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Isolation and Identification of Waterborne Antibiotic-Resistant Bacteria and Molecular Characterization of their Antibiotic Resistance Genes
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Intercontinental spread of OXA-48 beta-lactamase-producing Enterobacteriaceae over a 11-year period, 2001 to 2011

A Potron1, L Poirel, E Rondinaud

  • 1INSERM U914, Emerging Resistance to Antibiotics, Faculté de Médecine et Université Paris-Sud, K. Bicêtre, France.

Euro Surveillance : Bulletin Europeen Sur Les Maladies Transmissibles = European Communicable Disease Bulletin
|August 10, 2013
PubMed

Insights

OXA-48 beta-lactamase-producing bacteria are a growing threat, particularly in the Mediterranean. This study tracked their spread in Europe and North Africa, finding widespread resistance to ertapenem but susceptibility to colistin and tigecycline.

Area of Science:

  • Microbiology
  • Infectious Diseases
  • Molecular Epidemiology

Background:

  • OXA-48 beta-lactamase-producing Enterobacteriaceae pose a significant and increasing threat, especially in the Mediterranean region.
  • Understanding the molecular epidemiology of these resistant strains is crucial for public health surveillance and control.

Purpose of the Study:

  • To investigate the molecular epidemiology of OXA-48 beta-lactamase-positive Enterobacteriaceae isolates collected across Europe and North Africa.
  • To characterize the antimicrobial resistance profiles, genetic relatedness, and plasmid-mediated dissemination of bla(OXA-48).

Main Methods:

  • Analysis of 107 Enterobacteriaceae isolates (Klebsiella pneumoniae, Escherichia coli, Enterobacter cloacae) collected between 2001 and 2011.
  • Antimicrobial susceptibility testing using EUCAST breakpoints.
  • Multilocus sequence typing (MLST) and plasmid analysis to determine genetic relationships and bla(OXA-48) gene location.

Main Results:

  • Most isolates showed resistance to ertapenem (91.6%) but remained susceptible to imipenem (66%).
  • Co-production of extended-spectrum beta-lactamases, notably CTX-M-15 (77.5%), was common.
  • Colistin, tigecycline, amikacin, and fosfomycin demonstrated sustained activity.
  • MLST identified common sequence types (ST101 for K. pneumoniae, ST38 for E. coli).
  • The bla(OXA-48) gene was predominantly located on a 62 kb IncL/M plasmid (92.5%).

Conclusions:

  • OXA-48-producing Enterobacteriaceae have spread widely across Europe and North Africa, with evidence of importation and endemicity in some regions.
  • The IncL/M plasmid is a key vehicle for bla(OXA-48) dissemination.
  • Maintaining surveillance and understanding resistance mechanisms are vital to combat the spread of these multidrug-resistant organisms.

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