Peer-Reviewed Journal Details
Mandatory Fields
Brehony, C;McGrath, E;Brennan, W;Tuohy, A;Whyte, T;Brisse, S;Maiden, M;Jolley, K;Morris, D;Cormican, M
2019
July
Journal Of Antimicrobial Chemotherapy
An MLST approach to support tracking of plasmids carrying OXA-48-like carbapenemase
Published
Optional Fields
RESISTANT KLEBSIELLA-PNEUMONIAE ESCHERICHIA-COLI BETA-LACTAMASE ENTEROBACTERIACEAE COMMUNITY CARRIAGE SPREAD
74
1856
1862
Objectives The prevalence of infections caused by OXA-48-like carbapenemase-producing organisms in Ireland has increased dramatically since 2011 and is an urgent public health issue. Genome-based high-resolution genotyping was used to analyse clinical isolates submitted to the Irish Carbapenemase-Producing Enterobacteriaceae Reference Laboratory Service for a 13month period (2016-17).Methods A total of 109 OXA-48-producing non-duplicate clinical isolates from 16 submitting centres were sequenced. Using a gene-by-gene approach, isolate genomes were characterized by MLST and core genome MLST, and the presence of antimicrobial resistance determinants was determined. Reference mapping and a novel plasmid MLST-type approach was applied to determine plasmid background.Results The OXA-48-like-producing isolates were Escherichia coli (n=56), Klebsiella spp. (n=46) and Enterobacter cloacae (n=7). Amongst the E. coli isolates there were 37 different STs and amongst the Klebsiella spp. isolates there were 27 different STs. bla(OXA-48) was present in 105/109 (96.3%) of isolates. Based on mapping analysis and detection of the pOXA-48 IncL-type plasmid replicon and backbone genes, a pOXA-48-like plasmid was identified in 93/109 isolates (85.3%). The remaining isolates (n=16; 14.7%) harboured bla(OXA-48)-like genes in unknown environments. Using a gene-by-gene approach two pOXA-48-like plasmid groups with 2/71 pOXA-48-like locus differences between them were identified.Conclusions In Ireland we found a diversity of genotypes associated with OXA-48-like-producing clinical isolates with the IncL pOXA-48 plasmid type predominating as the bla(OXA-48) genetic environment. A plasmid MLST approach can rapidly identify plasmids associated with outbreaks and monitor spread of types temporally and geographically.
0305-7453
10.1093/jac/dkz136
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