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Abstract

Background

Carbapenemase-producing Enterobacterales are a public health threat worldwide and OXA-48 is the most prevalent carbapenemase in Germany and western Europe. However, the molecular epidemiology of OXA-48 in species other than and remains poorly understood.

Aim

To analyse the molecular epidemiology of OXA-48 and OXA-48-like carbapenemases in species (spp.) in Germany between 2011 and 2022.

Methods

Data of 26,822 Enterobacterales isolates sent to the National Reference Centre (NRC) for Gram-negative bacteria were evaluated. Ninety-one isolates from 40 German hospitals harbouring were analysed by whole genome sequencing and conjugation experiments.

Results

The frequency of OXA-48 in (CF) has increased steadily since 2011 and is now the most prevalent carbapenemase in this species in Germany. Among 91 in-depth analysed spp. isolates, CF (n = 73) and (n = 8) were the most common species and OXA-48 was the most common variant (n = 77), followed by OXA-162 (n = 11) and OXA‑181 (n = 3). Forty percent of the isolates belonged to only two sequence types (ST19 and ST22), while most other STs were singletons. The plasmids harbouring and belonged to the plasmid types IncL (n = 85) or IncF (n = 3), and plasmids harbouring to IncX3 (n = 3). Three IncL plasmid clusters (57/85 IncL plasmids) were identified, which were highly transferable in contrast to sporadic plasmids.

Conclusion

In CF in Germany, OXA-48 is the predominant carbapenemase. Dissemination is likely due to distinct highly transmissible plasmids harbouring or and the spread of the high-risk clonal lineages ST19 and ST22.

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2024-04-11
2024-07-19
http://instance.metastore.ingenta.com/content/10.2807/1560-7917.ES.2024.29.15.2300528
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