Screening of OXA-244 producers, a difficult-to-detect and emerging OXA-48 variant?


Journal

The Journal of antimicrobial chemotherapy
ISSN: 1460-2091
Titre abrégé: J Antimicrob Chemother
Pays: England
ID NLM: 7513617

Informations de publication

Date de publication:
01 08 2020
Historique:
received: 03 02 2020
revised: 28 02 2020
accepted: 27 03 2020
pubmed: 5 5 2020
medline: 25 6 2021
entrez: 5 5 2020
Statut: ppublish

Résumé

OXA-244, a single amino acid variant of OXA-48, demonstrates weaker hydrolytic activity towards carbapenems and temocillin compared with OXA-48. Of note, these antimicrobials are present in high concentrations in several carbapenemase-producing Enterobacterales (CPE) screening media. As a result, some screening media fail to grow OXA-244-producing isolates, while the prevalence of OXA-244 producers is constantly increasing in France. Here, we evaluate the performance of three commercially available CPE screening media [ChromID® CARBA SMART (bioMérieux), Brilliance™ CRE (Thermo Fisher) and mSuperCARBA™ (MAST Diagnostic)] for their ability to detect OXA-244 producers (n = 101). As OXA-244 producers may also express an ESBL, two additional ESBL screening media were tested (Brilliance™ ESBL and ChromID® BLSE). MICs of temocillin and imipenem were determined by broth microdilution. The clonality of OXA-244-producing Escherichia coli isolates (n = 97) was assessed by MLST. Overall, the sensitivity of the ChromID® CARBA SMART, Brilliance™ CRE and mSuperCARBA™ media were 14% (95% CI = 8.1%-22.5%), 54% (95% CI = 43.3%-63.4%) and 99% (95% CI = 93.8%-100%), respectively, for the detection of OXA-244 producers. Among the 101 OXA-244-producing isolates, 96% were E. coli and 77%-78% grew on ESBL screening media. MLST analysis identified five main STs among OXA-244-producing E. coli isolates: ST38 (n = 37), ST361 (n = 17), ST69 (n = 12), ST167 (n = 11) and ST10 (n = 8). Our results demonstrated that the mSuperCARBA™ medium is very efficient in the detection of OXA-244 producers, unlike the ChromID® CARBA SMART medium. The high prevalence of ESBLs among OXA-244 producers allowed detection of 77%-78% of them using ESBL-specific screening media.

Sections du résumé

BACKGROUND
OXA-244, a single amino acid variant of OXA-48, demonstrates weaker hydrolytic activity towards carbapenems and temocillin compared with OXA-48. Of note, these antimicrobials are present in high concentrations in several carbapenemase-producing Enterobacterales (CPE) screening media. As a result, some screening media fail to grow OXA-244-producing isolates, while the prevalence of OXA-244 producers is constantly increasing in France.
METHODS
Here, we evaluate the performance of three commercially available CPE screening media [ChromID® CARBA SMART (bioMérieux), Brilliance™ CRE (Thermo Fisher) and mSuperCARBA™ (MAST Diagnostic)] for their ability to detect OXA-244 producers (n = 101). As OXA-244 producers may also express an ESBL, two additional ESBL screening media were tested (Brilliance™ ESBL and ChromID® BLSE). MICs of temocillin and imipenem were determined by broth microdilution. The clonality of OXA-244-producing Escherichia coli isolates (n = 97) was assessed by MLST.
RESULTS
Overall, the sensitivity of the ChromID® CARBA SMART, Brilliance™ CRE and mSuperCARBA™ media were 14% (95% CI = 8.1%-22.5%), 54% (95% CI = 43.3%-63.4%) and 99% (95% CI = 93.8%-100%), respectively, for the detection of OXA-244 producers. Among the 101 OXA-244-producing isolates, 96% were E. coli and 77%-78% grew on ESBL screening media. MLST analysis identified five main STs among OXA-244-producing E. coli isolates: ST38 (n = 37), ST361 (n = 17), ST69 (n = 12), ST167 (n = 11) and ST10 (n = 8).
CONCLUSIONS
Our results demonstrated that the mSuperCARBA™ medium is very efficient in the detection of OXA-244 producers, unlike the ChromID® CARBA SMART medium. The high prevalence of ESBLs among OXA-244 producers allowed detection of 77%-78% of them using ESBL-specific screening media.

Identifiants

pubmed: 32363407
pii: 5828487
doi: 10.1093/jac/dkaa155
doi:

Substances chimiques

Bacterial Proteins 0
beta-Lactamases EC 3.5.2.6

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

2120-2123

Informations de copyright

© The Author(s) 2020. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Auteurs

Cecile Emeraud (C)

Department of Bacteriology-Hygiene, Bicêtre Hospital, Assistance Publique - Hôpitaux de Paris, Le Kremlin-Bicêtre, France.
UMR-S 1184, Paris-Saclay University, Le Kremlin-Bicêtre, France.
French National Reference Centre for Antibiotic Resistance, Le Kremlin-Bicêtre, France.
Paris-Saclay University, Faculty of Medicine, Le Kremlin-Bicêtre, France.

Laura Biez (L)

UMR-S 1184, Paris-Saclay University, Le Kremlin-Bicêtre, France.
Paris-Saclay University, Faculty of Medicine, Le Kremlin-Bicêtre, France.

Delphine Girlich (D)

UMR-S 1184, Paris-Saclay University, Le Kremlin-Bicêtre, France.
Paris-Saclay University, Faculty of Medicine, Le Kremlin-Bicêtre, France.

Agnès B Jousset (AB)

Department of Bacteriology-Hygiene, Bicêtre Hospital, Assistance Publique - Hôpitaux de Paris, Le Kremlin-Bicêtre, France.
UMR-S 1184, Paris-Saclay University, Le Kremlin-Bicêtre, France.
French National Reference Centre for Antibiotic Resistance, Le Kremlin-Bicêtre, France.
Paris-Saclay University, Faculty of Medicine, Le Kremlin-Bicêtre, France.

Thierry Naas (T)

Department of Bacteriology-Hygiene, Bicêtre Hospital, Assistance Publique - Hôpitaux de Paris, Le Kremlin-Bicêtre, France.
UMR-S 1184, Paris-Saclay University, Le Kremlin-Bicêtre, France.
French National Reference Centre for Antibiotic Resistance, Le Kremlin-Bicêtre, France.
Paris-Saclay University, Faculty of Medicine, Le Kremlin-Bicêtre, France.

Rémy A Bonnin (RA)

UMR-S 1184, Paris-Saclay University, Le Kremlin-Bicêtre, France.
French National Reference Centre for Antibiotic Resistance, Le Kremlin-Bicêtre, France.
Paris-Saclay University, Faculty of Medicine, Le Kremlin-Bicêtre, France.

Laurent Dortet (L)

Department of Bacteriology-Hygiene, Bicêtre Hospital, Assistance Publique - Hôpitaux de Paris, Le Kremlin-Bicêtre, France.
UMR-S 1184, Paris-Saclay University, Le Kremlin-Bicêtre, France.
French National Reference Centre for Antibiotic Resistance, Le Kremlin-Bicêtre, France.
Paris-Saclay University, Faculty of Medicine, Le Kremlin-Bicêtre, France.

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Classifications MeSH