acid or cloxacillin (19). Although resistance to carbapenems, often considered the antibiotic of last resort (20), is extremely rare in S. enterica, isolates expressing acquired carbapenemases have been reported (21)(22)(23).…”

High Prevalence of Extended-Spectrum β-Lactamase, Plasmid-Mediated AmpC, and Carbapenemase Genes in Pet Food

“…However, we emphasize that the detection of bla is worrisome due to its epidemiological and clinical impact (25). The bla OXA-48 gene is usually detected in humans (3,26), but bla OXA-48 -possessing Enterobacteriaceae isolates were found recently in pets (27).…”

“…The original pet food ingredients and/or the production processes were highly contaminated with bacteria carrying clinically relevant acquired bla genes. E nterobacteriaceae possessing ␤-lactamase genes (bla) encoding extended-spectrum ␤-lactamase (ESBL) (e.g., CTX-Ms, VEBs), plasmid-mediated AmpC (pAmpC) (e.g., CMYs), and carbapenemase (e.g., Klebsiella pneumoniae carbapenemases [KPCs], OXA-48-like, NDMs) enzymes have become a major threat to public health (1)(2)(3)(4). Pets and food-producing animals may be colonized or even infected with these drug-resistant bacteria, possibly acting as a potential reservoir for their spread to humans (5)(6)(7)(8)(9).…”