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2. Impact of Pseudomonas aeruginosa carriage on intensive care unit-acquired pneumonia: a European multicentre prospective cohort study

Author

Paling, F., Recanatini, C., Timbermont, L., Ewout van der Schalk, T., Sifakis, F., Wolkewitz, M., Hazard, D., Bonten, M., Goossens, H., Malhotra-Kumar, S., Kluytmans, J., Weber, S., Ali, O., Ruzin, A., Jafri, H., Lammens, C., Vlaeminck, J., Hullegie, S., Troeman, D., van Hout, D., Prins, D., Kalyani, R., Shoemaker, K., Vilken, T., Coppens, J., Xavier, B.B., Coenjaerts, F., Temelkov, A., Odisseeva, E., Vatcheva, R., Drab, M., Vajter, J., Tamme, K., Fartoukh, M., LePape, A., Landais, M., Plantefève, G., Tacconelli, E., Kaasch, A., Jurkinya, R., Zsolt, I., van Rijen, M., Cremer, O., Carevic, B., Jevdjić, J., Escudero, D., Garcia, M.S., Prat-Aymerich, C., Suberviola-Cañas, B., Arenzana-Seisdedos, A., Bodur, H., Kirakli, C., Bozkurt, I., Long, S., van Werkhoven, C.H., van der Schalk, T.E., Torrens, G., DiGiandomenico, A., Esser, M.T., and Oliver, A.

Published
2024
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6. Effect of outpatient antibiotics for urinary tract infections on antimicrobial resistance among commensal Enterobacteriaceae: a multinational prospective cohort study

Author

Vervoort, Jascha, Lammens, Christine, Malhotra-Kumar, Surbhi, Goossens, Herman, Adriaenssens, Niels, Coenen, Samuel, Kowalczyk, Anna, Godycki-Cwirko, Maciek, Stewardson, Andrew J., Huttner, Benedikt, Harbarth, Stephan, Brossier, Caroline, Delémont, Cécile, de Tejada, Begoña Martinez, Renzi, Gesuele, Schrenzel, Jacques, Van Bylen, Sylvie, Vanbergen, Jonathan, Koeck, Philip, Leysen, Peter, Vandercam, Kim, Kluijtmans, Jacques, Borkiewicz, Agnieszka, Heyvaert, Frank, Michels, Nele, Deswaef, Gerd, Beckx, Tine, Declerck, Hadewijch, Embrechts, Katy, Verheyen, Nina, Bauwens, Tine, Béghin, Josefien, Verpooten, Liesbeth, Bombeke, Katrien, Vandenabeele, Tine, Muras, Magdalena, Świstak, Joanna, Wesołowska, Anna, Sterniczuk, Ewa, Brzozowska, Lidia, Cichowska, Krystyna, Szewczyk, Jolanta, Krupińska, Grażyna, Błaszczyk, Honorata, Stawińska, Urszula, Szyler, Maria, Kasielski, Marek, Rydz, Rafał, Myszkowska, Agata, Żebrowska, Lilianna, Stewardson, A.J., Vervoort, J., Adriaenssens, N., Coenen, S., Godycki-Cwirko, M., Kowalczyk, A., Huttner, B.D., Lammens, C., Malhotra-Kumar, S., Goossens, H., and Harbarth, S.

Published
2018
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7. Amoxicillin for acute lower respiratory tract infection in primary care: subgroup analysis by bacterial and viral aetiology

Author

Almirall, J., Brugman, C., Chlabicz, S., De Sutter, A., Davies, M., Godycki-Cwirko, M., Fernandez, P., Hering, I., Hood, K., Schaberg, G.I.T., Torres, A., Kowalczyk, A., Lammens, C., Lemiengre, M., Leus, F., Loens, K., Mierzecki, A., Moore, M., Muras, M., O'Reilly, G., Romano, N.S., Prat, M.S., Swain, J., Veen, R., Worby, T., Bruyndonckx, R., Stuart, B., Little, P., Hens, N., Ieven, M., Butler, C.C., Verheij, T., Goossens, H., and Coenen, S.

