Rapid spread of OXA-244-producing Escherichia coli ST38 in Germany: insights from an integrated molecular surveillance approach; 2017 to January 2020

Abstract

Annually, increasing numbers of OXA-244-producing Escherichia coli in 13 German federal states prompted us to initiate an outbreak investigation. Whole genome sequencing revealed that among 148 isolates analysed, most belonged to sequence type 38 with 62 isolates forming a genetically distinct cluster. Although no epidemiological link could be identified between cases, ongoing investigations suggest non-healthcare associated transmission. A screening-PCR was developed facilitating early detection of ST38 cluster isolates to identify the source and transmission route.

Third Generation Cephalosporin Resistant Enterobacterales Infections in Hospitalized Horses and Donkeys: A Case–Case–Control Analysis

“…Some of these STs were identified as MDR international human clones. For example, E. coli ST38 is an emerging clone in Germany [48], E. cloacae ST66 was isolated from human hospitals in Japan, France, Spain and Israel [43], and K. pneumoniae ST35 was isolated from China and Yemen [49,50]. This ST dissemination has major implications for human medicine and the "one health" approach, due to the close human-horse proximities and interactions [51].…”

Emergence of carbapenem-resistant ST131 Escherichia coli carrying blaOXA-244 in Germany, 2019 to 2020

“…The increased incidence in Europe of communityacquired infections with E. coli carrying OXA-244 is of public health relevance as reflected by the rapid risk assessment by the European Centre for Disease Prevention and Control (ECDC) at the beginning of 2020 [18]. Recently, several federal states in Germany reported a rise in detection of community-acquired infections with ST38 OXA-244-producing E. coli [17]. Similar observations have been reported in other European countries [4,5,[19][20][21].…”

“…In Germany and other neighbouring countries in Europe, bla OXA-244 is predominantly found in ST38 E. coli [4,17,19,21,22]. Surveillance data from Denmark and France reported the presence of bla OXA-244 in other clonal groups (ST10, ST38, ST69, ST167, ST10, ST361 and ST 3268) [21,23], but to the best of our knowledge the presence of bla OXA-244 in ST131 E. coli in Europe has not been reported before.…”

“…In the ST38 cluster, there was no epidemiological overlap so that a nosocomial patient-to-patient transmission event is unlikely. Nevertheless, community transmissions caused by clonal dissemination of bla OXA-244 -positive ST38 E. coli in Germany cannot be entirely ruled out [17].…”

Emergence and Polyclonal Dissemination of OXA-244–Producing Escherichia coli, France

“…The global dissemination of carbapenemase-producing Enterobacterales (CPE; formerly known as carbapenemase-producing Enterobacteriaceae) pose a serious threat to public health (1). Oxacillin (OXA) 244, a single amino-acid variant of OXA-48 (Arg-222-Gly) (2), is an emerging carbapenemase variant in several countries in Europe (3)(4)(5)(6)(7). During 2013-2019, the French National Reference Center received a continuously increasing number of OXA-244-producing isolates for antimicrobial resistance (AMR) testing.…”