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. 2020 May;25(18):1900742.
doi: 10.2807/1560-7917.ES.2020.25.18.1900742.

Surveillance of OXA-244-producing Escherichia coli and epidemiologic investigation of cases, Denmark, January 2016 to August 2019

Anette M Hammerum  1 , Lone Jannok Porsbo  2 , Frank Hansen  1 , Louise Roer  1 , Hülya Kaya  1 , Anna Henius  1 , Karina Lauenborg Møller  3 , Ulrik S Justesen  4 , Lillian Søes  5 , Bent L Røder  6 , Philip K Thomsen  7 , Mikala Wang  8 , Turid Snekloth Søndergaard  9 , Barbara Juliane Holzknecht  10 , Claus Østergaard  11 , Anne Kjerulf  2 , Brian Kristensen  2 , Henrik Hasman  1
Affiliations

Surveillance of OXA-244-producing Escherichia coli and epidemiologic investigation of cases, Denmark, January 2016 to August 2019

Anette M Hammerum et al. Euro Surveill. 2020 May.

Abstract

BackgroundCarbapenemase-producing Escherichia coli are increasing worldwide. In recent years, an increase in OXA-244-producing E. coli isolates has been seen in the national surveillance of carbapenemase-producing organisms in Denmark.AimMolecular characterisation and epidemiological investigation of OXA-244-producing E. coli isolates from January 2016 to August 2019.MethodsFor the epidemiological investigation, data from the Danish National Patient Registry and the Danish register of civil registration were used together with data from phone interviews with patients. Isolates were characterised by analysing whole genome sequences for resistance genes, MLST and core genome MLST (cgMLST).ResultsIn total, 24 OXA-244-producing E. coli isolates were obtained from 23 patients. Among the 23 patients, 13 reported travelling before detection of the E. coli isolates, with seven having visited countries in Northern Africa. Fifteen isolates also carried an extended-spectrum beta-lactamase gene and one had a plasmid-encoded AmpC gene. The most common detected sequence type (ST) was ST38, followed by ST69, ST167, ST10, ST361 and ST3268. Three clonal clusters were detected by cgMLST, but none of these clusters seemed to reflect nosocomial transmission in Denmark.ConclusionImport of OXA-244 E. coli isolates from travelling abroad seems likely for the majority of cases. Community sources were also possible, as many of the patients had no history of hospitalisation and many of the E. coli isolates belonged to STs that are present in the community. It was not possible to point at a single country or a community source as risk factor for acquiring OXA-244-producing E. coli.

Keywords: Escherichia coli; MLST; OXA-244; carbapenemase; cgMLST.

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Conflict of interest statement

Conflict of interest: None declared.

Figures

Figure 1
Figure 1
Carbapenemase-producing Escherichia coli, Denmark, January 2015–August 2019 (n = 237)
Figure 2
Figure 2
OXA-244-producing Escherichia coli by date of detection and region, Denmark, January 2016–August 2019 (n = 24 isolates)
See this image and copyright information in PMC

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