Outbreak of colistin-resistant carbapenemase-producing Klebsiella pneumoniae in Tunisia

We investigated the prevalence of carbapenemase-producing Enterobacteriaceae (CPE) in chicken meat in Western Algeria in 2017. Results: From February to July 2017, samples of chicken meat from three poultry farms in Western Algeria were screened for the presence of CPE. Strains were characterized with regard to antibiotic resistance, blactamase content, Plasmid-mediated quinolone resistance, sulfonamide resistance genes, clonality (repetitive sequence-based profiles and multilocus sequence typing) and virulence traits. Of 181 samples analyzed, 29 (16.0%) carbapenemase-producing Klebsiella pneumoniae were detected. Twenty-three OXA-48-producers (79.3%) and six (20.7%) New Delhi metallo (NDM)-1-producers were observed. Clonality analysis showed three distinct lineages and clonal expansions of the OXA-48-producing K. pneumoniae ST48 and the NDM-1producing K. pneumoniae ST101. These isolates harbored fimH, ureA, mrkD, entB, uge, and wabG. Neither capsular serotype genes nor hypermucoviscous phenotype were detected. Plasmid analysis confirmed that all these isolates harbored the transferable IncL and IncFIIK plasmids. Conclusions: This study reports the spread of OXA-48 and NDM-1-producing K. pneumoniae ST48 and ST101 in chicken meat in Western Algeria and demonstrates that food represents a reservoir of the carbapenemases encoding genes.

Section: Discussionmentioning

confidence: 76%

Spread of OXA-48 and NDM-1-Producing Klebsiella pneumoniae ST48 and ST101 in Chicken Meat in Western Algeria

Chaalal

Touati

Bakour

et al. 2021

“…In the following decade, OXA-48 has been reported not only in numerous European countries such as Germany, France, Portugal, and Romania, but also in Far East countries. [4][5][6][7][8][9] The highest rates of class D are still reported from Turkey and in a recent study, 92% of carbapenem-resistant Enterobacteriaceae were OXA-48 producers. 10,11 According to the EuSCAPE working group report, in Spain, France, Belgium, and Romania, the epidemiologic level of OXA-48 reached stage 4 or ''inter-regional spread'' in 2014-2015.…”

mentioning

confidence: 99%

Hidden Carbapenem Resistance in OXA-48 and Extended-Spectrum β-Lactamase-PositiveEscherichia coli

Paradžik

Drenjančević

Presečki-Stanko

et al. 2019

The purpose of this study was to report the identification OXA-48 carbapenemase in seven extendedspectrum b-lactamase (ESBL)-positive Escherichia coli clinical isolates, fully susceptible to all carbapenems by disk diffusion and E-test methods, but with borderline minimal inhibitory concentration (MIC) values of ertapenem. This report points to the necessity for determination of carbapenem MICs in ESBL-positive E. coli isolates and additional phenotypic testing for carbapenemases in all isolates with borderline ertapenem MIC defined by EUCAST. The isolates showed a high level of resistance to expanded-spectrum cephalosporins because of the production of an additional ESBL belonging to CTX-M family. All isolates and their respective tranconjugants were found to possess L plasmid. Pulsed-field gel electrophoresis analysis revealed two clusters containing highly related isolates. The global spread of multidrug-resistant E. coli should be monitored closely because of the ability of isolates to rapidly obtain additional antibiotic resistance traits such as plasmid-mediated OXA-48 genes.

“…21,22 More recently, NDM-1-producing strains were isolated in Tunisia from patients who did not travel, thus confirming that NDM-1 has become endemic in this country. 23,24 A recent study conducted in our structure led to the identification of NDM-1-producing K. pneumoniae ST147 and ST101 isolates. 23 The lineage defined as ST147 is a notorious example of multidrug-resistant K. pneumoniae, which carries carbapenemase genes, as well as numerous other acquired resistance determinants, and has been responsible for outbreaks worldwide.…”

Section: Genome Features Of the K Pneumoniae Kp3771 Isolatementioning

confidence: 97%

“…23,24 A recent study conducted in our structure led to the identification of NDM-1-producing K. pneumoniae ST147 and ST101 isolates. 23 The lineage defined as ST147 is a notorious example of multidrug-resistant K. pneumoniae, which carries carbapenemase genes, as well as numerous other acquired resistance determinants, and has been responsible for outbreaks worldwide. 25 In Tunisia, this clone is emerging as one of the most carbapenem-resistant K. pneumoniae clones mostly associated with OXA-204 or NDM-1 enzymes.…”

Section: Genome Features Of the K Pneumoniae Kp3771 Isolatementioning

confidence: 97%

Epidemiology and Whole-Genome Analysis of NDM-1-Producing Klebsiella pneumoniae KP3771 from Tunisia

Mansour

Grami

Jaidane

et al. 2019

Self Cite

Objectives: The whole-genome sequence (WGS) of Klebsiella pneumoniae KP3771 isolate was characterized. This strain was recovered from the urine sample of an 80-year-old man hospitalized in an intensive care unit of the University Hospital Tahar Sfar in Tunisia. Materials and Methods: WGS using a MiSeq platform was used. The assembled genome was subjected to several software analyses. Results: K. pneumoniae KP3771 was resistant to all antibiotics but colistin and tigecycline. WGS analysis found 18 transmissible genes encoding resistance markers, including bla NDM-1 and bla CTX-M-15 genes, which were carried by four plasmids belonging to the Inc Ib, IIk, and R groups. Three families of genes encoding virulence factors were detected, including adhesins (fimH, fimA, fimB, fimC, mrkD, Kpn, and ycfM), siderophores (enterobactin, aerobactin, and yersiniabactin siderophores), and protectin/invasin (traT). The strain was assigned to the sequence type 147. Conclusions: This study describes the genome of a carbapenemase-producing K. pneumoniae clinical isolate recovered in Tunisia. Bacteria WGS has become the reference technology to address epidemiological issues; this high level of information is particularly well suited to enrich epidemiological workflows' output.