Nosocomial occurrence of OXA-48-producing enterobacterial isolates in a Moroccan hospital

Hays, Constantin; Benouda, A.; Poirel, Laurent; Elouennass, Mostafa; Nordmann, Patrice

doi:10.1016/j.ijantimicag.2012.03.002

Cited by 32 publications

(37 citation statements)

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“…Hammerum et al reported that patients transferred from Libya to Denmark carried OXA-48-producing K. pneumoniae [42].These studies underscore the importance of an early warning system at the European level and screening upon admission of patients transferred across countries. These findings may also confirm that North Africa, including Tunisia and Libya, are considered to be reservoirs of oxacillinase producers, particularly OXA-48; to date, this enzyme represents the most common carbapenemase type circulating in this region [43][44][45][46] (Table 5). Recently, in 2014, Agabou et al reported the first description of OXA-48-producing E. coli and the pandemic clone ST131 from patients hospitalized at the Regional Military Hospital of Constantine [33].…”

Section: Indeed Mamlouk Et Al Detected the Blactx-m-15 Gene Insupporting

confidence: 56%

Carbapenemases and extended-spectrum β-lactamases producing Enterobacteriaceae isolated from Tunisian and Libyan hospitals

Mathlouthi

Al-Bayssari

Salabi

et al. 2016

J Infect Dev Ctries

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Introduction: The aim of the study was to investigate the prevalence of extended-spectrum β-lactamase (ESBL) and carbapenemase production among clinical isolates of Enterobacteriaceae recovered from Tunisian and Libyan hospitals. Methodology: Bacterial isolates were recovered from patients in intensive care units and identified by biochemical tests and MALDI-TOF. Antibiotic susceptibility testing was performed by disk diffusion and the E-test method. ESBL and carbapenemase activities were detected using standard microbiological tests. Antibiotic resistance-encoding genes were screened by PCR and sequencing. Clonal relationships between Klebsiella pneumoniae strains were carried out using multi-locus sequence typing (MLST). Results: A total of 87 isolates were characterized, with 51 and 36, respectively, identified as E. coli and K. pneumoniae. Overall the resistance prevalence was high for aminoglycosides (> 60%), fluoroquinolones (> 80%), and extended-spectrum cephalosporins (> 94%), and was low for imipenem (11.4%). Among this collection, 58 strains (66.6%) were ESBL producers and 10 K. pneumoniae strains (11.4%) were carbapenemase producers. The antibiotic resistance-encoding genes detected were blaCTX-M-15 (51.7%), blaTEM-1 (35.6%), several variants of blaSHV (21.8%), and blaOXA-48 (11.4%). The MLST typing of K. pneumoniae isolates revealed the presence of multiple clones and three novel sequence types. Also, close relationships between the OXA-48-producing strains from Tunisia and Libya were demonstrated. Conclusions: This study is the first paper describing the emergence of carbapenemase-and ESBL-producing Enterobacteriaceae, sensitive to colistin, isolated in Tunisia and Libya. Active surveillance and testing for susceptibility to colistin should be implementing because resistance to colistin, mainly in Klebsiella, has been recently reported worldwide.

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Section: Indeed Mamlouk Et Al Detected the Blactx-m-15 Gene Insupporting

confidence: 56%

Carbapenemases and extended-spectrum β-lactamases producing Enterobacteriaceae isolated from Tunisian and Libyan hospitals

Mathlouthi

Al-Bayssari

Salabi

et al. 2016

J Infect Dev Ctries

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“…Recently, a nosocomial dissemination of OXA-48-producing K. pneumoniae isolates has been reported in Moroccan hospitals [21]- [23].…”

Section: Discussionmentioning

confidence: 99%

“…However, the enzymes of this group cannot be confirmed to be ESBL-encoding genes, particularly in strains presenting more than one bla gene. On the other hand, the bla SHV-12 and bla SHV-27 genes were also detected in K. pneumoniae from Moroccan hospitals [21] [26]. The bla TEM gene was identified in 47.05% of isolates, usually in association with SHV and/or CTX-M genes.…”

Section: Discussionmentioning

confidence: 99%

Incidence of Extended-Spectrum Be-ta-Lactamase-Producing <i>Klebsiella pneumoniae</i> among Patients and in the Environment of Hassan II Hospital, Settat, Morocco

