First description of OXA-48-producing Escherichia coli and the pandemic clone ST131 from patients hospitalised at a military hospital in Algeria

Abstract

The aim of the study was to assess the frequency and diversity of carbapenemases and extended-spectrum β-lactamases (ESBL) produced by Escherichia coli isolates from patients hospitalised in the Regional Military Hospital of Constantine (Algeria). E. coli isolates were collected over a 2-year period from patients presenting E. coli infections. Strains with reduced susceptibility to ertapenem and/or positive for ESBL were characterised with regard to antibiotic resistance, bla genes, phylogenetic groups, O25 serotyping, quinolone resistance, repetitive sequence-based polymerase chain reaction (rep-PCR) profiles and multi-locus sequence typing (MLST). Of the 448 isolated E. coli, 94 (20.9 %) were multidrug-resistant. One of them (1.1 %) produced a bla OXA-48 and was identified as a B1 ST5 strain. The transposon bearing this gene was Tn1999.2. This strain was isolated from a patient coming from a border province with Tunisia, where this carbapenemase is endemic. In addition, 84 (18.8 %) isolates among them produced an ESBL with predominance (97.6 %) of bla CTX-M-15, which was coupled with qnr genes in 10.9 %. ESBL-producing strains were mainly detected in phylogroups D and A. They displayed 20 rep-PCR profiles and all the clonally related isolates were of the same sequence type (ST). Ten strains (9.4 %) belonged to the pandemic clone ST131. This study describes for the first time the presence of OXA-48-producing E. coli and the emergence of the intercontinental ST131 bla CTX-15-producing E. coli strains in Algeria.

The difficult-to-control spread of carbapenemase producers among Enterobacteriaceae worldwide

“…3). In Africa, they have been mainly identified in the northern countries (Morocco, Algeria, Tunisia, Egypt, and Libya) [101,[115][116][117][118][119][120][121][122][123][124][125][126], but OXA-48 producers have also been identified in Senegal and South Africa [127,128] (Fig. 3).…”

Carbapenemases and extended-spectrum β-lactamases producing Enterobacteriaceae isolated from Tunisian and Libyan hospitals

“…These findings may also confirm that North Africa, including Tunisia and Libya, are considered to be reservoirs of oxacillinase producers, particularly OXA-48; to date, this enzyme represents the most common carbapenemase type circulating in this region [43][44][45][46] (Table 5). Recently, in 2014, Agabou et al reported the first description of OXA-48-producing E. coli and the pandemic clone ST131 from patients hospitalized at the Regional Military Hospital of Constantine [33]. In Morocco, Girlich et al showed a high prevalence of multidrug-resistant Enterobacteriaceae, and particularly OXA-48 producers, at a university hospital [34] (Table 5).…”

First outbreak of OXA-48-positive carbapenem-resistant Klebsiella pneumoniae isolates in Constantine, Algeria

“…Until now, only one OXA-48-producer, an E. coli ST5 isolate, has been described in Algeria from a patient hospitalised at the Military Hospital of Constantine [2,3]. The OXA-48-producing K. pneumoniae ST1853 isolates described in this study were from the University Hospital Benabib located in the same Algerian city, which is located close to the Tunisian border, a country where OXA-48-producers are endemic [1].…”