National survey of colistin resistance among carbapenemase-producing Enterobacteriaceae and outbreak caused by colistin-resistant OXA-48-producing Klebsiella pneumoniae, France, 2014

From January 2014 to December 2014, 972 consecutive non-replicate carbapenemase-producingEnterobacteriaceae isolates from colonised or infected patients were collected at the Associated French National Reference Centre as part of the French national survey on antimicrobial resistance. It included 577Klebsiella spp. (59%), 236Escherichia coli (24%), 108Enterobacter spp. (11%), 50Citrobacter spp. (5%), and a singleSalmonella spp. isolate (0.1%). Of 561K. pneumoniae isolates, 35 were found to be resistant to colistin (6.2%). PFGE analysis revealed a clonal outbreak involving 15K. pneumoniae isolates belonging to sequence type ST11, recovered in a single hospital in the Picardie region in northern France. Those clonally related isolates showed variable levels of resistance to colistin, ranging from 4 to 64 mg/L. They harboured theblaOXA-48 carbapenemase gene and theblaCTX-M-15 extended-spectrum beta-lactamase gene. Among the 91Enterobacter cloacae isolates, seven were resistant to colistin and produced different types of carbapenemases. Surprisingly, none of theE. coli andCitrobacter spp. isolates showed resistance to colistin. This national survey including carbapenemase-producing isolates recovered in 2014 reported a high rate of colistin resistance inK. pneumoniae andE. cloacae (6.2% and 7.7%, respectively) in France.
Source: Eurosurveillance - Category: Infectious Diseases Source Type: research