First Outbreak of a Plasmid-Mediated Carbapenem-Hydrolyzing OXA-48 β-Lactamase in Klebsiella pneumoniae in Spain

Abstract

Strains were clonally related and coproduced a CTX-M-15 ␤-lactamase. A conjugative plasmid of circa 70 kb carrying bla OXA-48 was identified. Eleven isolates showed low-level resistance to carbapenems, whereas nine showed high-level resistance. Decreased expression of OmpK36 was related to high-level resistance to carbapenems. The isolates belonged to sequence type 101 (ST101). This is the first outbreak caused by an OXA-48-producing K. pneumoniae strain in Spain.

Identification and characterization of CTX-M-15 producing Klebsiella pneumoniae clone ST101 in a Hungarian university teaching hospital

“…This sequence type was associated with various β-lactam resistance mechanisms in different parts of the world: CTX-M-15 production in France, Greece and Italy; SHV-12 production in the Czech Republic; OXA-48 production in Spain, Libya, France, Tunisia, Morocco, Switzerland and South Africa; KPC-2 production in Italy and Spain [32,[35][36][37][38][39][40][41][42]. In our institution the presence of CTX-M-15 producing ST101 seemed to be restricted both timely and spatially, as the majority of the isolates originated from a single department with a decreasing incidence ( Tables II and III).…”

Antimicrobial Treatment and Containment Measures for an Extremely Drug-Resistant Klebsiella pneumoniae ST101 Isolate Carrying pKPN101-IT, a Novel Fully Sequenced bla KPC-2 Plasmid

“…Interestingly, OXA-48-and CTX-M-15-producing ST101 strains have been described in the rest of the world (8,21); in particular, KPC-positive ST101 K. pneumoniae strains have been recently reported in Brazil and in the United States (6,27).…”

Isolation of OXA-48 Carbapenemase-Producing Klebsiella pneumoniae ST101 from an Overseas Traveler Returning to Japan

“…The patient had no other history of travel to a foreign country for 1 year prior to this episode; therefore, it is likely that he acquired OXA-48-producing K. pneumoniae while receiving medical care at the ICU in Egypt. Drugresistant K. pneumoniae ST101 has been reported as a causative agent of outbreaks or as a predominant clone of nosocomial pathogens in medical settings in several Mediterranean countries, including Greece (15), Italy (16,17), Libya (18), and Spain (19). The isolate from our patient was identified as ST101 by MLST, and thus, it was considered not to be of the K1 serotype, which is associated with liver abscess (20).…”