Dynamics and molecular features of OXA-48-like-producing Klebsiella pneumoniae lineages in a Tunisian hospital

Aziza Messaoudi (1) , Marisa Haenni (2, 3) , Olfa Bouallègue (4, 1) , Estelle Saras (2, 3) , Pierre Chatre (2, 3) , Cherifa Chaouch (5, 1) , Noureddine Boujâafar (5, 1) , Wejdene Mansour (4, 1) , Jean-Yves Madec (2, 3)

1 CHU Sahloul - Hôpital Universitaire Sahloul
2 Université de Lyon
3 AVB - Unité Antibiorésistance et Virulence Bactériennes
4 Faculté de médecine de Sousse [Ibn EL Jazzar]
5 FPHM - Faculté de Pharmacie [Monastir]

The aim of this study was to elucidate the molecular features of genes, plasmids and clones of OXA-48-like producingKlebsiella pneumoniae isolates recovered in Sahloul Hospital (Sousse, Tunisia) in the period 2012-2014. Methods: In vitro antimicrobial susceptibility testing, S1 nuclease pulsed-field gel electrophoresis (S1-PFGE), Southern blotting and PCR-based replicon typing (PBRT) were performed. Extended-spectrum βlactamase (ESBL) and carbapenemases genes were detected by PCR and sequencing. The clonality of isolates was assessed by PFGE and multilocus sequence typing (MLST). Results: Klebsiella pneumoniae accounted for 26.8% (1095/4083) of clinical Enterobacterales isolates identified during 2012-2014, of which 21.9% (240/1095) were resistant to carbapenems, mostly harbouring bla OXA-48-like genes (196/240; 81.7%). Plasmid analysis showed that bla OXA-204 and bla OXA-48 were mostly carried by IncA/C and IncL plasmids, respectively. The current data highlight the dominance of two ST101 and ST147 lineages spreading OXA-48 and OXA-204, respectively, through successive clonal spreads at this hospital. In addition, a large diversity of other K. pneumoniae lineages was also identified, such as ST15, ST36 and ST525 spreading OXA-48 as well as ST340, ST2032, ST301, ST199 and ST1561 spreading OXA-48 or OXA-204, constituting a reservoir of possible dominant clones in the future. Conclusion: This study reports the full molecular characterisation of carbapenem resistance in K. pneumoniae and the predominance of a few clones responsible for the dissemination of OXA-48 and OXA-204 enzymes in a Tunisian hospital.

Mots clés: Klebsiella pneumoniae; OXA-48; OXA-204; Sequence type; Tunisia

Domaines: Bactériologie

Aziza Messaoudi, Marisa Haenni, Olfa Bouallègue, Estelle Saras, Pierre Chatre, et al.. Dynamics and molecular features of OXA-48-like-producing Klebsiella pneumoniae lineages in a Tunisian hospital. Journal of Global Antimicrobial Resistance, 2020, 20, pp.87-93. ⟨10.1016/j.jgar.2019.07.005⟩. ⟨anses-03992728⟩