Epidemiological and Microbiological Characteristics of an Outbreak Caused by OXA-48-Producing Enterobacteriaceae in a Neonatal Intensive Care Unit in Jerusalem, Israel

Adler, Amos; Solter, Ester; Masarwa, Samira; Miller-Roll, Tamar; Abu‐Libdeh, Bassam; Khammash, Hatem; Najem, Khalil; Dekadek, Susan; Stein‐Zamir, Chen; Nubani, N; Kunbar, Amin; Assous, Marc V.; Carmeli, Yehuda; Schwaber, Mitchell J.

doi:10.1128/jcm.01049-13

Cited by 36 publications

(24 citation statements)

References 24 publications

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“…The ST74 clone consisted of carbapenem-resistant isolates carrying the bla OXA-48 gene. This is the first outbreak caused by OXA-48-producing E. cloacae reported in Europe, but a previous outbreak has been noticed in a neonatal ICU in Jerusalem [11]. In contrast to that observed here, isolates from Israel carried a derivative of the OXA-48 plasmid that had acquired the bla CTX-M-14 gene.…”

Section: Discussioncontrasting

confidence: 52%

Dissemination of multiresistant Enterobacter cloacae isolates producing OXA-48 and CTX-M-15 in a Spanish hospital

Fernández

Montero

Martinez

et al. 2015

International Journal of Antimicrobial Agents

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Twenty-one multiresistant Enterobacter cloacae isolates producing OXA-48 (n = 10), CTX-M-15 (n = 7) or both (n = 4) ␤-lactamases were detected in a Spanish hospital during a 1-year period (June 2013 to June 2014). The isolates were also resistant to non-␤-lactam antimicrobials, further complicating the therapeutic options. Genotyping of the isolates identified two major clones (ST74 and ST66) that caused prolonged outbreaks in different buildings of the hospital as well as some sporadic isolates (ST78, ST45 and ST295). Isolates belonging to clone 1 (n = 7) were carbapenem-resistant and carried the bla OXA-48 gene on a conjugative IncL/M plasmid of ca. 65 kb. Clone 2 isolates (n = 11) were resistant to cefepime and harboured the bla CTX-M-15 gene on an ca. 150-kb, non-conjugative plasmid of the IncF group, co-harbouring the qnrB and aac(6 )-Ib-cr genes encoding quinolone resistance. Four clone 2 isolates were also resistant to carbapenems owing to the co-production of OXA-48. Most of the isolates were recovered from critically ill patients and were admitted to intensive care units; a single patient was transferred from another Spanish hospital. Intrahospital and interhospital dissemination of multiresistant E. cloacae isolates is of major clinical concern as it could lead to endemic nosocomial situations.

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Section: Discussioncontrasting

confidence: 52%

Dissemination of multiresistant Enterobacter cloacae isolates producing OXA-48 and CTX-M-15 in a Spanish hospital

Fernández

Montero

Martinez

et al. 2015

International Journal of Antimicrobial Agents

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“…In the Mediterranean area, outbreaks involving OXA-48-producing isolates have implicated diverse sequence types, such as ST1853, ST15, ST11, ST39, ST405, ST395, and ST101 ( Fig. 1) (13,(19)(20)(21)(22)(23)(24)(25). However, in this investigation, the outbreak was due to the pandemic ST101, which was detected for the first time in Algeria.…”

contrasting

confidence: 41%

Outbreak of OXA-48-Producing Klebsiella pneumoniae Involving a Sequence Type 101 Clone in Batna University Hospital, Algeria

Loucif

Kassah-Laouar

et al. 2016

Antimicrob Agents Chemother

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Seven nonredundant ertapenem-resistant Klebsiella pneumoniae isolates were collected between May 2014 and 19 January 2015 in the nephrology and hematology units of Batna University Hospital in Algeria. All strains coproduced the bla OXA-48 , bla CTX-M-15 , bla SHV-1 , and bla TEM-1D genes. Six of these isolates belonged to the pandemic clone sequence type 101 (ST101). The bla OXA-48 gene was located on a conjugative IncL/M-type plasmid. This is the first known outbreak of OXA-48-producing K. pneumoniae isolates involving an ST101 clone in Batna University Hospital.

