Analysis of OXA-204 carbapenemase-producing Enterobacteriaceae reveals possible endoscopy-associated transmission,...

Area of Science:

• Molecular epidemiology of antimicrobial resistance
• Bacterial genetics and genomics
• Infectious disease outbreaks

Background:

• OXA-48-like beta-lactamases are prevalent in Europe and the Mediterranean.
• OXA-48 and OXA-181 are common variants, while OXA-204 is rarely reported.
• Emergence of novel carbapenemase variants poses a significant public health threat.

Purpose of the Study:

• To investigate the molecular epidemiology of OXA-204-producing Enterobacteriaceae in France.
• To characterize the first reported outbreak of OXA-204-producing Enterobacteriaceae in Europe.
• To identify the genetic elements and bacterial clones associated with OXA-204 dissemination.

Main Methods:

• Collection and molecular characterization of 29 OXA-204-positive enterobacterial isolates from France (Oct 2012-May 2014).
• Identification of bacterial species, sequence types (STs), and co-resistance genes.
• Plasmid analysis to determine the location and type of the blaOXA-204 gene.

Main Results:

• The study identified the first European outbreak of OXA-204-producing Enterobacteriaceae.
• The outbreak involved ST90 Escherichia coli (12 isolates) and ST147 Klebsiella pneumoniae (9 isolates).
• All isolates co-produced CMY-4, and 60% also produced CTX-M-15. The blaOXA-204 gene was located on a transferable 150-kb IncA/C plasmid.

Conclusions:

• This study reports the first outbreak of OXA-204-producing Enterobacteriaceae in Europe, driven by specific E. coli and K. pneumoniae clones.
• The blaOXA-204 gene is associated with a highly conjugative IncA/C plasmid, facilitating its spread among different enterobacterial species.
• The findings highlight the need for enhanced surveillance of rare carbapenemase variants and their mobile genetic elements.