Successful control of a hospital-wide outbreak of OXA-48 producing Enterobacteriaceae in the Netherlands, 2009 to 2011

Dautzenberg, Mirjam J. D.; Ossewaarde, Jacobus M.; Kraker, M. E. de; Zee, van der Aukje; Burgh, Sebastian van; Greeff, Sabine C. de; Bijlmer, H. A.; Grundmann, Hajo; Stuart, J.W. Cohen; Fluit, Ad C.; Troelstra, Annet; Bonten, Marc J. M.

doi:10.2807/1560-7917.es2014.19.9.20723

Cited by 65 publications

(47 citation statements)

References 28 publications

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“…OXA-48 is particularly known for consistently failing to be detected if not accompanied by another broad-spectrum ␤-lactamase (100). This was demonstrated in the unrecognized Dutch outbreak described above (53).…”

Section: Failure Of Carbapenem Breakpoints To Detect All Cposmentioning

confidence: 82%

“…Nonetheless, an early outbreak of OXA-48-producing K. pneumoniae in England was not linked to known regions of endemicity (52). More concerning, however, was a retrospective analysis that uncovered an outbreak of OXA-48-producing Enterobacteriaceae in a Dutch hospital that had been ongoing for 2 years (53). OXA-48 has disseminated to a wide variety of Enterobacteriaceae species, including Klebsiella spp., E. coli, Citrobacter spp., Serratia marcescens (54)(55)(56), Enterobacter spp., Morganella morganii (55), Providencia stuartii (57), Raoultella planticola (56), and Salmonella enterica (51).…”

Section: Current Status Of Carbapenemasesmentioning

confidence: 99%

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Intestinal Carriage of Carbapenemase-Producing Organisms: Current Status of Surveillance Methods

et al. 2016

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SUMMARYCarbapenemases have become a significant mechanism for broad-spectrum β-lactam resistance inEnterobacteriaceaeand other Gram-negative bacteria such asPseudomonasandAcinetobacterspp. Intestinal carriage of carbapenemase-producing organisms (CPOs) is an important source of transmission. Isolation of carriers is one strategy that can be used to limit the spread of these bacteria. In this review, we critically examine the clinical performance, advantages, and disadvantages of methods available for the detection of intestinal carriage of CPOs. Culture-based methods (Centers for Disease Control and Prevention [CDC] protocols, chromogenic media, specialized agars, and double-disk synergy tests) for detecting carriage of CPOs are convenient due to their ready availability and low cost, but their limited sensitivity and long turnaround time may not always be optimal for infection control practices. Contemporary nucleic acid amplification techniques (NAATs) such as real-time PCR, hybridization assays, loop-mediated isothermal amplification (LAMP), or a combined culture and NAAT approach may provide fast results and/or added sensitivity and specificity compared with culture-based methods. Infection control practitioners and clinical microbiologists should be aware of the strengths and limitations of available methods to determine the most suitable approach for their medical facility to fit their infection control needs.

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Section: Failure Of Carbapenem Breakpoints To Detect All Cposmentioning

confidence: 82%

Section: Current Status Of Carbapenemasesmentioning

confidence: 99%

Intestinal Carriage of Carbapenemase-Producing Organisms: Current Status of Surveillance Methods

et al. 2016

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“…In the clinical laboratory, it is crucial to promptly report any isolate with carbapenemase activity to the hospital infection control team to allow the implementation of appropriate contact isolation precautions (11,41). In that respect, the OXA-48 disk test, using an imipenem disk and two blank paper disks implemented with EDTA and EDTA plus PBA, respectively, was found to be a convenient procedure that, in contrast with previously proposed methods (22)(23)(24), may be used effectively for detecting OXA-48 production in a single test.…”

Section: Discussionmentioning

confidence: 99%

“…In contrast to other carbapenemases, these oxacillinases hydrolyze carbapenems weakly, while sparing expanded-spectrum cephalosporins (9). However, when OXA-48 carbapenemases are associated with the production of extended-spectrum ␤-lactamases (ESBLs) and impaired permeability, the level of resistance conferred to cephalosporins and carbapenems is substantially higher (7,9,11).…”

mentioning

confidence: 99%

Evaluation of a New Phenotypic OXA-48 Disk Test for Differentiation of OXA-48 Carbapenemase-Producing Enterobacteriaceae Clinical Isolates