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“…for the group carrying the bla CTX-M allele (10) and by PCR and sequencing for the groups carrying the bla TEM and bla SHV alleles (11). The multiple imputation of missing data was conducted, but bivariate analyses with the imputed data for the relevant covariates did not converge; therefore all analyses were conducted with the available data only.…”

Section: Figmentioning

confidence: 99%

Prevalence, Risk Factors, and Transmission Dynamics of Extended-Spectrum-β-Lactamase-Producing Enterobacteriaceae: a National Survey of Cattle Farms in Israel in 2013

et al. 2015

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b; Kimron Veterinary Institute, Beit Dagan, Israel c Our objectives were to study the prevalence, risk factors for carriage, and transmission dynamics of extended-spectrum-␤-lactamase (ESBL)-producing Enterobacteriaceae (ESBLPE) in a national survey of cattle. This was a point prevalence study conducted from July to October 2013 in Israel. Stool samples were collected from 1,226 cows in 123 sections on 40 farms of all production types. ESBLPE were identified in 291 samples (23.7%): 287 contained Escherichia coli and 4 contained Klebsiella pneumoniae. The number of ESBLPE-positive cows was the highest in quarantine stations and on fattening farms and was the lowest on pasture farms (P ‫؍‬ 0.03). The number of ESBLPE-positive cows was the lowest in sections containing adult cows (age, >25 months) and highest in sections containing calves (age, <4 months) (P < 0.001). Infrastructure variables that were significant risk factors for ESBLPE carriage included crowding, a lack of manure cleaning, and a lack of a cooling (P < 0.001 for each), all of which were more common in sections containing calves. Antimicrobial prophylaxis was given almost exclusively to calves and was associated with a high number of ESBLPE carriers (P < 0.001). The 287 E. coli isolates were typed into 106 repetitive extragenic palindromic (REP)-PCR types and mostly harbored bla CTX-M-1 or bla CTX-M-9 group genes. The isolates on the six farms with >15 isolates of ESBLPE were of 4 to 7 different REP-PCR types, with one dominant type being harbored by about half of the isolates. Fourteen types were identified on more than one farm, with only six of the farms being adjacent to each other. The prevalence of ESBLPE carriage is high in calves in cowsheds where the use of antimicrobial prophylaxis is common. ESBLPE disseminate within cowsheds mainly by clonal spread, with limited intercowshed transmission occurring. Since the advent of the first antimicrobials, antimicrobial-resistant bacteria (AMRB) have spread in conjunction with the use of the respective antimicrobial agents (1). Accordingly, the emergence of extended-spectrum ␤-lactamase (ESBL) enzymes as a global threat followed the introduction of third-generation cephalosporins (TGC), used mainly in health care settings (2). Although the ESBLs were first noted in the 1980s, a substantial increase in their prevalence in Escherichia coli was noted in the 2000s. This increase was mainly related to the emergence of a pandemic clone, designated sequence type (ST) 131. A particular worrisome feature of this clone was its predominance in community-onset cases of infection with ESBL-producing bacteria (3). This epidemiologic feature has attracted attention to the possibility of sources of acquisition other than health care settings, including the food and livestock industries. Indeed, many studies have documented the presence of ESBL-producing bacteria in a variety of meats and other livestock-origin food samples. Although the use of antimicrobials has often been suggested to be the main culprit for this ...

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Epidemiological and Microbiological Characteristics of an Outbreak Caused by OXA-48-Producing Enterobacteriaceae in a Neonatal Intensive Care Unit in Jerusalem, Israel

Cited by 36 publications

References 24 publications

Dissemination of multiresistant Enterobacter cloacae isolates producing OXA-48 and CTX-M-15 in a Spanish hospital

Dissemination of multiresistant Enterobacter cloacae isolates producing OXA-48 and CTX-M-15 in a Spanish hospital

Outbreak of OXA-48-Producing Klebsiella pneumoniae Involving a Sequence Type 101 Clone in Batna University Hospital, Algeria

Prevalence, Risk Factors, and Transmission Dynamics of Extended-Spectrum-β-Lactamase-Producing Enterobacteriaceae: a National Survey of Cattle Farms in Israel in 2013

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