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https://www.infmed.dk/udbrud?rss_filter=pneumoni&setpoint=101365#101946
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Julian Sommer, Hannah Reiter, Janko Sattler, Elisabetta Cacace, Jessica Eisfeld, Sören Gatermann, Axel Hamprecht and Stephan Göttig
Eurosurveillance latest updates, 12.04.2024
Tilføjet 12.04.2024
BackgroundCarbapenemase-producing Enterobacterales are a public health threat worldwide and OXA-48 is the most prevalent carbapenemase in Germany and western Europe. However, the molecular epidemiology of OXA-48 in species other than Escherichia coli and Klebsiella pneumoniae remains poorly understood. AimTo analyse the molecular epidemiology of OXA-48 and OXA-48-like carbapenemases in Citrobacter species (spp.) in Germany between 2011 and 2022. MethodsData of 26,822 Enterobacterales isolates sent to the National Reference Centre (NRC) for Gram-negative bacteria were evaluated. Ninety-one Citrobacter isolates from 40 German hospitals harbouring blaOXA-48/OXA-48‑like were analysed by whole genome sequencing and conjugation experiments. ResultsThe frequency of OXA-48 in Citrobacter freundii (CF) has increased steadily since 2011 and is now the most prevalent carbapenemase in this species in Germany. Among 91 in-depth analysed Citrobacter spp. isolates, CF (n = 73) and C. koseri (n = 8) were the most common species and OXA-48 was the most common variant (n = 77), followed by OXA-162 (n = 11) and OXA‑181 (n = 3). Forty percent of the isolates belonged to only two sequence types (ST19 and ST22), while most other STs were singletons. The plasmids harbouring blaOXA‑48 and blaOXA-162 belonged to the plasmid types IncL (n = 85) or IncF (n = 3), and plasmids harbouring blaOXA‑181 to IncX3 (n = 3). Three IncL plasmid clusters (57/85 IncL plasmids) were identified, which were highly transferable in contrast to sporadic plasmids. ConclusionIn CF in Germany, OXA-48 is the predominant carbapenemase. Dissemination is likely due to distinct highly transmissible plasmids harbouring blaOXA‑48 or blaOXA-48-like and the spread of the high-risk clonal lineages ST19 and ST22.
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