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Updated: Mar 31, 2026
Population and Single-Cell Analysis of Antibiotic Persistence in Escherichia coli
Published on: March 24, 2023
Within-Host and Population Transmission of blaOXA-48 in K. pneumoniae and E. coli
Manon R Haverkate1, Mirjam J D Dautzenberg2, Tjaco J M Ossewaarde3
1Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands.
Abstract:
During a large hospital outbreak of OXA-48 producing bacteria, most K. pneumoniaeOXA-48 isolates were phenotypically resistant to meropenem or imipenem, whereas most E. coliOXA-48 isolates were phenotypically susceptible to these antibiotics. In the absence of molecular gene-detection E. coliOXA-48 could remain undetected, facilitating cross-transmission and horizontal gene transfer of blaOXA-48. Based on 868 longitudinal molecular microbiological screening results from patients carrying K. pneumoniaeOXA-48 (n = 24), E. coliOXA-48 (n = 17), or both (n = 40) and mathematical modelling we determined mean durations of colonisation (278 and 225 days for K. pneumoniaeOXA-48 and E. coliOXA-48, respectively), and horizontal gene transfer rates (0.0091/day from K. pneumoniae to E. coli and 0.0015/day vice versa). Based on these findings the maximum effect of horizontal gene transfer of blaOXA-48 originating from E. coliOXA-48 on the basic reproduction number (R0) is 1.9%, and it is, therefore, unlikely that phenotypically susceptible E. coliOXA-48 will contribute significantly to the spread of blaOXA-48.
Insights
Most OXA-48 producing E. coli are susceptible to meropenem, potentially remaining undetected. However, their contribution to blaOXA-48 spread is minimal, despite prolonged colonization.
Area of Science:
- Microbiology
- Infectious Diseases
- Antimicrobial Resistance
Background:
- OXA-48 carbapenemase is a significant threat in hospital settings.
- OXA-48 producing Klebsiella pneumoniae are typically resistant to carbapenems.
- OXA-48 producing Escherichia coli often exhibit susceptibility to carbapenems, complicating detection.
Purpose of the Study:
- To investigate the colonization dynamics and horizontal gene transfer of OXA-48 in Klebsiella pneumoniae and Escherichia coli.
- To assess the contribution of phenotypically susceptible E. coli OXA-48 to the spread of the blaOXA-48 gene.
Main Methods:
- Longitudinal molecular screening of 868 samples from patients colonized with K. pneumoniae OXA-48, E. coli OXA-48, or both.
- Mathematical modeling to determine colonization durations and horizontal gene transfer rates.
- Calculation of the impact of E. coli OXA-48 on the basic reproduction number (R0) of blaOXA-48.
Main Results:
- Mean colonization durations were 278 days for K. pneumoniae OXA-48 and 225 days for E. coli OXA-48.
- Horizontal gene transfer rates were determined: 0.0091/day from K. pneumoniae to E. coli and 0.0015/day from E. coli to K. pneumoniae.
- The maximum impact of blaOXA-48 horizontal gene transfer from E. coli OXA-48 on R0 was 1.9%.
Conclusions:
- Phenotypically susceptible E. coli OXA-48 may remain undetected in clinical settings.
- Despite prolonged colonization, E. coli OXA-48 is unlikely to significantly contribute to the spread of blaOXA-48.
- Molecular detection methods are crucial for identifying all OXA-48 carriers and understanding transmission dynamics.
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