Dissemination of extensively drug-resistant NDM-producing Providencia stuartii in Europe linked to patients transferred from Ukraine, March 2022 to March 2023

Sandra Witteveen, Jörg B. Hans, Radosław Izdebski, Henrik Hasman, Ørjan Samuelsen, Laurent Dortet, Yvonne Pfeifer, Niall Delappe, Jesús Oteo-Iglesias, Dorota Żabicka, Martin Cormican, Mirco Sandfort, Felix Reichert, Anna K. Pöntinen, Martin A. Fischer, Nelianne Verkaik, María Pérez-Vazquez, Niels Pfennigwerth, Anette M. Hammerum, Søren HallstrømMarta Biedrzycka, Kati Räisänen, Cornelia C.H. Wielders, Paweł Urbanowicz, Angela de Haan, Karin Westmo, Fabian Landman, Han G.J. van der Heide, Simon Lansu, Romy D. Zwittink, Daan W. Notermans, Aneta Guzek, Viacheslav Kondratiuk, Aidyn Salmanov, Sebastian Haller, Marius Linkevicius, Sören Gatermann, Anke Kohlenberg, Marek Gniadkowski, Guido Werner, Antoni P.A. Hendrickx

Research output: Contribution to a Journal (Peer & Non Peer)Articlepeer-review

14 Citations (Scopus)

Abstract

Background: The 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. Aim: To investigate the genomic epidemiology of New Delhi metallo-β-lactamase (NDM)-producing Providencia stuartii from Ukrainian patients among European countries. Methods: Whole-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 blaNDM-1-carrying-P. stuartii isolates underwent antimicrobial susceptibility testing (AST). Transferability to Escherichia coli of a blaNDM-1-carrying plasmid from a patient strain was assessed. Epidemiological characteristics of patients with NDM-producing P. stuartii were gathered by questionnaire. Results: wgMLST of the 66 isolates revealed two genetic clusters unrelated to Ukraine and three linked toUkrainian patients. Of these three, two comprised blaNDM-1-carrying-P. stuartii and the third blaNDM-5-carrying-P. stuartii. The blaNDM-1 clusters (PstCluster-001, n=22 isolates; PstCluster-002, n=8 isolates) comprised strains from seven and four countries, respectively. The blaNDM-5 cluster (PstCluster-003) included 13 isolates from six countries. PstCluster-001 and PstCluster-002 isolates carried an MDR plasmid harbouring blaNDM-1,blaOXA-10, blaCMY-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 19–74years old; of 49 with information on sex, 38 were male. Conclusion: XDR P. stuartii were introduced into European countries, requiring increased awareness and precautions when treating patients from conflict-affected areas.

Original languageEnglish
Article numberpii=2300616
JournalEurosurveillance
Volume9
Issue number23
DOIs
Publication statusPublished - 6 Jun 2024

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