et al. 2015

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The current phenotypic methods for detecting carbapenemase-producing Enterobacteriaceae (CPE) allow differentiation between class A and B carbapenemases, but they cannot confirm in a single test class D OXA-48 carbapenemase producers. In this study, we evaluated a new phenotypic test, the OXA-48 disk test, which is based on an imipenem disk and two blank disks adjacent to the imipenem disk, loaded with the tested strain and impregnated with EDTA and EDTA plus phenyl boronic acid (PBA), respectively. The evaluation of the OXA-48 disk test was performed with 81 genotypically confirmed OXA-48-type-producing Enterobacteriaceae isolates (41 extended-spectrum ␤-lactamase [ESBL] producers, 3 AmpC producers, and 37 non-ESBL, nonAmpC producers). To measure the specificity of the test, 173 genotypically confirmed OXA-48-negative Enterobacteriaceae isolates (57 Klebsiella pneumoniae carbapenemase [KPC] producers, 34 VIM producers, 23 KPC/VIM producers, 22 NDM producers, and 37 AmpC or ESBL producers and porin deficient) that were nonsusceptible to at least one carbapenem were chosen for testing. Using the imipenem disk and the distortion of the inhibition halo around both blank disks containing EDTA and EDTA/ PBA, the test differentiated all but 3 of the 81 OXA-48 producers (sensitivity of 96.3%). The test was negative for OXA-48 production in all but 4 of the 173 carbapenem-nonsusceptible isolates producing other carbapenemases, AmpCs, or ESBLs (specificity of 97.7%). This evaluation shows that the OXA-48 disk test is an accurate phenotypic method for the direct differentiation of OXA-48-producing Enterobacteriaceae. Its use along with combined disk tests employing inhibitor-supplemented carbapenem disks might allow the differentiation of the currently known carbapenemase types in Enterobacteriaceae species and provide important infection control information. During the last decade, carbapenem resistance has emerged among Enterobacteriaceae in health care settings and is increasingly being attributed to the production of ␤-lactamases capable of hydrolyzing carbapenems (1). Among these enzymes, the class A Klebsiella pneumoniae carbapenemases (KPCs) and class B acquired metallo-␤-lactamases (MBLs) have shown rapid international spread, being harbored predominantly by K. pneumoniae and less frequently by other Enterobacteriaceae species (2, 3). Additionally, the class D OXA-48-type carbapenemases have become increasingly prevalent among the carbapenem-nonsusceptible Enterobacteriaceae in regions of North Africa, the Middle East, and Turkey (1, 4, 5) and subsequently have disseminated and caused outbreaks in several European countries as well as sporadically in South and North America, Israel, and India (1, 6-9). Notably, OXA-48-type carbapenemases are spread in K. pneumoniae but also in Escherichia coli and other Enterobacteriaceae species (10). In contrast to other carbapenemases, these oxacillinases hydrolyze carbapenems weakly, while sparing expanded-spectrum cephalosporins (9). However, when OXA-48 carbapenemases are as...

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“…They have been found in clinical isolates worldwide and are endemic in the Indian subcontinent. CPOs encoding OXA-type carbapenemases (particularly OXA-48-like) have been implicated in a number of outbreaks, especially in Europe and the Mediterranean region (6)(7)(8). VIM and IMP carbapenemases have been reported globally and are sporadically detected (1).…”

mentioning

confidence: 99%

Epidemiologic and Genotypic Review of Carbapenemase-Producing Organisms in British Columbia, Canada, between 2008 and 2014

Sekirov

Croxen

et al. 2016

J Clin Microbiol

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pneumoniae isolates lack clonality, although some seemingly related clusters have been found. Plasmid analysis showed evidence of the spread of plasmids carrying carbapenemase-encoding genes between the examined isolates. Analysis of Enterobacter cloacae isolates revealed a more clonal nature of these CPOs in BC. The presence of related clusters provides evidence of interpatient organism transmission both within and between institutions. Although in our study, NDM-harboring E. cloacae isolates appeared to spread clonally, the spread of carbapenem resistance in K. pneumoniae seems to be plasmid mediated.

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Successful control of a hospital-wide outbreak of OXA-48 producing Enterobacteriaceae in the Netherlands, 2009 to 2011

Cited by 65 publications

References 28 publications

Intestinal Carriage of Carbapenemase-Producing Organisms: Current Status of Surveillance Methods

Intestinal Carriage of Carbapenemase-Producing Organisms: Current Status of Surveillance Methods

Evaluation of a New Phenotypic OXA-48 Disk Test for Differentiation of OXA-48 Carbapenemase-Producing Enterobacteriaceae Clinical Isolates

Epidemiologic and Genotypic Review of Carbapenemase-Producing Organisms in British Columbia, Canada, between 2008 and 2014

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