First report of a carbapenemase OXA-48 producing-Hafnia alvei clinical isolate.

Abstract

Introduction: Carbapenems are usually used in the treatment of infections caused by cephalosporin-resistant Enterobacterales; however, the increase in carbapenem-resistant enterobacterales (CRE) has become one of the most important problems in public health. Hafnia alvei is associated with intestinal and extraintestinal infections, especially in patients with any chronic disease or some type of inmunosupression. H. alvei is resistant to first-generation aminopenicillins and cephalosporins because of the β-lactamase (Amp C) in their chromosome, the only carbapenem-resistant Hafnia strain described until now was due to the lack of OmpK36 protein that plays an important role in permeability to carbapenems. Case presentation: We present the case of a 65 years old male diagnosed with acute lithiasic cholecystitis. The culture of the biliary prosthesis yielded a OXA-48-producing H. alvei that was identified by MALDI-TOF (matrix-assisted laser desorption/ionization-time of flight) mass spectrometry. Carbapenemase production was detected by immunochromatography and confirmed by sequencing. Conclusion: To our knowledge, this is the first report of OXA-48-producing H. alvei probably obtained by horizontal transference from E. cloacae -OXA-48 isolated in previous samples.