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Dissemination of multiresistant Enterobacter cloacae isolates producing OXA-48 and CTX-M-15 in a Spanish hospital

  • Fernández, Javier Department of Functional Biology, Section of Microbiology, University of Oviedo, Spain - Service of Microbiology, Hospital Universitario Central de Asturias, Oviedo, Spain
  • Montero, Ignacio Department of Functional Biology, Section of Microbiology, University of Oviedo, Spain
  • Martínez, Óscar Service of Microbiology, Hospital Universitario Central de Asturias, Oviedo, Spain
  • Fleites, Ana Service of Microbiology, Hospital Universitario Central de Asturias, Oviedo, Spain
  • Poirel, Laurent Medical and Molecular Microbiology, ‘Emerging Antibiotic Resistance’ Unit, Department of Medicine, University of Fribourg, Switzerland
  • Nordmann, Patrice Medical and Molecular Microbiology, ‘Emerging Antibiotic Resistance’ Unit, Department of Medicine, University of Fribourg, Switzerland - HFR – Hôpital Cantonal, Fribourg, Switzerland
  • Rodicio, M. Rosario Department of Functional Biology, Section of Microbiology, University of Oviedo, Spain
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    07.08.2015
Published in:
  • International Journal of Antimicrobial Agents. - 2015, vol. 46, no. 4, p. 469–474
Enterobacter cloacae
Carbapenemase
OXA 48
CTX M 15
Plasmid mediated quinolone resistance
Nosocomial outbreak
English Twenty-one multiresistant Enterobacter cloacae isolates producing OXA-48 (n = 10), CTX-M-15 (n = 7) or both (n = 4) β-lactamases were detected in a Spanish hospital during a 1-year period (June 2013 to June 2014). The isolates were also resistant to non-β-lactam antimicrobials, further complicating the therapeutic options. Genotyping of the isolates identified two major clones (ST74 and ST66) that caused prolonged outbreaks in different buildings of the hospital as well as some sporadic isolates (ST78, ST45 and ST295). Isolates belonging to clone 1 (n = 7) were carbapenem-resistant and carried the blaOXA-48 gene on a conjugative IncL/M plasmid of ca. 65 kb. Clone 2 isolates (n = 11) were resistant to cefepime and harboured the blaCTX-M-15 gene on an ca. 150-kb, non-conjugative plasmid of the IncF group, co-harbouring the qnrB and aac(6′)-Ib-cr genes encoding quinolone resistance. Four clone 2 isolates were also resistant to carbapenems owing to the co-production of OXA-48. Most of the isolates were recovered from critically ill patients and were admitted to intensive care units; a single patient was transferred from another Spanish hospital. Intrahospital and interhospital dissemination of multiresistant E. cloacae isolates is of major clinical concern as it could lead to endemic nosocomial situations.
Faculty
Faculté des sciences et de médecine
Department
Médecine 3ème année
Language
  • English
Classification
Biological sciences
License
License undefined
Identifiers
Persistent URL
https://folia.unifr.ch/unifr/documents/304718
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