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. 2024 Nov;29(47):2400587.
doi: 10.2807/1560-7917.ES.2024.29.47.2400587.

Genomic surveillance detects interregional spread of New Delhi metallo-beta-lactamase-1-producing Providencia stuartii in hospitals, Romania, December 2021 to September 2023

Marius Linkevicius  1 , Sandra Witteveen  2 , Mariana Buzea  3 , Mirela Flonta  4 , Marina Indreas  5 , Maria Nica  6 , Edit Székely  7 , Daniela Tălăpan  8   9 , Olov Svartström  1 , Erik Alm  1 , Daniel Palm  1 , Dominique L Monnet  1 , Antoni Pa Hendrickx  2 , Anke Kohlenberg  1 , Gabriel Adrian Popescu  9
Affiliations

Genomic surveillance detects interregional spread of New Delhi metallo-beta-lactamase-1-producing Providencia stuartii in hospitals, Romania, December 2021 to September 2023

Marius Linkevicius et al. Euro Surveill. 2024 Nov.

Abstract

BackgroundNew Delhi metallo-beta-lactamase (NDM)-producing Providencia stuartii has been reported from European Union/European Economic Area (EU/EEA) countries with increasing frequency. During 2018 to 2022, 355 cases of NDM-producing P. stuartii were detected in seven hospitals reporting on NDM-production in Enterobacterales in Romania.AimOur aim was to determine the extent of spread of NDM-producing P. stuartii in hospitals in Romania.MethodsWe analysed whole genome sequences and epidemiological data of 74 P. stuartii isolates collected in six hospitals from December 2021 to September 2023.ResultsWe identified four multi-hospital clusters including isolates detected over more than a year, indicating sustained spread of bla NDM-1-carrying P. stuartii within the healthcare system. These clusters consisted of isolates from up to four hospitals and three regions. Three multi-hospital clusters were caused by a specific multidrug-resistant P. stuartii sequence type 46 lineage carrying bla NDM-1 and a large set of additional resistance markers. Investigation in an international context showed that this lineage had already been detected in nine countries (Bulgaria, France, Germany, Ireland, the Netherlands, Romania, Switzerland, United Kingdom, United States) since 2015.ConclusionOur results alert about the risk of carbapenem-resistant P. stuartii transmission in healthcare settings. Enhanced infection prevention and control measures should be instituted as soon as cases are detected in healthcare facilities. National surveillance systems in EU/EEA countries should, in addition to carbapenem-resistant and/or carbapenemase-producing Klebsiella pneumoniae and Escherichia coli, consider reporting carbapenem-resistant and/or carbapenemase-producing P. stuartii and other Enterobacterales where relevant.

Keywords: NDM-1; Providencia stuartii; carbapenem-resistant Enterobacterales; carbapenemase; surveillance; whole genome sequencing.

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Conflict of interest statement

Conflict of interest: None declared.

Figures

Figure 1
Figure 1
Time distribution of Providencia stuartii isolates by hospital, Romania, December 2021–September 2023 (n = 74)
Figure 2
Figure 2
Phenotypic antimicrobial susceptibility testing results and relevant genotypic antimicrobial resistance results of Providencia stuartii isolates, by cluster, Romania, December 2021–September 2023 (n = 74)
Figure 3
Figure 3
Presence of different clusters among Providencia stuartii isolates in six hospitals, Romania, December 2021–September 2023 (n = 74)
Figure 4
Figure 4
Phylogenetic tree of Providencia stuartii isolates belonging to the ST46 lineage and carrying carbapenemase genes, Romania and other countries, 2015–2023 (n = 83 isolates)
See this image and copyright information in PMC

References

    1. Grundmann H, Glasner C, Albiger B, Aanensen DM, Tomlinson CT, Andrasević AT, et al. Occurrence of carbapenemase-producing Klebsiella pneumoniae and Escherichia coli in the European survey of carbapenemase-producing Enterobacteriaceae (EuSCAPE): a prospective, multinational study. Lancet Infect Dis. 2017;17(2):153-63. 10.1016/S1473-3099(16)30257-2 - DOI - PubMed
    1. European Centre for Disease Prevention and Control (ECDC). ECDC study protocol for genomic-based surveillance of carbapenem-resistant and/or colistin-resistant Enterobacteriaceae at the EU level - version 2.0. Stockholm: ECDC; 2018. Available from: https://ecdc.europa.eu/en/publications-data/ecdc-study-protocol-genomic-...
    1. Witteveen S, Hans JB, Izdebski R, Hasman H, Samuelsen Ø, Dortet L, et al. Dissemination of extensively drug-resistant NDM-producing Providencia stuartii in Europe linked to patients transferred from Ukraine, March 2022 to March 2023. Euro Surveill. 2024;29(23):2300616. 10.2807/1560-7917.ES.2024.29.23.2300616 - DOI - PMC - PubMed
    1. Molnár S, Flonta MMM, Almaş A, Buzea M, Licker M, Rus M, et al. Dissemination of NDM-1 carbapenemase-producer Providencia stuartii strains in Romanian hospitals: a multicentre study. J Hosp Infect. 2019;103(2):165-9. 10.1016/j.jhin.2019.04.015 - DOI - PubMed
    1. European Committee for Antimicrobial Susceptibility Testing (EUCAST). Breakpoint tables for interpretation of MICs and zone diameters, version 14.0, valid from 2024-01-01. Växjö: EUCAST; 2024. Available from: https://www.eucast.org/fileadmin/src/media/PDFs/EUCAST_files/Breakpoint_...

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