Published
2018
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8. Increase in bloodstream infections caused by emm1 group A Streptococcus correlates with emergence of toxigenic M1UK, Belgium, May 2022 to August 2023.

Author

Rodriguez-Ruiz, Juan Pablo, Lin, Qiang, Lammens, C, Smeesters, Pierre, van Kleef-van Koeveringe, Stefanie, Matheeussen, Veerle, Malhotra-Kumar, Surbhi, Rodriguez-Ruiz, Juan Pablo, Lin, Qiang, Lammens, C, Smeesters, Pierre, van Kleef-van Koeveringe, Stefanie, Matheeussen, Veerle, and Malhotra-Kumar, Surbhi

Abstract

Many European countries have recently reported upsurges in invasive group A Streptococcus (iGAS) infections, mainly caused by emm1 Streptococcus pyogenes, specifically the toxigenic M1UK lineage. We present the epidemiology of emm1 causing iGAS in Belgium during 2018-August 2023, and describe an emergence of the toxigenic M1UK lineage in Belgium in mid-2022 that was observed as an increase in bloodstream infections caused by emm1 S. pyogenes that continued into 2023., SCOPUS: ar.j, info:eu-repo/semantics/published

Published
2023

9. European survey on the current surveillance practices, management guidelines, treatment pathways and heterogeneity of testing of Clostridioides difficile, 2018–2019: results from The Combatting Bacterial Resistance in Europe CDI (COMBACTE-CDI)

Author

Viprey, V.F., primary, Granata, G., additional, Vendrik, K.E.W., additional, Davis, G.L., additional, Petrosillo, N., additional, Kuijper, E.J., additional, Vilken, T., additional, Lammens, C., additional, Schotsman, J.J., additional, Benson, A.D., additional, Cataldo, M.A., additional, van der Kooi, T.I.I., additional, Wilcox, M.H., additional, and Davies, K.A., additional

Published
2023
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10. A multinational study of colonization with extended spectrum β-lactamase-producing Enterobacteriaceae in healthcare personnel and family members of carrier patients hospitalized in rehabilitation centres

Author

Adler, A., Baraniak, A., Izdebski, R., Fiett, J., Salvia, A., Samso, J.V., Lawrence, C., Solomon, J., Paul, M., Lerman, Y., Schwartzberg, Y., Mordechai, E., Rossini, A., Fierro, J., Lammens, C., Malhotra-Kumar, S., Goossens, H., Hryniewicz, W., Brun-Buisson, C., Gniadkowski, M., Carmeli, Y., and for MOSAR team

Published
2014
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11. Remarkable geographical variations between India and Europe in carriage of the staphylococcal surface protein-encoding sasX/sesI and in the population structure of methicillin-resistant Staphylococcus aureus belonging to clonal complex 8

Author

De Backer, S., Xavier, B.B., Vanjari, L., Coppens, J., Lammens, C., Vemu, L., Carevic, B., Hryniewicz, W., Jorens, P., Kumar-Singh, S., Lee, A., Harbarth, S., Schrenzel, J., Tacconelli, E., Goossens, H., and Malhotra-Kumar, S.

Published
2019
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16. Phylogenetic lineages, clones and β-lactamases in an international collection of Klebsiella oxytoca isolates non-susceptible to expanded-spectrum cephalosporins

Author

Izdebski, R., Fiett, J., Urbanowicz, P., Baraniak, A., Derde, L. P. G., Bonten, M. J. M., Carmeli, Y., Goossens, H., Hryniewicz, W., Brun-Buisson, C., Brisse, S., Gniadkowski, M., Herda, M., Dautzenberg, M. J., Adler, A., Kazma, M., Navon-Venezia, S., Malhotra-Kumar, S., Lammens, C., Legrand, P., Chalfine, A., Giamarellou, H., Petrikkos, G. L., Balode, A., Dumpis, U., Stammet, P., Aragăo, I., Esteves, F., Martí, A. Torres, Lawrence, C., Salomon, J., Paul, M., Lerman, Y., Rossini, A., Salvia, A., Samso, J. Vidal, and Fierro, J.

