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Antibiotic Dereplication Using the Antibiotic Resistance Platform
Published on: October 17, 2019
Contaminated dicloxacillin capsules as the source of an NDM-5/OXA-48-producing Enterobacter hormaechei ST79 outbreak,
Charlotte Nielsen Agergaard1, Lone Jannok Porsbo2, Thomas Vognbjerg Sydenham1
1Department of Clinical Microbiology, Odense University Hospital, Odense, Denmark.
Abstract:
From October 2022 through January 2023, nine patients with NDM-5/OXA-48-carbapenemase-producing Enterobacter hormaechei ST79 were detected in Denmark and subsequently one patient in Iceland. There were no nosocomial links between patients, but they had all been treated with dicloxacillin capsules. An NDM-5/OXA-48-carbapenemase-producing E. hormaechei ST79, identical to patient isolates, was cultured from the surface of dicloxacillin capsules in Denmark, strongly implicating them as the source of the outbreak. Special attention is required to detect the outbreak strain in the microbiology laboratory.
Insights
A multi-drug resistant Enterobacter hormaechei ST79 strain producing NDM-5/OXA-48 carbapenemase was identified in Denmark and Iceland. Dicloxacillin capsules were implicated as the source, highlighting the need for enhanced laboratory detection.
Area of Science:
- Clinical Microbiology
- Infectious Diseases
- Antimicrobial Resistance
Background:
- Detection of NDM-5/OXA-48-carbapenemase-producing Enterobacter hormaechei ST79 in Denmark and Iceland.
- Absence of nosocomial links between the ten identified patients.
Purpose of the Study:
- To identify the source of the Enterobacter hormaechei ST79 outbreak.
- To investigate the potential role of dicloxacillin capsules in the dissemination of carbapenemase-producing Enterobacteriaceae.
Main Methods:
- Bacterial isolate identification and antimicrobial susceptibility testing.
- Molecular typing to confirm isolate relatedness.
- Environmental sampling of suspected contaminated source.
Main Results:
- Identical NDM-5/OXA-48-carbapenemase-producing E. hormaechei ST79 strains were cultured from patient samples and the surface of dicloxacillin capsules.
- The outbreak strain was indistinguishable between patient and capsule isolates.
Conclusions:
- Dicloxacillin capsules are strongly implicated as the source of this NDM-5/OXA-48-carbapenemase-producing E. hormaechei ST79 outbreak.
- Enhanced vigilance and detection strategies are crucial in clinical microbiology laboratories to identify similar strains and prevent further spread.
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