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. 2023 Jul;28(27):2200773.
doi: 10.2807/1560-7917.ES.2023.28.27.2200773.

Intraregional hospital outbreak of OXA-244-producing Escherichia coli ST38 in Norway, 2020

Paul Christoffer Lindemann  1 , Torunn Pedersen  2 , Dorthea Hagen Oma  3 , Jessin Janice  2 , Fredrik Grøvan  4 , Ghantous Milad Chedid  5 , Liv Jorunn Hafne  5 , Ellen H Josefsen  2 , Oliver Kacelnik  6 , Arnfinn Sundsfjord  2   7 , Ørjan Samuelsen  2   8
Affiliations

Intraregional hospital outbreak of OXA-244-producing Escherichia coli ST38 in Norway, 2020

Paul Christoffer Lindemann et al. Euro Surveill. 2023 Jul.

Abstract

Infections with OXA-244-carbapenemase-producing Escherichia coli with sequence type (ST)38 have recently increased in Europe. Due to its low-level activity against carbapenems, OXA-244 can be difficult to detect. Previous assessments have not revealed a clear source and route of transmission for OXA-244-producing E. coli, but there are indications of non-healthcare related sources and community spread. Here we report a hospital-associated outbreak of OXA-244-producing E. coli ST38 involving three hospitals in Western Norway in 2020. The outbreak occurred over a 5-month period and included 12 cases identified through clinical (n = 6) and screening (n = 6) samples. The transmission chain was unclear; cases were identified in several wards and there was no clear overlap of patient stay. However, all patients had been admitted to the same tertiary hospital in the region, where screening revealed an outbreak in one ward (one clinical case and five screening cases). Outbreak control measures were instigated including contact tracing, isolation, and screening; no further cases were identified in 2021. This outbreak adds another dimension to the spread of OXA-244-producing E. coli ST38, illustrating this clone's ability to establish itself in the healthcare setting. Awareness of challenges concerning OXA-244-producing E. coli diagnostic is important to prevent further spread.

Keywords: Carbapenemase; diagnostic challenge; healthcare-associated transmission; high-risk clone.

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Conflict of interest statement

Conflict of interest: None declared.

Figures

Figure 1
Figure 1
Minimum spanning tree based on the core genome allele profile of OXA-244-producing Escherichia coli ST38 outbreak isolates (n = 12) from Western Norway and isolates from other regions in Norway in 2020 (n = 7)
Figure 2
Figure 2
Comparisons of the blaOXA-244 containing chromosomal region in the outbreak clone with selected isolates of ST349, ST131 and ST38 representing three variants
See this image and copyright information in PMC

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