Dissemination of extensively drug-resistant NDM-producing in Europe linked to patients transferred from Ukraine, March 2022 to March 2023
Witteveen, Sandra Hans, Jörg B Izdebski, Radosław Hasman, Henrik Samuelsen, Ørjan Dortet, Laurent Pfeifer, Yvonne Delappe, Niall Oteo-Iglesias, Jesús Żabicka, Dorota
Witteveen, Sandra
Hans, Jörg B
Izdebski, Radosław
Hasman, Henrik
Samuelsen, Ørjan
Dortet, Laurent
Pfeifer, Yvonne
Delappe, Niall
Oteo-Iglesias, Jesús
Żabicka, Dorota
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Series / Report no.
Open Access
Type
Article
Language
en
Date of publication
2024-06-01
Year of publication
Research Projects
Organizational Units
Journal Issue
Title
Dissemination of extensively drug-resistant NDM-producing in Europe linked to patients transferred from Ukraine, March 2022 to March 2023
Translated Title
Published in
Euro Surveill 2024; 29(23):2300616
Abstract
BackgroundThe 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.AimTo investigate the genomic epidemiology of New Delhi metallo-β-lactamase (NDM)-producing Providencia stuartii from Ukrainian patients among European countries.MethodsWhole-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.ResultswgMLST 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.ConclusionXDR P. stuartii were introduced into European countries, requiring increased awareness and precautions when treating patients from conflict-affected areas.