Published
2015
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17. Survey of metallo-β-lactamase-producing Enterobacteriaceae colonizing patients in European ICUs and rehabilitation units, 2008–11

Author

Papagiannitsis, C. C., Izdebski, R., Baraniak, A., Fiett, J., Herda, M., Hrabák, J., Derde, L. P. G., Bonten, M. J. M., Carmeli, Y., Goossens, H., Hryniewicz, W., Brun-Buisson, C., Gniadkowski, M., Grabowska, A., Nikonorow, E., Dautzenberg, M. J., Adler, A., Kazma, M., Navon-Venezia, S., Malhotra-Kumar, S., Lammens, C., Legrand, P., Annane, D., Chalfine, A., Giamarellou, H., Petrikkos, G. L., Nardi, G., Balode, A., Dumpis, U., Stammet, P., Arag, I., Esteves, F., Muzlovic, I., Tomic, V., Mart, A. Torres, Lawrence, C., Salomon, J., Paul, M., Lerman, Y., Rossini, A., Salvia, A., Samso, J. Vidal, and Fierro, J.

Published
2015
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18. MLST reveals potentially high-risk international clones of Enterobacter cloacae

Author

Izdebski, R., Baraniak, A., Herda, M., Fiett, J., Bonten, M. J. M., Carmeli, Y., Goossens, H., Hryniewicz, W., Brun-Buisson, C., Gniadkowski, M., Grabowska, A., Nikonorow, E., Derde, L. P. G., Dautzenberg, M. J., Adler, A., Kazma, M., Navon-Venezia, S., Malhotra-Kumar, S., Lammens, C., Dumpis, U., Giamarellou, H., Muzlovic, I., Nardi, G., Petrikkos, G. L., Stammet, P., Salomon, J., Lawrence, C., Legrand, P., Rossini, A., Salvia, A., Samso, J. Vidal, Fierro, J., Paul, M., and Lerman, Y.

Published
2015
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19. Incidence and predictive biomarkers of Clostridioides difficile infection in hospitalized patients receiving broad-spectrum antibiotics

Author

Van Werkhoven, C. H., Ducher, A., Berkell, M., Mysara, M., Lammens, C., Torre-Cisneros, J., Rodríguez-Baño, Jesús, Vehreschild, M. J. G. T., Universidad de Sevilla. Departamento de Medicina, and Universidad de Sevilla. CTS-406: Estudio enfermedades infecciosas en la práctica clínica

Abstract

Trial enrichment using gut microbiota derived biomarkers by high-risk individuals can improve the feasibility of randomized controlled trials for prevention of Clostridioides difficile infection (CDI). Here, we report in a prospective observational cohort study the incidence of CDI and assess potential clinical characteristics and biomarkers to predict CDI in 1,007 patients ≥ 50 years receiving newly initiated antibiotic treatment with penicillins plus a beta lactamase inhibitor, 3rd/4th generation cephalosporins, carbapenems, fluoroquinolones or clindamycin from 34 European hospitals. The estimated 90-day cumulative incidences of a first CDI episode is 1.9% (95% CI 1.1-3.0). Carbapenem treatment (Hazard Ratio (95% CI): 5.3 (1.7-16.6)), toxigenic C. difficile rectal carriage (10.3 (3.2-33.1)), high intestinal abundance of Enterococcus spp. relative to Ruminococcus spp. (5.4 (2.1-18.7)), and low Shannon alpha diversity index as determined by 16 S rRNA gene profiling (9.7 (3.2-29.7)), but not nor malized urinary 3-indoxyl sulfate levels, predicts an increased CDI risk.

