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Characterization of blaOXA-48-carrying plasmids and small non-AMR-coding plasmids collected from Ukrainian patients
Vincent F van Almsick1,2, Annika Sobkowiak3,4, Natalie Scherff3
1Institute of Hygiene, University Hospital Münster, Robert-Koch-Straße 41, Münster, Germany. vincentfrederic.vanalmsick@ukmuenster.de.
Purpose:
Carbapenemase-producing Enterobacterales (CPE) pose a serious threat for healthcare facilities worldwide, yet the mode of transmission is often unclear. Recently, we recorded an increase of blaOXA-48-harboring isolates at our hospital associated with patients with previous medical treatment in the Ukraine. We used long-read whole genome sequencing (lrWGS) to characterize these isolates including their plasmids.
Methods:
Samples were collected as part of clinical routine diagnostic or screening of multi-drug resistance bacteria (MDRB). Antimicrobial susceptibility testing was performed and all MDRB (n = 10) were sequenced by lrWGS for genotyping, identification of antimicrobial resistance (AMR) genes, and characterization of plasmids.
Results:
While routine analysis of core genome multilocus sequence typing (cgMLST) did not show any genetic similarities between isolates, we found an unexpected high similarity in the plasmid diversity of different Enterobacterales in patients with previous medical treatment in the Ukraine. This included an IncL/M plasmid carrying blaOXA-48 and additional small non-AMR-coding plasmids.
Conclusion:
Our results show that lrWGS can be used in the routine setting to uncover similarities in plasmids and may give further information about potential epidemiologic associations. In the future, analysis of both AMR and non-AMR plasmids may provide an additional layer of information for molecular surveillance of CPE.
Insights
Long-read whole genome sequencing revealed similar plasmids, not core genome similarities, in carbapenemase-producing Enterobacterales (CPE) from patients with recent Ukraine medical treatment, suggesting a novel surveillance approach.
Area of Science:
- Microbiology
- Genomics
- Epidemiology
Background:
- Carbapenemase-producing Enterobacterales (CPE) are a global healthcare threat, with transmission routes often unknown.
- An increase in blaOXA-48-harboring CPE was observed, linked to patients with prior medical treatment in Ukraine.
Purpose of the Study:
- To characterize blaOXA-48-harboring CPE isolates using long-read whole genome sequencing (lrWGS).
- To investigate potential transmission pathways and plasmid diversity among these isolates.
Main Methods:
- Clinical samples from multi-drug resistant bacteria (MDRB) were sequenced using lrWGS.
- Antimicrobial susceptibility testing, genotyping, AMR gene identification, and plasmid characterization were performed.
Main Results:
- Core genome multilocus sequence typing (cgMLST) showed no genetic similarity between isolates.
- Unexpectedly high similarity in plasmid diversity was found among Enterobacterales from patients with Ukraine medical history.
- An IncL/M plasmid carrying blaOXA-48 and other non-AMR plasmids were identified.
Conclusions:
- lrWGS can identify plasmid similarities, aiding in understanding potential epidemiologic associations for CPE.
- Analyzing both AMR and non-AMR plasmids offers an enhanced layer for molecular surveillance of CPE.
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