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

Fernández, Javier; Montero, Ignacio; Martínez, Óscar; Fleites, Ana; Poirel, Laurent; Nordmann, Patrice; Rodicio, M. Rosario

doi:10.1016/j.ijantimicag.2015.07.003

Back

Journal article

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

07.08.2015

Published in:

International Journal of Antimicrobial Agents. - 2015, vol. 46, no. 4, p. 469–474

Plasmid mediated quinolone resistance

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 bla_OXA-48 gene on a conjugative IncL/M plasmid of ca. 65 kb. Clone 2 isolates (n = 11) were resistant to cefepime and harboured the bla_CTX-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