Published
2021

20. Phenotypic and molecular characterizations of carbapenem-resistant Acinetobacter baumannii isolates collected within the EURECA study

Author

Universidad de Sevilla. Departamento de Medicina, Instituto de Salud Carlos III, Subdirección General de Redes y Centros de Investigación Cooperativa, Ministerio de Ciencia, Innovación y Universidades, Kostyanev, T., Xavier, B. B., García-Castillo, M., Lammens, C., Bravo-Ferrer Acosta, J., Rodríguez-Baño, Jesús, Cantón, Rafael, Glupczynski, Y., Goossens, H., Universidad de Sevilla. Departamento de Medicina, Instituto de Salud Carlos III, Subdirección General de Redes y Centros de Investigación Cooperativa, Ministerio de Ciencia, Innovación y Universidades, Kostyanev, T., Xavier, B. B., García-Castillo, M., Lammens, C., Bravo-Ferrer Acosta, J., Rodríguez-Baño, Jesús, Cantón, Rafael, Glupczynski, Y., and Goossens, H.

Abstract

Multi-drug-resistant Acinetobacter baumannii isolates are key pathogens that contribute to the global bur den of antimicrobial resistance. This study aimed to investigate the phenotypic and molecular character istics of carbapenem-resistant A. baumannii (CRAB) isolates from the EURECA clinical trial. In total, 228 CRAB clinical strains were recovered from 29 sites in 10 European countries participating in the EURECA study between May 2016 and November 2018. All strains were reconfirmed centrally for identification and antimicrobial susceptibility testing, and were then subjected to DNA isolation and whole-genome sequencing (WGS), with analysis performed using BacPipe v.1.2.6. K and O typing was performed using KAPTIVE. Overall, 226 (99.1%) strains were confirmed as CRAB isolates. The minimum inhibitory con centration (MIC90) results of imipenem and meropenem were >16 mg/L. WGS showed that the isolates mainly harboured blaOXA-23 (n=153, 67.7%) or blaOXA-72 (n=70, 30.1%). Four blaOXA-72 isolates from Serbia co-harboured blaNDM-1. An IS5 transposase family element, ISAba31, was found upstream of the blaOXA-72 gene harboured on a small (~10-kb) pSE41030-EUR plasmid. The majority of isolates (n=178, 79.1%) be longed to international clone II. Strains belonging to the same sequence type but isolated in different countries or within the same country could be delineated in different clusters by core-genome multi locus sequence typing (MLST). Whole-genome/core-genome MLST showed high diversity among the iso lates, and the most common sequence type was ST2 (n=153, 67.7%). The EURECA A. baumannii strain collection represents a unique, diverse repository of carbapenem-resistant isolates that adds to the exist ing knowledge of A. baumannii epidemiology and resistance genes harboured by these strains

Published
2021

21. Incidence and predictive biomarkers of Clostridioides difficile infection in hospitalized patients receiving broad-spectrum antibiotics

Author

Universidad de Sevilla. Departamento de Medicina, Universidad de Sevilla. CTS-406: Estudio enfermedades infecciosas en la práctica clínica, Van Werkhoven, C. H., Ducher, A., Berkell, M., Mysara, M., Lammens, C., Torre-Cisneros, J., Rodríguez-Baño, Jesús, Vehreschild, M. J. G. T., Universidad de Sevilla. Departamento de Medicina, Universidad de Sevilla. CTS-406: Estudio enfermedades infecciosas en la práctica clínica, Van Werkhoven, C. H., Ducher, A., Berkell, M., Mysara, M., Lammens, C., Torre-Cisneros, J., Rodríguez-Baño, Jesús, and Vehreschild, M. J. G. T.

