Retrospective identification of a previously undetected clinical case of OXA-48-producing K. pneumoniae and E. coli: the importance of adequate detection guidelines

Autor: Carlo Verhulst, John W. A. Rossen, Jan Kluytmans, Kai Zhou, Joost van Esser, Marjolein F. Q. Kluytmans-van den Bergh, Ina Willemsen, Kees Verduin
Přispěvatelé: Microbes in Health and Disease (MHD)
Rok vydání: 2015
Předmět:
0301 basic medicine
OXACILLINASE
Carbapenem
Imipenem
Klebsiella pneumoniae
medicine.medical_treatment
Case Reports
Antimicrobial resistance
Plasmid
ENTEROBACTERIACEAE
Mass Screening
OXA-48
Escherichia coli Infections
Netherlands
biology
IMIPENEM
Escherichia coli Proteins
Lymphoma
Non-Hodgkin
General Medicine
Middle Aged
Enterobacteriaceae
Infectious Diseases
Plasmid transfer
Female
Guideline Adherence
KLEBSIELLA-PNEUMONIAE
beta-lactamase
medicine.drug
Plasmids
Microbiology (medical)
Gene Transfer
Horizontal
030106 microbiology
CARBAPENEMASES
beta-Lactamases
Microbiology
03 medical and health sciences
Antibiotic resistance
medicine
Journal Article
Escherichia coli
Humans
Bacteriological Techniques
Sequence Analysis
DNA
biology.organism_classification
medicine.disease
β-lactamase
Klebsiella Infections
ISTANBUL
Detection guidelines
TURKEY
Beta-lactamase
Klebsiella pneumonia
PLASMID
Genome
Bacterial
Zdroj: Infection, 44(1), 107-110. Urban und Vogel GmbH
Infection, 44(1), 107. Urban und Vogel
ISSN: 1439-0973
0300-8126
Popis: INTRODUCTION: The laboratory detection of OXA-48-carbapenemase-producing Enterobacteriaceae is difficult, as minimum inhibition concentrations for carbapenems are often below the clinical breakpoint. In 2011, the Dutch national guideline for the detection of highly resistant micro-organisms was issued, which includes recommendations on the use of carbapenem screening breakpoints for the detection of carbapenemase-producing Enterobacteriaceae. MATERIALS AND METHODS: During a validation study of the Check-MDR CT103 microarray (Check-Points, Wageningen, The Netherlands) in 2013, an OXA-48-like carbapenemase gen was identified in two isolates that were previously obtained from a patient with non-Hodgkin lymphoma in 2007. Whole-genome sequencing (WGS) and subsequent BLAST Ringe Image Generator (BRIG) analysis were performed to establish the presence of OXA-48 carbapenemase encoding plasmids and their similarity. RESULTS: This case report describes the first documented OXA-48-producing Klebsiella pneumonia (ST648) and Escherichia coli (ST866) in the Netherlands. A similar IncL/M plasmid was identified in both strains, suggesting within-patient horizontal transfer. CONCLUSION: This case illustrates that OXA-48-carbapenemase-producing Enterobacteriaceae can be unnoticed without adequate laboratory detection procedures. Our observation stresses the importance of uniform and adequate laboratory methods for the timely and accurate detection of important antimicrobial resistance.
Databáze: OpenAIRE
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