A Long-Term Study of the Diversity of OXA-48-Like Carbapenemase-Producing Bacterial Strains in Infected Patients and Carriers
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Paul-Louis Woerther1, Taha Jardak1, Inès Ben Hassine1
11 Department of Microbiology, Gustave Roussy Cancer Campus , Villejuif, France .
Purpose:
Since their emergence at the beginning of the century, OXA-48 carbapenemases have spread in the community and in hospitals. To assess the diversity of OXA-48-producing bacterial strains and plasmids in the hospital setting, we studied the strains isolated from patients in three hospitals in the Paris area.
Materials And Methods:
All possible OXA-48-like strains were included in the study. OXA-48-like and extended-spectrum beta-lactamase-encoding genes were identified, and fingerprinting analysis was performed for all Escherichia coli and Klebsiella pneumoniae strains. The backbones and close genetic environments of blaOXA-48 were assessed by amplifying genes that were specific to the pOXA-48a plasmid and PCR, encompassing the junctions between blaOXA-48 and its direct genetic environment.
Results:
Overall, 68 strains from 30 patients were studied. These strains belonged to seven different enterobacterial species. OXA-48, OXA-204, and OXA-401 were identified in 62, 3, and 3 isolates, respectively. Additional broad-spectrum beta-lactamases were identified in 34% (23/68) of the strains. The strain diversity was high between and within patients. Identical patterns were observed only within individual patients or among epidemiologically related patients. Plasmid mapping was performed in the 62 OXA-48-producing strains and the 3 OXA-405-producing strains, resulting in the identification of 5 different patterns.
Conclusion:
Because of their ability to transfer between strains, OXA-48 carbapenemases have a high risk of dissemination and may become endemic in France.
Insights
OXA-48 carbapenemases are spreading in French hospitals. This study found diverse bacterial strains and plasmids carrying these resistance genes, highlighting a high risk of dissemination and potential endemicity.
Area of Science:
- Microbiology
- Infectious Diseases
- Molecular Biology
Background:
- OXA-48 carbapenemases have emerged and spread globally.
- Understanding their diversity in hospital settings is crucial for infection control.
Purpose of the Study:
- To assess the diversity of OXA-48-producing bacterial strains and plasmids.
- To investigate strains isolated from patients in three Paris-area hospitals.
Main Methods:
- Included all identified OXA-48-like strains.
- Performed gene identification (OXA-48-like, ESBLs) and strain fingerprinting (E. coli, K. pneumoniae).
- Assessed blaOXA-48 genetic environments and plasmid backbones.
Main Results:
- Studied 68 strains from 30 patients across seven enterobacterial species.
- Identified OXA-48 (62 isolates), OXA-204 (3 isolates), and OXA-401 (3 isolates).
- Found high strain diversity within and between patients; identified 5 plasmid patterns.
Conclusions:
- OXA-48 carbapenemases exhibit high dissemination potential due to transferability.
- These enzymes may become endemic in France, necessitating ongoing surveillance.
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