Abstract

Trial enrichment using gut microbiota derived biomarkers by high-risk individuals can improve the feasibility of randomized controlled trials for prevention of Clostridioides difficile infection (CDI). Here, we report in a prospective observational cohort study the incidence of CDI and assess potential clinical characteristics and biomarkers to predict CDI in 1,007 patients ≥ 50 years receiving newly initiated antibiotic treatment with penicillins plus a beta lactamase inhibitor, 3rd/4th generation cephalosporins, carbapenems, fluoroquinolones or clindamycin from 34 European hospitals. The estimated 90-day cumulative incidences of a first CDI episode is 1.9% (95% CI 1.1-3.0). Carbapenem treatment (Hazard Ratio (95% CI): 5.3 (1.7-16.6)), toxigenic C. difficile rectal carriage (10.3 (3.2-33.1)), high intestinal abundance of Enterococcus spp. relative to Ruminococcus spp. (5.4 (2.1-18.7)), and low Shannon alpha diversity index as determined by 16 S rRNA gene profiling (9.7 (3.2-29.7)), but not nor malized urinary 3-indoxyl sulfate levels, predicts an increased CDI risk.

Published
2021

22. Lower respiratory tract infection in the community: associations between viral aetiology and illness course

Author

MS Infectieziekten, Biostatistiek Onderzoek, Other research (not in main researchprogram), MS Interne Geneeskunde, Infection & Immunity, HAG Infectieziekten, MMB onderwijs, MMB, JC onderzoeksprogramma Infectieziekten, MMB Research line 3a, Vos, L. M., Bruyndonckx, R., Zuithoff, N. P.A., Little, P., Oosterheert, J. J., Broekhuizen, B. D.L., Lammens, C., Loens, K., Viveen, M., Butler, C. C., Crook, D., Zlateva, K., Goossens, H., Claas, E. C.J., Ieven, M., Van Loon, A. M., Verheij, T. J.M., Coenjaerts, F. E.J., GRACE Consortium, MS Infectieziekten, Biostatistiek Onderzoek, Other research (not in main researchprogram), MS Interne Geneeskunde, Infection & Immunity, HAG Infectieziekten, MMB onderwijs, MMB, JC onderzoeksprogramma Infectieziekten, MMB Research line 3a, Vos, L. M., Bruyndonckx, R., Zuithoff, N. P.A., Little, P., Oosterheert, J. J., Broekhuizen, B. D.L., Lammens, C., Loens, K., Viveen, M., Butler, C. C., Crook, D., Zlateva, K., Goossens, H., Claas, E. C.J., Ieven, M., Van Loon, A. M., Verheij, T. J.M., Coenjaerts, F. E.J., and GRACE Consortium

Published
2021

27. Transmission of SARS-CoV-2 within households: a prospective cohort study in the Netherlands and Belgium – Interim results

Author

Verberk, JDM, primary, de Hoog, MLA, additional, Westerhof, I, additional, Van Goethem, S, additional, Lammens, C, additional, Ieven, M, additional, de Bruin, E, additional, Bielicki, J, additional, Coenen, S, additional, van Beek, J, additional, Bonten, M, additional, Goossens, H, additional, and Bruijning-Verhagen, PCJL, additional

Published
2021
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43. Evaluation of colistin stability in agar and comparison of four methods for MIC testing of colistin

Author

Turlej-Rogacka, A. Xavier, B.B. Janssens, L. Lammens, C. Zarkotou, O. Pournaras, S. Goossens, H. Malhotra-Kumar, S.

