Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Mar;28(9):2300108.
doi: 10.2807/1560-7917.ES.2023.28.9.2300108.

Contaminated dicloxacillin capsules as the source of an NDM-5/OXA-48-producing Enterobacter hormaechei ST79 outbreak, Denmark and Iceland, 2022 and 2023

Charlotte Nielsen Agergaard  1 , Lone Jannok Porsbo  2 , Thomas Vognbjerg Sydenham  1 , Sanne Grønvall Kjær Hansen  1 , Kat Steinke  1 , Sanne Løkkegaard Larsen  1 , Kristján Orri Helgason  3 , Frank Hansen  4 , Kasper Thystrup Karstensen  4 , Anna E Henius  4 , Barbara Juliane Holzknecht  5 , Lillian Søes  6 , Kristian Schønning  7 , Mikala Wang  8 , Nina Ank  9 , Anna Margrét Halldórsdóttir  10 , Ólafur Guðlaugsson  11 , Anette M Hammerum  4 , Anne Kjerulf  2 , Brian Kristensen  2 , Henrik Hasman  4 , Ulrik Stenz Justesen  1
Affiliations

Contaminated dicloxacillin capsules as the source of an NDM-5/OXA-48-producing Enterobacter hormaechei ST79 outbreak, Denmark and Iceland, 2022 and 2023

Charlotte Nielsen Agergaard et al. Euro Surveill. 2023 Mar.

Abstract

From October 2022 through January 2023, nine patients with NDM-5/OXA-48-carbapenemase-producing Enterobacter hormaechei ST79 were detected in Denmark and subsequently one patient in Iceland. There were no nosocomial links between patients, but they had all been treated with dicloxacillin capsules. An NDM-5/OXA-48-carbapenemase-producing E. hormaechei ST79, identical to patient isolates, was cultured from the surface of dicloxacillin capsules in Denmark, strongly implicating them as the source of the outbreak. Special attention is required to detect the outbreak strain in the microbiology laboratory.

Keywords: CPO; Enterobacter hormaechei; Outbreak; antibiotic; dicloxacillin.

PubMed Disclaimer

Conflict of interest statement

Conflict of interest: None declared.

Figures

Figure 1
Figure 1
Number of patients with carbapenemase-producing Enterobacter hormaechei ST79, by month, Denmark and Iceland, 2020–January 2023 (n = 12)
Figure 2
Figure 2
cgMLST analysis of Enterobacter hormaechei isolated from the dicloxacillin capsule and patient samples from Denmark and Iceland, 2020–January 2023 (n = 13)
See this image and copyright information in PMC

References

    1. Raun-Petersen C, Toft A, Nordestgaard MM, Holm A, Overballe-Petersen S, Hammerum AM, et al. Investigation of an Enterobacter hormaechei OXA-436 carbapenemase outbreak: when everything goes down the drain. Infect Prev Pract. 2022;4(3):100228. 10.1016/j.infpip.2022.100228 - DOI - PMC - PubMed
    1. Peirano G, Matsumura Y, Adams MD, Bradford P, Motyl M, Chen L, et al. Genomic epidemiology of global carbapenemase-producing Enterobacter spp., 2008-2014. Emerg Infect Dis. 2018;24(6):1010-9. 10.3201/eid2406.171648 - DOI - PMC - PubMed
    1. Villa J, Carretero O, Viedma E, Lora-Tamayo J, Mingorance J, Chaves F. Emergence of NDM-7-producing multi-drug-resistant Enterobacter hormaechei sequence type ST-78 in Spain: a high-risk international clone. Int J Antimicrob Agents. 2019;53(4):533-4. 10.1016/j.ijantimicag.2018.11.009 - DOI - PubMed
    1. Li R, Liu Z, Li Y, Xiao X, Wang Z. Characterization of blaNDM-positive Enterobacteriaceae reveals the clonal dissemination of Enterobacter hormaechei coharboring blaNDM and tet(X4) along the pork production chain. Int J Food Microbiol. 2022;372:109692. 10.1016/j.ijfoodmicro.2022.109692 - DOI - PubMed
    1. European Committee on Antimicrobial Susceptibility Testing (EUCAST). Antimicrobial susceptibility testing. Växjö: EUCAST. [Accessed: 1 Mar 2023]. Available from: https://www.eucast.org/ast_of_bacteria

Supplementary concepts

LinkOut - more resources