Within-Host and Population Transmission of blaOXA-48 in K. pneumoniae and E. coli.
During a large hospital outbreak of OXA-48 producing bacteria, most K. pneumoniaeOXA-48 isolates were phenotypically resistant to meropenem or imipenem, whereas most E. coliOXA-48 isolates were phenotypically susceptible to these antibiotics. In the absence of molecular gene-detection E. coliOXA-48 could remain undetected, facilitating cross-transmission and horizontal gene transfer of blaOXA-48. Based on 868 longitudinal molecular microbiological screening results from patients carrying K. pneumoniaeOXA-48 (n = 24), E. coliOXA-48 (n = 17), or both (n = 40) and mathematical modelling we determined mean durations of colonisation (278 and 225 days for K. pneumoniaeOXA-48 and E. coliOXA-48, respectively), and horizontal gene transfer rates (0.0091/day from K. pneumoniae to E. coli and 0.0015/day vice versa). Based on these findings the maximum effect of horizontal gene transfer of blaOXA-48 originating from E. coliOXA-48 on the basic reproduction number (R0) is 1.9%, and it is, therefore, unlikely that phenotypically susceptible E. coliOXA-48 will contribute significantly to the spread of blaOXA-48.
Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands.
Manon R
MR
Haverkate
Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands; Department of Medical Microbiology, University Medical Center Utrecht, Utrecht, the Netherlands; Department of Medical Microbiology, Maasstad Ziekenhuis, Rotterdam, the Netherlands.
Mirjam J D
MJ
Dautzenberg
Department of Medical Microbiology, Maasstad Ziekenhuis, Rotterdam, the Netherlands.
Tjaco J M
TJ
Ossewaarde
Department of Medical Microbiology, Maasstad Ziekenhuis, Rotterdam, the Netherlands.
Anneke
A
van der Zee
Department of Internal Medicine, Maasstad Ziekenhuis, Rotterdam, the Netherlands.
Jan G
JG
den Hollander
Department of Medical Microbiology, University Medical Center Utrecht, Utrecht, the Netherlands.
Annet
A
Troelstra
Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands; Department of Medical Microbiology, University Medical Center Utrecht, Utrecht, the Netherlands.
Marc J M
MJ
Bonten
Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands; Department of Mathematics, Utrecht University, Utrecht, the Netherlands.
Martin C J
MC
Bootsma
D024881:Drug Resistance, Bacterial / Q000235:genetics*; D004926:Escherichia coli / Q000235:genetics* / Q000378:metabolism; D004927:Escherichia coli Infections / Q000382:microbiology / Q000635:transmission; D029968:Escherichia coli Proteins / Q000235:genetics* / Q000378:metabolism; D022761:Gene Transfer, Horizontal; D006801:Humans; D007710:Klebsiella Infections / Q000382:microbiology / Q000635:transmission; D007711:Klebsiella pneumoniae / Q000235:genetics* / Q000378:metabolism; D001618:beta-Lactamases / Q000235:genetics* / Q000378:metabolism
D029968:Escherichia coli Proteins; D001618:beta-Lactamases; C000601047:beta-lactamase OXA-48, E coli