Abstract

Susceptibility testing for colistin remains challenging primarily due to its inherent properties. We evaluated colistin stability in agar and reproducibility of colistin MICs obtained by agar dilution, broth macro- and micro-dilution and MIC gradient strips on 3–7 iterations of each method using clinical Klebsiella pneumoniae (susceptible-CS, and resistant-CR, n = 2 each), mcr-harboring Escherichia coli (n = 2), and reference strains E. coli ATCC25922 and Pseudomonas aeruginosa ATCC27853. MICs for reference strains were not in the given range using Etest and broth microdilution (ATCC25922, 0.125 and 4 μg/ml, respectively). MICs of CR-1 and CR-2, and of the mcr-harboring E. coli showed high concordance between agar and broth dilution varying up to one 2-fold dilution. However, remarkable variations were observed on broth dilution with CS-1 and CS-2 (MIC range 0.25–32 and 0.5–64 μg/ml, respectively); whereas for agar dilution the MIC for both CS strains was 0.5 μg/ml in all the runs. MICs obtained by MIC gradient strips were lower than those obtained by dilution methods (1–2 dilutions for CS and mcr strains, and up to five dilutions for CR strains). To confirm uniform distribution of colistin in agar, a single strain was spotted in five different regions of the same plate. All spots showed concordant growth with maximum one dilution difference. No effect on MIC was found due to storage of colistin-containing agar plates for 7 days at 4 °C. In our hands, agar dilution was superior in terms of reproducibility and robustness, compared to broth dilution methods, for colistin MIC determination. © 2017, The Author(s).

Published
2018

45. Aetiology of lower respiratory tract infection in adults in primary care: a prospective study in 11 European countries

Author

MMB Research line 3a, Infection & Immunity, HAG Infectieziekten, JC onderzoeksprogramma Infectieziekten, MMB, Epi Infectieziekten Team 1, Ieven, M., Coenen, S., Loens, K., Lammens, C., Coenjaerts, E., Vanderstraeten, A., Henriques-Normark, B., Crook, D., Huygen, K., Butler, C. C., Verheij, T. J. M., Little, P., Zlateva, K., van Loon, A., Claas, E. C. J., Goossens, H., MMB Research line 3a, Infection & Immunity, HAG Infectieziekten, JC onderzoeksprogramma Infectieziekten, MMB, Epi Infectieziekten Team 1, Ieven, M., Coenen, S., Loens, K., Lammens, C., Coenjaerts, E., Vanderstraeten, A., Henriques-Normark, B., Crook, D., Huygen, K., Butler, C. C., Verheij, T. J. M., Little, P., Zlateva, K., van Loon, A., Claas, E. C. J., and Goossens, H.

Published
2018

46. Effect of outpatient antibiotics for urinary tract infections on antimicrobial resistance among commensal Enterobacteriaceae: a multinational prospective cohort study

Author

Stewardson, A.J., primary, Vervoort, J., additional, Adriaenssens, N., additional, Coenen, S., additional, Godycki-Cwirko, M., additional, Kowalczyk, A., additional, Huttner, B.D., additional, Lammens, C., additional, Malhotra-Kumar, S., additional, Goossens, H., additional, Harbarth, S., additional, Vervoort, Jascha, additional, Lammens, Christine, additional, Malhotra-Kumar, Surbhi, additional, Goossens, Herman, additional, Adriaenssens, Niels, additional, Coenen, Samuel, additional, Kowalczyk, Anna, additional, Godycki-Cwirko, Maciek, additional, Stewardson, Andrew J., additional, Huttner, Benedikt, additional, Harbarth, Stephan, additional, Brossier, Caroline, additional, Delémont, Cécile, additional, de Tejada, Begoña Martinez, additional, Renzi, Gesuele, additional, Schrenzel, Jacques, additional, Van Bylen, Sylvie, additional, Vanbergen, Jonathan, additional, Koeck, Philip, additional, Leysen, Peter, additional, Vandercam, Kim, additional, Kluijtmans, Jacques, additional, Borkiewicz, Agnieszka, additional, Heyvaert, Frank, additional, Michels, Nele, additional, Deswaef, Gerd, additional, Beckx, Tine, additional, Declerck, Hadewijch, additional, Embrechts, Katy, additional, Verheyen, Nina, additional, Bauwens, Tine, additional, Béghin, Josefien, additional, Verpooten, Liesbeth, additional, Bombeke, Katrien, additional, Vandenabeele, Tine, additional, Muras, Magdalena, additional, Świstak, Joanna, additional, Wesołowska, Anna, additional, Sterniczuk, Ewa, additional, Brzozowska, Lidia, additional, Cichowska, Krystyna, additional, Szewczyk, Jolanta, additional, Krupińska, Grażyna, additional, Błaszczyk, Honorata, additional, Stawińska, Urszula, additional, Szyler, Maria, additional, Kasielski, Marek, additional, Rydz, Rafał, additional, Myszkowska, Agata, additional, and Żebrowska, Lilianna, additional

