Trends in carbapenemase-producing Enterobacteriaceae, France, 2012 to 2014

Abstract

In 2014, a total of 2,976 Enterobacteriaceae isolates with decreased susceptibility to carbapenems were received at the French Associated National Reference Center for Antibiotic Resistance (NRC) and were characterised for their molecular resistance mechanism to carbapenems and compared with results obtained during 2012 and 2013.The overall number of enterobacterial isolates with decreased susceptibility to carbapenems received at the NRC rapidly increased (more than twofold in two years) with a growing proportion of carbapenemase producers (23.1% in 2012 vs 28.6% in 2013 vs 36.2% in 2014). Between 2012 and 2014, the main carbapenemase type was OXA-48, with an increase in OXA-48 variants (mostly OXA-181) and NDM producers, whereas the number KPC producers decreased. We identified a potential spread of OXA-181 producers in the tropical region of Africa. Finally, OXA-48 and OXA-48-related enzymes remained the predominant carbapenemases in France. The number of carbapenemase-producing Escherischia coli isolates was multiplied by fivefold between 2012 and 2014, suggesting a possible dissemination in the community.

Diversity of Carbapenemase-Producing Escherichia coli Isolates in France in 2012-2013

“…However, identification of CP-Ec strains strongly suggest a dissemination of these strains outside the hospital. This is further supported by the increasing number of CP-Ec isolates received by the F-NRC despite the lack of hospital outbreaks (6). Only one hospital outbreak was clearly established in our study, an endoscopy-associated transmission of a carbapenemresistant ST90 and OXA-204-producing E. coli strain (14).…”

Epidemiology and resistance phenotypes of carbapenemase-producing Klebsiella pneumoniae in Greece, 2014 to 2016

“…The Greek situation differs greatly from other European countries such as Spain, France, Germany, Turkey, Romania and Belgium, where OXA-48, most often linked with community-onset healthcare associated sources, is the most frequently encountered carbapenemase [26,[28][29][30][31].…”

Characteristics of Enterobacteriaceae Isolates Coharboring Distinct Carbapenemase Genes

“…2 Moreover, a few studies have indicated that the number of bla NDM-1 and bla OXA-48 is constantly increasing, and this combination has been the most frequently described. 2,9,10 Relatively few reports of Enterobacteriaceae coproducing carbapenemases are available; here, we describe 2 additional species harboring 2 carbapenemases, and we observed other combinations such as a New Delhi metallo (NDM)-codifying gene with an OXA-48 variant carbapenemase.…”