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Journal of Antimicrobial Chemotherapy
Article . 2012 . Peer-reviewed
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Characterization of Enterobacteriaceae producing OXA-48-like carbapenemases in the UK

Authors: Dimou, Vassiliki; Dhanji, Hiran; Pike, Rachel; Livermore, David M.; Woodford, Neil;

Characterization of Enterobacteriaceae producing OXA-48-like carbapenemases in the UK

Abstract

To characterize UK clinical isolates of Enterobacteriaceae producing OXA-48-like carbapenemases and to compare their resistance plasmids.Twenty-six enterobacteria producing OXA-48-like enzymes were studied. These were from 22 diverse hospitals in the UK. Isolates of Escherichia coli and Klebsiella pneumoniae were assigned to clonal lineages by multilocus sequence typing. Carbapenemase genes and their genetic environments were characterized by PCR and sequencing. Resistance plasmids were transferred by transformation or conjugation and compared by restriction analysis and PCR for genes encoding critical plasmid functions.Thirteen isolates of K. pneumoniae, 10 E. coli and 2 Enterobacter cloacae harboured a classical bla(OXA-48) gene; the K. pneumoniae isolates belonged to 11 sequence types (STs) and the E. coli to 7 STs, including ST131 and ST38. The bla(OXA-48) genes were located within either Tn1999 or Tn1999.2 transposons on related ≈ 50 kb or ≈ 62 kb plasmids, which lacked other resistance genes or, in one isolate, on an ≈ 140 kb plasmid that also encoded OXA-9 and CTX-M group-9 β-lactamases. One India-linked K. pneumoniae isolate had a bla(OXA-181) gene in association with an ISEcp1 insertion sequence on a 7 kb plasmid.Horizontal transfer of related plasmids has facilitated the spread of OXA-48 carbapenemase into multiple strains of several Enterobacteriaceae species. The clonal diversity of the producers suggests repeated introduction into the UK. Low carbapenem MICs for some producers complicates detection and creates a risk for unrecognized spread.

Country
United Kingdom
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Keywords

DNA, Bacterial, Gene Transfer, Horizontal, Genotype, Restriction Mapping, Enterobacteriaceae Infections, 610, Sequence Analysis, DNA, 630, Hospitals, United Kingdom, beta-Lactamases, Molecular Typing, Enterobacteriaceae, Conjugation, Genetic, Humans, Plasmids

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    popularity
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    Top 10%
    influence
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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
105
Top 10%
Top 1%
Top 1%
bronze