Class D OXA-48 Carbapenemase in Multidrug-Resistant Enterobacteria, Senegal

Moquet, Olivier; Bouchiat, Coralie; Kinana, Alfred; Seck, Abdoulaye; Arouna, Omar; Bercion, Raymond; Breurec, Sébastien; Garin, Benoît

doi:10.3201/eid1701.100224

Cited by 46 publications

(46 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…However, there are no indications of an overall significant spread of these microorganisms across Europe. Although the Middle East and North Africa remain the main foci of infection, the recent isolation of K. pneumoniae isolates producing OXA-48-type enzymes in India (47), Senegal (173), and Argentina (216) suggests an expansion that can safely be considered global. Additionally, the recent isolation of OXA-48 producers belonging to species other than K. pneumoniae underlines the spreading potential of bla (Table 1) (46).…”

Section: Producers Of Oxa-48mentioning

confidence: 99%

Carbapenemases in Klebsiella pneumoniae and Other Enterobacteriaceae: an Evolving Crisis of Global Dimensions

et al. 2012

View full text Add to dashboard Cite

SUMMARY The spread of Enterobacteriaceae , primarily Klebsiella pneumoniae , producing KPC, VIM, IMP, and NDM carbapenemases, is causing an unprecedented public health crisis. Carbapenemase-producing enterobacteria (CPE) infect mainly hospitalized patients but also have been spreading in long-term care facilities. Given their multidrug resistance, therapeutic options are limited and, as discussed here, should be reevaluated and optimized. Based on susceptibility data, colistin and tigecycline are commonly used to treat CPE infections. Nevertheless, a review of the literature revealed high failure rates in cases of monotherapy with these drugs, whilst monotherapy with either a carbapenem or an aminoglycoside appeared to be more effective. Combination therapies not including carbapenems were comparable to aminoglycoside and carbapenem monotherapies. Higher success rates have been achieved with carbapenem-containing combinations. Pharmacodynamic simulations and experimental infections indicate that modification of the current patterns of carbapenem use against CPE warrants further attention. Epidemiological data, though fragmentary in many countries, indicate CPE foci and transmission routes, to some extent, whilst also underlining the lack of international collaborative systems that could react promptly and effectively. Fortunately, there are sound studies showing successful containment of CPE by bundles of measures, among which the most important are active surveillance cultures, separation of carriers, and assignment of dedicated nursing staff.

show abstract

Section: Producers Of Oxa-48mentioning

confidence: 99%

Carbapenemases in Klebsiella pneumoniae and Other Enterobacteriaceae: an Evolving Crisis of Global Dimensions

et al. 2012

View full text Add to dashboard Cite

show abstract

“…OXA-48 exhibits a hydrolysis profile that includes penicillins and carbapenems and that spares cephalosporins (29). Lately, the bla OXA-48 gene has been identified in different countries, such as Lebanon, Tunisia, Israel, Belgium, and France and recently in Senegal and Morocco (3,[9][10][11]14,19,[20][21][22]34). Several isolates producing OXA-48 have been involved as a source of nosocomial outbreaks (5, 11).…”

mentioning

confidence: 99%

OXA-163, an OXA-48-Related Class D β-Lactamase with Extended Activity Toward Expanded-Spectrum Cephalosporins

Poirel

Castanheira

Carrër

et al. 2011

Antimicrob Agents Chemother

135

160

View full text Add to dashboard Cite

Two bla OXA-48 -like-positive isolates (Klebsiella pneumoniae and Enterobacter cloacae) were recovered in Argentina in 2008 as part of a large-scale survey focused on multidrug resistance in Enterobacteriaceae. In both cases, sequencing identified ␤-lactamase OXA-163, differing from OXA-48 by a single amino substitution and a 4-amino-acid deletion. OXA-163 hydrolyzed penicillins, ceftazidime, and cefotaxime, whereas OXA-48 did not. However, OXA-163 had a much lower ability to hydrolyze carbapenems than OXA-48, therefore barely being considered a carbapenemase. In both isolates, the bla OXA-163 gene was located on plasmids that differed in structure and size. However, a detailed genetic analysis revealed a similar genetic context in those isolates, with the bla OXA-163 gene being bracketed by novel transposase genes, making this genetic environment different from that reported for the bla OXA-48 gene. This study identified the first class D ␤-lactamase compromising both extended-spectrum cephalosporin and carbapenem activities.Class D ␤-lactamases or oxacillinases are widely distributed among clinically relevant Gram-negative species (31). A high degree of diversity is observed at the biochemical and genetic levels among these enzymes exhibiting a narrow or broad spectrum of hydrolysis toward ␤-lactams (31). Genes encoding oxacillinases are usually embedded as gene cassettes into class 1 integrons, but other potentially mobile genetic vehicles have also been described, including insertion sequences (ISs) (31). Among class D ␤-lactamases, some enzymes confer the ability to hydrolyze carbapenems and have mostly been identified in Acinetobacter spp. (32) but rarely in Enterobacteriaceae (33). The carbapenem-hydrolyzing class D ␤-lactamase (CHDL) OXA-48 was initially identified in Turkey, first in Klebsiella pneumoniae and then in other enterobacterial species (1,5,6,15,23,29). OXA-48 exhibits a hydrolysis profile that includes penicillins and carbapenems and that spares cephalosporins (29). Lately, the bla OXA-48 gene has been identified in different countries, such as Lebanon, Tunisia, Israel, Belgium, and France and recently in Senegal and Morocco (3,[9][10][11]14,19,[20][21][22]34). Several isolates producing OXA-48 have been involved as a source of nosocomial outbreaks (5, 11). The bla OXA-48 gene has often been identified on a 70-kb plasmid featured by the replication protein RepP (6). The bla gene is usually identified in association with two IS1999 insertion sequences, forming the composite transposon Tn1999 (2). Here we report an OXA-48-related CHDL that possesses very peculiar hydrolytic properties and whose gene is associated with novel genetic structures. MATERIALS AND METHODSBacterial strains. Identification of K. pneumoniae (isolate Kp6299) and Enterobacter cloacae 2185 (isolate Enc2185) was performed by using the API 20E system (bioMérieux, Marcy l'Étoile, France). Escherichia coli TOP10 was used as the host strain for cloning, and E. coli J53 (resistant to azide) was used as the host for conjugation ...

show abstract

“…After 2009, OXA-48-producing K. pneumoniae spread rapidly among European countries and caused several outbreaks in hospital settings (4-6). The first cases in the United States were recently identified (7), although OXA-48-producing Gram-negative bacteria belonging to the family Enterobacteriaceae have been reported in several developing countries or regions (8,9).…”

mentioning

confidence: 99%

First Report of OXA-48 Carbapenemase-Producing Klebsiella pneumoniae and Escherichia coli in Japan from a Patient Returned from Southeast Asia

et al. 2013

View full text Add to dashboard Cite

Class D OXA-48 Carbapenemase in Multidrug-Resistant Enterobacteria, Senegal

Cited by 46 publications

References 9 publications

Carbapenemases in Klebsiella pneumoniae and Other Enterobacteriaceae: an Evolving Crisis of Global Dimensions

Carbapenemases in Klebsiella pneumoniae and Other Enterobacteriaceae: an Evolving Crisis of Global Dimensions

OXA-163, an OXA-48-Related Class D β-Lactamase with Extended Activity Toward Expanded-Spectrum Cephalosporins

First Report of OXA-48 Carbapenemase-Producing Klebsiella pneumoniae and Escherichia coli in Japan from a Patient Returned from Southeast Asia

Contact Info

Product

Resources

About