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

Cuzon, Gaëlle; Bentchouala, Chafia; Vogel, Anaïs; Héry, Mélanie; Lezzar, Abdesselam; Smati, F; Dortet, Laurent; Naas, Thierry

doi:10.1016/j.ijantimicag.2015.08.005

International Journal of Antimicrobial Agents

2015

DOI: 10.1016/j.ijantimicag.2015.08.005

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

Gaëlle Cuzon

Chafia Bentchouala

Anaïs Vogel

et al.

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Cited by 26 publications

(21 citation statements)

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“…This represents the second reported outbreak of OXA-48-producing K. pneumoniae in Algeria, after the recent study by Cuzon et al (13), who characterized an outbreak of OXA-48-producing K. pneumoniae ST1853 in Constantine University Hospital in Algeria. In 2012, Poirel et al (5) suggested that the OXA-48 enzyme may be endemic in Algeria, since its dissemination has been described worldwide (4), particularly in the Mediterranean area, including Egypt, Lebanon, Morocco, and Tunisia (14)(15)(16)(17).…”

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confidence: 56%

“…This suggestion is supported by the isolation of OXA-48-producing Enterobacteriaceae strains from patients hospitalized in French hospitals who had recently travelled to or were hospitalized in Algeria (13). Previous studies reported the isolation of clinical K. pneumoniae strains coproducing extended-spectrum ␤-lactamase (ESBL) and the bla OXA-48 gene (1,13,18). In this study, we identified the association of bla OXA-48 with three different ␤-lactamase genes (bla CTX-M-15 , bla SHV-1 , and bla TEM-1D ) that had not been previously described in Algeria; the same association was observed in Tunisia, except for the TEM variant (17).…”

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confidence: 87%

“…In 2012, Poirel et al (5) suggested that the OXA-48 enzyme may be endemic in Algeria, since its dissemination has been described worldwide (4), particularly in the Mediterranean area, including Egypt, Lebanon, Morocco, and Tunisia (14)(15)(16)(17). This suggestion is supported by the isolation of OXA-48-producing Enterobacteriaceae strains from patients hospitalized in French hospitals who had recently travelled to or were hospitalized in Algeria (13). Previous studies reported the isolation of clinical K. pneumoniae strains coproducing extended-spectrum ␤-lactamase (ESBL) and the bla OXA-48 gene (1,13,18).…”

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confidence: 99%

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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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confidence: 56%

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confidence: 87%

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confidence: 99%

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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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“…The production of ␤-lactamases such as extended-spectrum ␤-lactamase (ESBL) and carbapenemase remains the main mechanism of resistance in Enterobacteriaceae (2). Algeria is now feaures among the Mediterranean countries known to be affected by the spread of CTX-M-15 type ESBL and the emergence of the phantom menace OXA-48 type carbapenemase (3,4). Indeed, the transmission and dissemination of MDRE in hospitals are usually related to hand contact (5) and poorly sterilized instruments (6).…”

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confidence: 99%

“…Prior to its first description in Algeria, Poirel et al suggested that OXA-48 may be endemic in this country (34). The huge spread of CTX-M-15 ESBL-producing Enterobacteriaceae and the emergence of OXA-48-type carbapenemase-producing Enterobacteriaceae in Algerian hospitals may explain the carriage of such drug-resistant bacteria by hospital cockroaches through their particular feeding habits (3,4,35).…”

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First Report of German Cockroaches (Blattella germanica) as Reservoirs of CTX-M-15 Extended-Spectrum-β-Lactamase- and OXA-48 Carbapenemase-Producing Enterobacteriaceae in Batna University Hospital, Algeria

