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Case Reports
. 2023 Jun 22;5(6):acmi000498.v3.
doi: 10.1099/acmi.0.000498.v3. eCollection 2023.

First report of a carbapenemase OXA-48-producing Hafnia alvei clinical isolate

Laura Sevillano  1 , Cristhian Herrera  1 , Álvaro Valdes  2 , Ángela de la Hoz  2 , Laura Cardeñoso  1 , Diego Domingo  1 , Maria Auxiliadora Semiglia  1
Affiliations
Case Reports

First report of a carbapenemase OXA-48-producing Hafnia alvei clinical isolate

Laura Sevillano et al. Access Microbiol. .

Abstract

Introduction: Carbapenems are usually used in the treatment of infections caused by cephalosporin-resistant Enterobacterales ; however, the increase in carbapenem-resistant Enterobacterales (CRE) has become one of the most important problems in public health. Hafnia alvei is associated with intestinal and extraintestinal infections, especially in patients with any chronic disease or some type of immunosupression. H. alvei is resistant to first-generation aminopenicillins and cephalosporins owing to the β-lactamase (Amp C) in their chromosome; the only carbapenem-resistant Hafnia strain described until now was due to a lack of the OmpK36 protein that plays an important role in permeability to carbapenems.

Case presentation: We present the case of a 65-year-old male diagnosed with acute lithiasic cholecystitis. Culture of the biliary prosthesis yielded a OXA-48-producing H. alvei that was identified by MALDI-TOF (matrix-assisted laser desorption/ionization-time of flight) MS. Carbapenemase production was detected by immunochromatography and confirmed by sequencing.

Conclusion: To our knowledge, this is the first report of OXA-48-producing H. alvei probably obtained by horizontal transfer from Enterobacter cloacae OXA-48 isolated in previous samples.

Keywords: Hafnia alvei; OXA-48; carbapenem; carbapenemase.

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Conflict of interest statement

The authors declare that there are no conflicts of interest.

Figures

Fig. 1.
Fig. 1.
Abdominal ultrasound: acute cholecystitis and intra- and extra-hepatic biliary dilatation.
Fig. 2.
Fig. 2.
Abdominal CT scan: multiple cholelithiasis with acute cholecystitis.
See this image and copyright information in PMC

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