Published
2018
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47. Amoxicillin for acute lower respiratory tract infection in primary care: subgroup analysis by bacterial and viral aetiology

Author

Bruyndonckx, R., primary, Stuart, B., additional, Little, P., additional, Hens, N., additional, Ieven, M., additional, Butler, C.C., additional, Verheij, T., additional, Goossens, H., additional, Coenen, S., additional, Almirall, J., additional, Brugman, C., additional, Chlabicz, S., additional, De Sutter, A., additional, Davies, M., additional, Godycki-Cwirko, M., additional, Fernandez, P., additional, Hering, I., additional, Hood, K., additional, Schaberg, G.I.T., additional, Torres, A., additional, Kowalczyk, A., additional, Lammens, C., additional, Lemiengre, M., additional, Leus, F., additional, Loens, K., additional, Mierzecki, A., additional, Moore, M., additional, Muras, M., additional, O'Reilly, G., additional, Romano, N.S., additional, Prat, M.S., additional, Swain, J., additional, Veen, R., additional, and Worby, T., additional

Published
2018
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48. Colistin-resistant Acinetobacter baumannii clinical strains with deficient biofilm formation

Author

Dafopoulou, K. Xavier, B.B. Hotterbeekx, A. Janssens, L. Lammens, C. Dé, E. Goossens, H. Tsakris, A. Malhotra-Kumar, S. Pournaras, S.

Subjects
biochemical phenomena, metabolism, and nutrition
Abstract

In two pairs of clinical colistin-susceptible/colistin-resistant (Csts/Cstr) Acinetobacter baumannii strains, the Cstr strains showed significantly decreased biofilm formation in static and dynamic assays (P

Published
2016

49. MLST reveals potentially high-risk international clones of Enterobacter cloacae

Author

Izdebski, R. Baraniak, A. Herda, M. Fiett, J. Bonten, M.J.M. Carmeli, Y. Goossens, H. Hryniewicz, W. Brun-buisson, C. Gniadkowski, M. Grabowska, A. Nikonorow, E. Derde, L.P.G. Dautzenberg, M.J. Adler, A. Kazma, M. Navon-venezia, S. Malhotra-kumar, S. Lammens, C. Dumpis, U. Giamarellou, H. Muzlovic, I. Nardi, G. Petrikkos, G.L. Stammet, P. Salomon, J. Lawrence, C. Legrand, P. Rossini, A. Salvia, A. Samso, J.V. Fierro, J. Paul, M. Lerman, Y. MOSAR WP2, WP3 WP5 study groups

