OXA-48-like carbapenemases producing Enterobacteriaceae in different niches

Abstract

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.

Intensive infection control responses and whole genome sequencing to interrupt and resolve widespread transmission of OXA-181 Escherichia coli in a hospital setting

“…Currently, four classes of carbapenem-hydrolysing β-lactamases have been described, including class A (such as KPC), class B (also known as metallo-β-lactamases, such as IMP, VIM and NDM), ampC-type β-lactamases (also referred to as class C) and class D (such as OXA-48-like) [1,2]. In recent years, OXA-48-like carbapenemases have been increasingly detected globally in Enterobacterales [2,3]. As of 2014, 11 OXA-48-like variants have been described.…”

“…Due to this low-level carbapenemase activity, detection of OXA-48-like enzymes can often be missed by standard phenotypic methods employed routinely in diagnostic laboratories [4]. OXA-48-like enzymes are also not susceptible to classical βlactamase inhibitors, such as clavulanic acid, tazobactam and sulbactam, complicating treatment options if not correctly identified [2,3]. OXA-48-like genes are often found in Enterobacterales that already possess extended spectrum β-lactamases (ESBL) or plasmid-encoded ampC (pAmpC) genes, and are often associated with blaCTX-M genes [3].…”

“…OXA-48-like enzymes are also not susceptible to classical βlactamase inhibitors, such as clavulanic acid, tazobactam and sulbactam, complicating treatment options if not correctly identified [2,3]. OXA-48-like genes are often found in Enterobacterales that already possess extended spectrum β-lactamases (ESBL) or plasmid-encoded ampC (pAmpC) genes, and are often associated with blaCTX-M genes [3]. OXA-48-like genes have been detected in multiple hospital outbreaks [5,6], although few of these outbreaks have been investigated using whole genome sequencing (WGS) [7,8].…”

Performance of a new in-house medium Carba MTL-broth for the rapid detection of carbapenemase-producing Enterobacteriaceae

“…Vigilant surveillance, rapid and reliable identification of these strains by the personnel in the clinical microbiology laboratory are essential to effective infection control [7]. In this aim, it is important to define robust standardized screening methods for the detection of carbapenemase-producing Enterobacteriaceae (CPEs) which can be used in all laboratories, particularly in developing countries where the carbapenemases are diffused [3,4,8,9]. Currently, different methods are used to detect enzymatic resistance to carbapenems including phenotypic methods (e.g.…”

Functionally redundant forms of extended-spectrum beta-lactamases and aminoglycoside-modifying enzymes drive the evolution of two distinct multidrug resistance gene clusters in clinical populations of EXPEC

“…ESBL activity can be constitutive (CTX-Ms) or evolved, as is the case of mutant TEM, mutant SHVs, and some OXAs. Carbapenems have been introduced more recently for the treatment of ESBL resistance, and only carbapenemases (KPC, NDM, VIM) (Martinez-Martinez and Gonzalez-Lopez 2014; Jeon et al 2015) and most -lactamases of the OXA family exhibit activity against them (Mairi et al 2017).…”