Dissemination of extensively drug-resistant NDM-producing Providencia stuartii in Europe linked to patients transferred from Ukraine, March 2022 to March 2023-Reference-Cited by-同舟云学术

Dissemination of extensively drug-resistant NDM-producing Providencia stuartii in Europe linked to patients transferred from Ukraine, March 2022 to March 2023

Published:2024-06-06 Issue:23 Volume:29 Page:
ISSN:1560-7917
Container-title:Eurosurveillance
language:en
Short-container-title:

Author:

Witteveen Sandra¹^ORCID,Hans Jörg B²³^ORCID,Izdebski Radosław⁴^ORCID,Hasman Henrik⁵^ORCID,Samuelsen Ørjan⁶⁷^ORCID,Dortet Laurent⁸^ORCID,Pfeifer Yvonne⁹,Delappe Niall¹⁰,Oteo-Iglesias Jesús¹¹^ORCID,Żabicka Dorota¹²^ORCID,Cormican Martin¹⁰^ORCID,Sandfort Mirco²^ORCID,Reichert Felix²^ORCID,Pöntinen Anna K¹³⁷^ORCID,Fischer Martin A⁹^ORCID,Verkaik Nelianne¹⁴^ORCID,Pérez-Vazquez María¹¹^ORCID,Pfennigwerth Niels³^ORCID,Hammerum Anette M⁵^ORCID,Hallstrøm Søren⁵^ORCID,Biedrzycka Marta⁴^ORCID,Räisänen Kati¹⁵^ORCID,Wielders Cornelia CH¹^ORCID,Urbanowicz Paweł⁴^ORCID,de Haan Angela¹,Westmo Karin¹⁶,Landman Fabian¹,van der Heide Han GJ¹,Lansu Simon¹^ORCID,Zwittink Romy D¹^ORCID,Notermans Daan W¹^ORCID,Guzek Aneta¹⁷^ORCID,Kondratiuk Viacheslav¹⁸^ORCID,Salmanov Aidyn¹⁹^ORCID,Haller Sebastian²^ORCID,Linkevicius Marius²⁰^ORCID,Gatermann Sören³,Kohlenberg Anke²⁰,Gniadkowski Marek⁴^ORCID,Werner Guido⁹^ORCID,Hendrickx Antoni PA¹^ORCID

Affiliation:

1. Centre for Infectious Disease Control (CIb), National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands

2. Department for Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany

3. German National Reference Centre for Multidrug-Resistant Gram-Negative Bacteria, Department of Medical Microbiology, Ruhr-University Bochum, Bochum, Germany

4. Departement of Molecular Microbiology, National Medicines Institute, Warsaw, Poland

5. National Reference Laboratory for Antimicrobial Resistance, Department of Bacteria, Parasites and Fungi, Statens Serum Institut, Copenhagen, Denmark

6. Department of Pharmacy, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway

7. Norwegian National Advisory Unit on Detection of Antimicrobial Resistance, Department of Microbiology and Infection Control, University Hospital of North Norway, Tromsø, Norway

8. French National Reference Center for Antimicrobial Resistance, INSERM UMR 1184, Paris-Saclay University, Bicêtre Hospital, Assistance Publique des Hôpitaux de Paris, Paris, France

9. Division of Nosocomial Pathogens and Antibiotic Resistances, Department of Infectious Diseases, Robert Koch Institute, Wernigerode Branch, Wernigerode, Germany

10. University of Galway, Galway, Ireland

11. Reference and Research Laboratory on Antibiotic Resistance of the National Center for Microbiology and CIBERINFEC, Instituto de Salud Carlos III, Madrid, Spain

12. Departement of Epidemiology and Clinical Microbiology, National Medicines Institute, Warsaw, Poland

13. Department of Biostatistics, Faculty of Medicine, University of Oslo, Oslo, Norway

14. Department of Medical Microbiology and Infectious Diseases, Erasmus University Medical Center, Rotterdam, the Netherlands

15. Department of Health Security, Finnish Institute for Health and Welfare, Helsinki, Finland

16. Department of Microbiology, Public Health Agency of Sweden, Solna, Sweden

17. Department of Laboratory Diagnostics, Section of Microbiology, Military Institute of Medicine - National Research Institute, Warsaw, Poland

18. National Pirogov Memorial University, Vinnytsia, Ukraine

19. Shupyk National Healthcare University of Ukraine, Kyiv, Ukraine

20. European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden

Abstract

Background The war in Ukraine led to migration of Ukrainian people. Early 2022, several European national surveillance systems detected multidrug-resistant (MDR) bacteria related to Ukrainian patients. Aim To investigate the genomic epidemiology of New Delhi metallo-β-lactamase (NDM)-producing Providencia stuartii from Ukrainian patients among European countries. Methods Whole-genome sequencing of 66 isolates sampled in 2022–2023 in 10 European countries enabled whole-genome multilocus sequence typing (wgMLST), identification of resistance genes, replicons, and plasmid reconstructions. Five bla NDM-1-carrying-P. stuartii isolates underwent antimicrobial susceptibility testing (AST). Transferability to Escherichia coli of a bla NDM-1-carrying plasmid from a patient strain was assessed. Epidemiological characteristics of patients with NDM-producing P. stuartii were gathered by questionnaire. Results wgMLST of the 66 isolates revealed two genetic clusters unrelated to Ukraine and three linked to Ukrainian patients. Of these three, two comprised bla NDM-1-carrying-P. stuartii and the third bla NDM-5-carrying-P. stuartii. The bla NDM-1 clusters (PstCluster-001, n = 22 isolates; PstCluster-002, n = 8 isolates) comprised strains from seven and four countries, respectively. The bla NDM-5 cluster (PstCluster-003) included 13 isolates from six countries. PstCluster-001 and PstCluster-002 isolates carried an MDR plasmid harbouring bla NDM-1, bla OXA-10, bla CMY-16, rmtC and armA, which was transferrable in vitro and, for some Ukrainian patients, shared by other Enterobacterales. AST revealed PstCluster-001 isolates to be extensively drug-resistant (XDR), but susceptible to cefiderocol and aztreonam–avibactam. Patients with data on age (n = 41) were 19–74 years old; of 49 with information on sex, 38 were male. Conclusion XDR P. stuartii were introduced into European countries, requiring increased awareness and precautions when treating patients from conflict-affected areas.

Publisher

European Centre for Disease Control and Prevention (ECDC)

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