Subjects
bacterial infections and mycoses
Abstract

Objectives: To perform the first multinational Enterobacter cloacae clonality study, using the MLST scheme newly developed in Japan. Methods: The analysis included 195 rectal carriage E. cloacae isolates resistant to expanded-spectrum cephalosporins (ESCs), collected from patients in 12 hospital units across Europe and Israel. All of the isolates were typed by PFGE and 173 isolates were subjected to MLST. ESC resistance was analysed phenotypically; genes encoding ESBLs and carbapenemases were identified by PCR and sequencing. Results: MLST distinguished 88 STs, which correlated with the PFGE data. PFGE was more discriminatory, producing 129 pulsotypes (169 patterns). Numerous STs were observed in several countries each. The most widespread were ST66, ST78, ST108 and ST114, each having at least 10 isolates from three to five countries, diversified into multiple pulsotypes, with clusters of related isolates in one or more centres. Analysis of the STs against the MLST database revealed several epidemic clonal complexes, such as those with central genotypes ST74 (including ST78) or ST114 (including ST66). ESC resistance was equally related to overexpression of the AmpC cephalosporinase and to ESBL production. Among ESBL producers some spreading subclones were identified, including specific ST66, ST78 and ST114 pulsotypes, associated with CTX-M-15 production. Several isolates produced carbapenemase VIM-1 or KPC-2. Conclusions: Together with the information available in the MLST database, our results suggest that, like Escherichia coli and Klebsiella pneumoniae, E. cloacae harbours clonal lineages of increased epidemic potential that may be associated with resistance spread. © The Author 2014. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved.

Published
2015

50. Phylogenetic lineages, clones and β-lactamases in an international collection of Klebsiella oxytoca isolates non-susceptible to expanded-spectrum cephalosporins

Author

Izdebski, R. Fiett, J. Urbanowicz, P. Baraniak, A. Derde, L.P.G. Bonten, M.J.M. Carmeli, Y. Goossens, H. Hryniewicz, W. Brun-Buisson, C. Brisse, S. Gniadkowski, M. Herda, M. Dautzenberg, M.J. Adler, A. Kazma, M. Navon-Venezia, S. Malhotra-Kumar, S. Lammens, C. Legrand, P. Chalfine, A. Giamarellou, H. Petrikkos, G.L. Balode, A. Dumpis, U. Stammet, P. Aragăo, I. Esteves, F. Torres Martí, A. Lawrence, C. Salomon, J. Paul, M. Lerman, Y. Rossini, A. Salvia, A. Vidal Samso, J. Fierro, J. MOSAR WP2, WP3 WP5 Study Groups

Subjects
biochemical phenomena, metabolism, and nutrition, bacterial infections and mycoses
Abstract

Objectives: The objective of this study was to examine Klebsiella oxytoca clonal and phylogenetic diversity, based on an international collection of carriage isolates non-susceptible to expanded-spectrum cephalosporins (ESCs). Methods: The study material comprised 68 rectal carriage K. oxytoca isolates non-susceptible to ESCs recovered in 2008-11 from patients in 14 hospitals across Europe and Israel. ESC resistance was tested phenotypically; genes encoding ESBLs, AmpC cephalosporinases and carbapenemases were amplified and sequenced. The isolates were typed by PFGE and MLST, followed by sequencing of blaOXY genes. Results: MLSTand PFGE distinguished 34 STs and 47 pulsotypes among the isolates, respectively. Six STswere split into several pulsotypes each. Five STs were more prevalent (n=2-9) and occurred in several countries each, including ST2, ST9 and ST141, which belong to a growing international clonal complex (CC), CC2. Four phylogenetic lineages were distinguished, each with another type of chromosomal OXY-type β-lactamase. Three of these, with OXY-1/-5, OXY-2 types and OXY-4, corresponded to previously described phylogroups KoI, KoII and KoIV, respectively. A single isolate from Israel represented a distinct lineage with a newly defined OXY-7 type. The phylogroups showed interesting differences in mechanisms of ESC resistance; KoI strains rarely overexpressed the OXY enzymes but commonly produced ESBLs, whereas KoII strains often were OXY hyperproducers and carried ESBLs much less frequently. AmpCs (DHA-1) and carbapenemases (VIM-1) occurred sporadically. Conclusions: The study confirmed the high genetic diversity of the collection of K. oxytoca ESC-non-susceptible isolates, composed of phylogroups with distinct types of OXY-type β-lactamases, and revealed some STs of broad geographical distribution.

Published
2015

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