Loucif

Gacemi-Kirane

Cherak

et al. 2016

Antimicrob Agents Chemother

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Here we report the isolation of extended-spectrum ␤-lactamase (ESBL)-and carbapenemase-producing Enterobacteriaceae from German cockroaches caught in the burn unit of Batna University Hospital in Algeria. Nine of 12 isolates harbored the bla CTX-M-15 ESBL gene. One Enterobacter cloacae isolate belonging to sequence type 528 coexpressed the bla OXA-48 , bla CTX-M-15 , and bla TEM genes. Our findings indicate that cockroaches may be one of the most dangerous reservoirs for ESBL and carbapenemase producers in hospitals.T he emergence of multidrug-resistant Enterobacteriaceae (MDRE) and their dissemination in hospitals have become a major health concern worldwide (1). The production of ␤-lactamases such as extended-spectrum ␤-lactamase (ESBL) and carbapenemase remains the main mechanism of resistance in Enterobacteriaceae (2). Algeria is now feaures among the Mediterranean countries known to be affected by the spread of CTX-M-15 type ESBL and the emergence of the phantom menace OXA-48 type carbapenemase (3, 4). Indeed, the transmission and dissemination of MDRE in hospitals are usually related to hand contact (5) and poorly sterilized instruments (6). However, cockroaches which colonize these environments may also act as potential mechanical vectors of antibiotic-resistant bacteria (7). Cockroaches are among the most prevalent pests in hospitals, where they are attracted by moisture, food, and suitable temperatures (8, 9). The medical significance of cockroaches has been largely overlooked, but it has been proven that they can harbor a number of pathogenic microorganisms with different levels of antibiotic resistance (10). Blattella germanica is the most abundant cockroach species (11), and the external surfaces and excrement of these cockroaches can contaminate food, human habitats, and hospital equipment; therefore, these insects can present a threat to human health (12).The aim of our study was to screen for broad-spectrum-cephalosporin-and carbapenem-resistant Enterobacteriaceae in B. germanica cockroaches collected from the burn unit of Batna University Hospital in Algeria and then to investigate the molecular support of ESBL and carbapenemase production.In March 2015, 10 cockroaches were randomly captured from different parts of the burn unit, including the kitchen and the guard, treatment, and patient rooms, directly in sterile containers. Samples were immobilized by freezing at 0°C for 10 min (8). Each cockroach was soaked in 5 ml of Tween 80 solution at 0.05% and vortexed vigorously for 2 min. The resulting wash was used as an external-body-homogenate sample. To remove the external body contamination, cockroaches were immersed in bleach for 2 min, in sterile physiological saline for 2 min, and then in 70% ethanol for 5 min (12). Then, each sample was washed with sterile physiological saline. Subsequently, the insect was soaked in a sterile bottle containing 5 ml of Tween 80 solution at 0.05% and then crushed inside using a sterile pestle. The triturate was then vortexed vigorously for 2 min. The resulting s...

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OXA-48-like carbapenemases producing Enterobacteriaceae in different niches

Mairi

Pantel

Sotto

et al. 2017

Eur J Clin Microbiol Infect Dis

144

115

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The emergence of carbapenem-resistant enterobacterial species poses a serious threat to public health worldwide. OXA-48-type carbapenem-hydrolyzing class D β-lactamases are widely distributed among Enterobacteriaceae, with significant geographical differences. To date, 11 OXA-48-like variants have been identified, with classical OXA-48 being the most widespread. These enzymes show high-level hydrolytic activity against penicillins and low-level hydrolysis towards carbapenems. Since the first description of the OXA-48 carbapenemase in Turkey, bacterial strains producing the enzyme have been extensively reported in nosocomial and community outbreaks in many parts of the word, particularly in the Mediterranean area and European countries. The rapid spread of Enterobacteriaceae producing OXA-48-like enzymes in different ecosystems has become a serious issue recently. The number of reservoirs for such organisms is increasing, not only in hospitals, but also in the community, among animals (e.g., livestock, companion animals, and wildlife) and in the environment. This review aims to summarize the main characteristics of the OXA-48-type carbapenemases, covering genetic and enzymatic traits, their epidemiology, clonality and associated genes, correlation with extended-spectrum β-lactamases (ESBLs) or plasmidic AmpC (pAmpC) in different bacterial species worldwide.

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

Cited by 26 publications

References 5 publications

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

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

First Report of German Cockroaches (Blattella germanica) as Reservoirs of CTX-M-15 Extended-Spectrum-β-Lactamase- and OXA-48 Carbapenemase-Producing Enterobacteriaceae in Batna University Hospital, Algeria

OXA-48-like carbapenemases producing Enterobacteriaceae in different niches

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