Emergence of NDM-1-Producing Enterobacteriaceae in Belgium

Bogaerts, Pierre; Bouchahrouf, Warda; Castro, Roberta Rezende de; Deplano, Ariane; Berhin, Catherine; Piérard, Denis; Denis, Olivier; Glupczynski, Youri

doi:10.1128/aac.00049-11

Cited by 57 publications

(37 citation statements)

References 16 publications

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“…However, this specific association between the bla NDM-1 and rmtB genes has been very rarely reported, and mainly in E. coli, with a single isolate from Australia (25) and a single isolate from Belgium (Pakistan origin) (31).…”

Section: W Orldwide Occurrence Of Carbapenemase Producers Amongmentioning

confidence: 99%

Outbreak Caused by NDM-1- and RmtB-Producing Escherichia coli in Bulgaria

Poirel

Savov

Nazli

et al. 2014

Antimicrob Agents Chemother

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Twelve consecutive carbapenem-resistant Escherichia coli isolates were recovered from patients (infection or colonization) hospitalized between March and September 2012 in different units at a hospital in Bulgaria. They all produced the carbapenemase NDM-1 and the extended-spectrum-␤-lactamase CTX-M-15, together with the 16S rRNA methylase RmtB, conferring high-level resistance to all aminoglycosides. All those isolates were clonally related and belonged to the same sequence type, ST101. In addition to being the first to identify NDM-producing isolates in Bulgaria, this is the very first study reporting an outbreak of NDM-1-producing E. coli in the world. W orldwide occurrence of carbapenemase producers amongEnterobacteriaceae is now well recognized (1, 2). In Europe, there are distinct epidemiological situations corresponding mainly to the diffusion of OXA-48 producers in France, Belgium, The Netherlands, and Turkey (3, 4) and KPC-producing isolates in Italy and Greece (5), while some countries show more diverse distributions, such as in the United Kingdom, where KPC, OXA-48, VIM, and NDM-1 producers are being found (6). The recent emergence of NDM-1 producers (mostly Klebsiella pneumoniae isolates) is often related to imported cases, with a link to the Indian subcontinent (7). In addition, there are sporadic reports of NDM-1 producers (Enterobacteriaceae, Acinetobacter baumannii, and Pseudomonas aeruginosa) originating from countries of the Middle East or the Balkan region, including Croatia, Kosovo, and Serbia (7,8). Very little information is available regarding the diffusion of carbapenemase producers in Eastern Europe. Therefore, our study aimed to characterize the mechanisms responsible for carbapenem resistance by investigating a collection of enterobacterial isolates recovered in Bulgaria. From March to September 2012, 12 Escherichia coli isolates being resistant to carbapenems were recovered at the Military Medical Academy hospital of Sofia, Bulgaria. Susceptibility testing was performed by disk diffusion on solid agar plates following the CLSI recommendations (9). Those isolates had been recovered from urine (n ϭ 4), blood (n ϭ 1), respiratory specimens (n ϭ 2), wound (n ϭ 1), catheter (n ϭ 1), abdominal exudate (n ϭ 1), and rectal swabs (n ϭ 2). The MICs of carbapenems were determined by Etest (AB bioMérieux, La Balme-les-Grottes, France) on Mueller-Hinton agar plates at 37°C, and results of susceptibility testing were interpreted according to the CLSI guidelines (10). The MICs of imipenem, meropenem, and ertapenem were 32, Ͼ32, and Ͼ32 g/ml for all the E. coli isolates, respectively. They were resistant to all ␤-lactams, including broad-spectrum cephalosporins (MICs of ceftazidime and cefotaxime being Ͼ32 g/ml) ( Table 1). In addition, they were resistant to all tested aminoglycosides (amikacin, gentamicin, netilmicin, kanamycin) and to fluoroquinolones and sulfonamides. Using the Etest, the MIC of rifampin was elevated (128 g/ml), and that of colistin was found to be 0.5 g/ml.Carbapenemase detecti...

