Genomic surveillance detects interregional spread of New Delhi metallo-beta-lactamase-1-producing Providencia stuartii in hospitals, Romania, December 2021 to September 2023
BackgroundNew Delhi metallo-beta-lactamase (NDM)-producing <i>Providencia stuartii</i> has been reported from European Union/European Economic Area (EU/EEA) countries with increasing frequency. During 2018 to 2022, 355 cases of NDM-producing <i>P. stuartii</i> were detected in seven hospitals reporting on NDM-production in Enterobacterales in Romania.AimOur aim was to determine the extent of spread of NDM-producing <i>P. stuartii</i> in hospitals in Romania.MethodsWe analysed whole genome sequences and epidemiological data of 74 <i>P. stuartii</i> isolates collected in six hospitals from December 2021 to September 2023.ResultsWe identified four multi-hospital clusters including isolates detected over more than a year, indicating sustained spread of <i>bla</i> <sub>NDM-1</sub>-carrying <i>P. stuartii</i> within the healthcare system. These clusters consisted of isolates from up to four hospitals and three regions. Three multi-hospital clusters were caused by a specific multidrug-resistant <i>P. stuartii</i> sequence type 46 lineage carrying <i>bla</i> <sub>NDM-1</sub> and a large set of additional resistance markers. Investigation in an international context showed that this lineage had already been detected in nine countries (Bulgaria, France, Germany, Ireland, the Netherlands, Romania, Switzerland, United Kingdom, United States) since 2015.ConclusionOur results alert about the risk of carbapenem-resistant <i>P. stuartii</i> transmission in healthcare settings. Enhanced infection prevention and control measures should be instituted as soon as cases are detected in healthcare facilities. National surveillance systems in EU/EEA countries should, in addition to carbapenem-resistant and/or carbapenemase-producing <i>Klebsiella pneumoniae</i> and <i>Escherichia coli</i>, consider reporting carbapenem-resistant and/or carbapenemase-producing <i>P. stuartii</i> and other Enterobacterales where relevant.
Authors
- Edit Székely (ORCID: https://orcid.org/0000-0002-3350-1675)
- Sandra Witteveen (ORCID: https://orcid.org/0000-0001-9132-9028)
- Anke Kohlenberg
- Daniela Tălăpan (ORCID: https://orcid.org/0000-0001-5202-8417)
- Olov Svartström (ORCID: https://orcid.org/0000-0003-3100-5325)
- Gabriel Adrian Popescu
- Dominique L. Monnet (ORCID: https://orcid.org/0009-0002-7810-1859)
- Marius Linkevičius (ORCID: https://orcid.org/0000-0001-5760-2721)
- Marina Indreas
- Erik Alm (ORCID: https://orcid.org/0000-0002-2903-607X)
- Antoni P. A. Hendrickx (ORCID: https://orcid.org/0000-0003-4431-9323)
- Mirela Flonta (ORCID: https://orcid.org/0000-0001-5478-8815)
- Mariana Buzea
- Daniel Palm (ORCID: https://orcid.org/0000-0002-2354-5498)
- Maria Nica
Institutions
- Carol Davila University of Medicine and Pharmacy (RO)
- Clinical Emergency Hospital Bucharest (RO)
- National Institute for Public Health and the Environment (NL)
- National Institute of Research and Development for Biological Sciences (RO)
- Spitalul Clinic Judetean de Urgenta Târgu Mureş (RO)
- Spitalul Clinic Judetean de Urgenta Sibiu (RO)
- European Centre for Disease Prevention and Control (SE)
Publication Details
- Journal
- Eurosurveillance
- Published
- 2024-11-21
- DOI
- https://doi.org/10.2807/1560-7917.es.2024.29.47.2400587
- Citations
- 9
- Primary Topic
- Antibiotic Resistance in Bacteria
- Type
- article
- Field-Weighted Citation Impact
- 1.53
Funders
- European Centre for Disease Prevention and Control