Natoubi¹,

Barguigua²,

Zriouil³

et al. 2016

AiM

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Aim: The aim of the current study is to determine: (1) the prevalence of extended-spectrum β-lactamase-producing K. pneumoniae (ESBL-Kp) isolated from clinical samples and a hospital environment in Hassan II Hospital (Settat, Morocco); (2) the associated risk factors of ESBL-Kp infections; (3) the link between clinical and environmental isolates. Methods: During the study period (April 2010 to March 2011), all patients infected and hospital environment sites contaminated by K. pneumoniae were considered as the potential study population and environmental site. The clinical data were collected to identify risk factors for ESBL carriage of K. pneumoniae infection. Screening of ESBL-and carbapenemase-producing isolates was performed by using a double-disk synergy test and the modified Hodge test, respectively. ESBL-Kp isolates were tested for the presence of genes encoding β-lactamases and were investigated by PCR. The clonal relationship between * Corresponding author. S. Natoubi et al. 153 ESBL-producing isolates was analysed by ERIC-and REP-PCR method. Results:The overall prevalence of ESBL-Kp among clinical and environmental K. pneumoniae isolates was 35.13% (13/37) and 4.04% (4/99), respectively. The main risk factors for carrying ESBL-Kp were renal disease (46.15%), recent surgery (53.84%), previous hospitalisation (76.92%), and the presence of many invasive devices (53.84%). All ESBL isolates were multidrug resistant. The blaCTX-M group1and blaSHV (70.58% for each) were the most prevalent followed by blaTEM (52.94%). Thirteen strains expressed at least two bla genes. One isolate was positive in the modified Hodge test and was a blaOXA-48 producer. ERIC and Rep-PCR methods revealed an epidemic clonal dissemination of these isolates. Conclusion: The emergence of OXA-48 carbapenemase, endemic clonal dissemination and multi-drug resistance of ESBL-Kp isolates in our institution is highly alarming.

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“…This represents the second reported outbreak of OXA-48-producing K. pneumoniae in Algeria, after the recent study by Cuzon et al (13), who characterized an outbreak of OXA-48-producing K. pneumoniae ST1853 in Constantine University Hospital in Algeria. In 2012, Poirel et al (5) suggested that the OXA-48 enzyme may be endemic in Algeria, since its dissemination has been described worldwide (4), particularly in the Mediterranean area, including Egypt, Lebanon, Morocco, and Tunisia (14)(15)(16)(17). This suggestion is supported by the isolation of OXA-48-producing Enterobacteriaceae strains from patients hospitalized in French hospitals who had recently travelled to or were hospitalized in Algeria (13).…”

mentioning

confidence: 99%

Outbreak of OXA-48-Producing Klebsiella pneumoniae Involving a Sequence Type 101 Clone in Batna University Hospital, Algeria

Loucif

Kassah-Laouar

et al. 2016

Antimicrob Agents Chemother

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Seven nonredundant ertapenem-resistant Klebsiella pneumoniae isolates were collected between May 2014 and 19 January 2015 in the nephrology and hematology units of Batna University Hospital in Algeria. All strains coproduced the bla OXA-48 , bla CTX-M-15 , bla SHV-1 , and bla TEM-1D genes. Six of these isolates belonged to the pandemic clone sequence type 101 (ST101). The bla OXA-48 gene was located on a conjugative IncL/M-type plasmid. This is the first known outbreak of OXA-48-producing K. pneumoniae isolates involving an ST101 clone in Batna University Hospital.

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Nosocomial occurrence of OXA-48-producing enterobacterial isolates in a Moroccan hospital

Cited by 32 publications

References 5 publications

Carbapenemases and extended-spectrum β-lactamases producing Enterobacteriaceae isolated from Tunisian and Libyan hospitals

Carbapenemases and extended-spectrum β-lactamases producing Enterobacteriaceae isolated from Tunisian and Libyan hospitals

Incidence of Extended-Spectrum Be-ta-Lactamase-Producing <i>Klebsiella pneumoniae</i> among Patients and in the Environment of Hassan II Hospital, Settat, Morocco

Outbreak of OXA-48-Producing Klebsiella pneumoniae Involving a Sequence Type 101 Clone in Batna University Hospital, Algeria

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Nosocomial occurrence of OXA-48-producing enterobacterial isolates in a Moroccan hospital

Cited by 32 publications

References 5 publications

Carbapenemases and extended-spectrum β-lactamases producing Enterobacteriaceae isolated from Tunisian and Libyan hospitals

Carbapenemases and extended-spectrum β-lactamases producing Enterobacteriaceae isolated from Tunisian and Libyan hospitals

Incidence of Extended-Spectrum Be-ta-Lactamase-Producing &lt;i&gt;Klebsiella pneumoniae&lt;/i&gt; among Patients and in the Environment of Hassan II Hospital, Settat, Morocco

Outbreak of OXA-48-Producing Klebsiella pneumoniae Involving a Sequence Type 101 Clone in Batna University Hospital, Algeria

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Incidence of Extended-Spectrum Be-ta-Lactamase-Producing <i>Klebsiella pneumoniae</i> among Patients and in the Environment of Hassan II Hospital, Settat, Morocco