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Section: W Orldwide Occurrence Of Carbapenemase Producers Amongmentioning

confidence: 99%

Outbreak Caused by NDM-1- and RmtB-Producing Escherichia coli in Bulgaria

Poirel

Savov

Nazli

et al. 2014

Antimicrob Agents Chemother

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“…NDM-producing bacteria have been implicated in both hospital-and community-acquired infections and have been recovered from several infection sites, including those associated with urinary tract infections, pneumonia, septicemia, and wound infections as well as from device-associated infections and companion animals (10)(11)(12)(13). Although the exact geographical origin and the precise time for the emergence of the bla NDM gene are unknown, the first NDM-1-positive isolate was recovered in 2009 from a Swedish patient who previously (2007) had an episode of hospitalization in New Delhi, India (14).…”

mentioning

confidence: 99%

Molecular Epidemiology and Genome Dynamics of New Delhi Metallo-β-Lactamase-Producing Extraintestinal Pathogenic Escherichia coli Strains from India

Ranjan

Shaik

Mondal

et al. 2016

Antimicrob Agents Chemother

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cThe global dissemination and increasing incidence of carbapenem-resistant, Gram-negative organisms have resulted in acute public health concerns. Here, we present a retrospective multicenter study on molecular characterization of metallo-␤-lactamase (MBL)-producing clinical Escherichia coli isolates recovered from extraintestinal infections in two hospitals in Pune, India. We screened a large sample size of 510 E. coli isolates for MBL production wherein we profiled their molecular determinants, antimicrobial resistance phenotypes, functional virulence properties, genomic features, and transmission dynamics. Approximately 8% of these isolates were MBL producers, the majority of which were of the NDM-1 (69%) type, followed by NDM-5 (19%), NDM-4 (5.5%), and NDM-7 (5.5%). MBL producers were resistant to all antibiotics tested except for colistin, fosfomycin, and chloramphenicol, which were effective to various extents. Plasmids were found to be an effective means of dissemination of NDM genes and other resistance traits. All MBL producers adhered to and invaded bladder epithelial (T24) cells and demonstrated significant serum resistance. Genomic analysis of MBL-producing E. coli isolates revealed higher resistance but a moderate virulence gene repertoire. A subset of NDM-1-positive E. coli isolates was identified as dominant sequence type 101 (ST101) while two strains belonging to ST167 and ST405 harbored NDM-5. A majority of MBL-producing E. coli strains revealed unique genotypes, suggesting that they were clonally unrelated. Overall, the coexistence of virulence and carbapenem resistance in clinical E. coli isolates is of serious concern. Moreover, the emergence of NDM-1 among the globally dominant E. coli ST101 isolates warrants stringent surveillance and control measures.

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“…All isolates referred between Janurary 2007 and April 2011 were re-tested at the NRC for antimicrobial susceptibility by the disk diffusion method according to the guidelines of the Clinical and Laboratory Standards Institute (CLSI) and meropenem inhibition zones were recorded. Isolates displaying an inhibition zone of <23 mm to 10 µg meropenem disks, categorised retrospectively as intermediately resistant according to the CLSI interpretative criteria of January 2011 [8], were screened for the presence of carbapenemase-encoding genes by PCR using primers specific for bla VIM, bla IMP, bla KPC, bla NDM and bla OXA-48 [6]. Carbapenemase-encoding genes were identified by sequencing of the amplicons.…”

Section: Methodsmentioning

confidence: 99%

“…In Belgium, sporadic cases of carbapenemase-producing Enterobacteriaceae (CPE) isolates have been reported, the majority of which occurred in patients returning from travel abroad [4][5][6].…”

Section: Introductionmentioning

confidence: 99%

Rapid emergence of carbapenemase-producing Enterobacteriaceae isolates in Belgium

et al. 2011

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We report on the evolution and epidemiology of carbapenem non-susceptible Enterobacteriaceae (CNSE) including carbapenemase-producing Enterobacteriaceae (CPE) in Belgium between January 2007 and April 2011. Significantly higher numbers of CNSE and of CPE were detected in 2010 and 2011 compared to the years 2007 to 2009. The majority of patients carrying CPE did not have history of travel abroad. The rapid emergence of autochthonous CPE strains in Belgium since 2010 warrants strengthened epidemiological surveillance at national level.

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Emergence of NDM-1-Producing Enterobacteriaceae in Belgium

Cited by 57 publications

References 16 publications

Outbreak Caused by NDM-1- and RmtB-Producing Escherichia coli in Bulgaria

Outbreak Caused by NDM-1- and RmtB-Producing Escherichia coli in Bulgaria

Molecular Epidemiology and Genome Dynamics of New Delhi Metallo-β-Lactamase-Producing Extraintestinal Pathogenic Escherichia coli Strains from India

Rapid emergence of carbapenemase-producing Enterobacteriaceae isolates in Belgium

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