OXA-48-Carbapenemase-Producing Klebsiella pneumoniae infections - the first cases diagnosed in Romanian National Institute of Infectious Diseases

Cristina Popescu 1 , 2 , Gabriel Adrian Popescu 1 , 2 , Olga Dorobăț 2 , Alexandru Rafilă 1 , 2 , Diana Tănase 2 , Claudia Mikula 3 , 4 , Gudrun Weissensteiner 3 , 4 ,  and Steliana Huhulescu 3 , 5
  • 1 „Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
  • 2 „Matei Balș” National Institute for Infectious Diseases, Bucharest, Romania
  • 3 Austrian Agency for Health and Food Safety, Vienna, Austria
  • 4 Institute for Medical Microbiology and Hygiene, Graz, Austria
  • 5 Institute for Medical Microbiology and Hygiene, Vienna, Austria


We report first description of clinical cases of OXA-48 carbapenemase-producing Klebsiella pneumoniae originating from patients hospitalized in the most important Infectious Diseases Hospital from Romania, between December 2012 and March 2013. All strains were isolated from patients who were previously admitted in surgical wards. None of the patients had been admitted in a hospital outside of Romania.

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  • 1. Poirel L, Pitout JD, Nordmann P. Carbapenemases: molecular diversity and clinical consequences. Future Microbiol. 2007 Oct;2(5): 501-12. DOI: 10.2217/17460913.2.5.501

  • 2. Poirel L, Héritier C, Tolün V, Nordmann P. Emergence of oxacillinase-mediated resistance to imipenem in Klebsiella pneumoniae. Antimicrob Agents Chemother. 2004 Jan;48(1):15–22. DOI: 10.1128/AAC.48.1.15-22.2004

  • 3. Carrër A, Poirel L, Yilmaz M, Akan OA, Feriha C, Cuzon G, et al. Spread of OXA-48–encoding plasmid in Turkey and beyond. Antimicrob Agents Chemother. 2010 Mar;54(3):1369–73. DOI: 10.1128/AAC.01312-09

  • 4. Benouda A, Touzani O, Khairallah MT, Araj GF, Matar GM. First detection of oxacillinase-mediated resistance to carbapenems in Klebsiella pneumoniae from Morocco. Ann Trop Med Parasitol. 2010 Jun;104(4):327–30. DOI: 10.1179/136485910X12743554760108

  • 5. Poirel L, Potron A, Nordmann P. OXA-48-like carbapenemases: the phantom menace. J Antimicrob Chemother. 2012 Jul;67(7):1597-606. DOI: 10.1093/jac/dks121

  • 6. Lascols C, Peirano G, Hackel M Laupland KB, Pitout JD. Surveillance and molecular epidemiology of Klebsiella pneumoniae isolates that produce carbapenemases: first report of OXA-48-like enzymes in North America. Antimicrob Agents Chemother. 2013 Jan;57(1):130-6. DOI: 10.1128/AAC.01686-12

  • 7. Lascols C, Hackel M, Marshal SH, Hujer AM, Bouchillon S, Badal R, et al. Increasing prevalence and dissemination of NDM-1 metallo-betalactamases in India: data from the SMART study. J Antimicrob Chemother. 2009 Sep;66(9):1992-7. DOI: 10.1093/jac/dkr240

  • 8. Vaux S, Carbonne A, Thiolet JM, Jarlier V, Coignard B. Emergence of carbapenemase-producing enterobacteriaceae in France, 2004 to 2011. Euro Surveill. 2011 Jun;16(22):pii=19880.

  • 9. Osterblad M, Kirveskari J, Hakanen AJ, Tissari P, Vaara M, Jalava J. Carbapenemase-producing Enterobacteriaceae in Finland: the first years (2008-11). J Antimicrob Chemother. 2012 Dec;67(12):2860-4. DOI: 10.1093/jac/dks299

  • 10. O’Brien DJ, Wrenn C, Roche C Rose L, Fenelon C, Flynn A, et al. First isolation and outbreak of OXA-48-producing Klebsiella pneumoniae in an Irish hospital, March to June 2011. Euro Surveillance. 2011 Jul;16(29):pii=19921.

  • 11. European Centre for Disease Prevention and Control (ECDC). Rapid risk assessment. Transfer of Libyan patients to hospitals in the European Union. Stockholm: ECDC; 31 Oct 2011.

  • 12. Pirš M, Andlovic A, Cerar T, Žohar-Čretnik T, Kobola L, Kolman J, et al. A case of OXA-48 carbapenemase-producing Klebsiella pneumoniae in a patient transferred to Slovenia from Libya, November 2011. Euro Surveill. 2011 Dec;16(50):pii=20042.

  • 13. Dallenne C, Da Costa A, Decré D, Favier C, Arlet G. Development of a set of multiplex PCR assays for the detection of genes encoding important beta-lactamases in Enterobacteriaceae. J Antimicrob Chemother. 2010 Mar; 65(3):490-5. DOI: 10.1093/jac/dkp498

  • 14. Perez-Perez FJ, Hanson ND. Detection of plasmid-mediated AmpC β-lactamase genes in clinical isolates by using multiplex PCR. J Clin Microbiol. 2002 Jun;40(6):2153-62. DOI: 10.1128/JCM.40.6.2153-2162.2002

  • 15. Nordmann P, Naas T, Poirel L. Global spread of carbapenemase-producing enterobacteriaceae. Emerg Infect Dis. 2011 Oct;17(10):1791–8. DOI: 10.3201/eid1710.110655

  • 16. Szekely E, Damjanova I, Janvari L, Vas K.E, Molnar S, Bilca DV, et al. First description of blaNDM−1, blaOXA−48, blaOXA−181 producing Enterobacteriaceae strains in Romania. Int J Med Microbiol.2013 Dec; 303(8): 697-700. DOI: 10.1016/j.ijmm.2013.10.001

  • 17. Dortet L, Flonta M, Boudehen Y-M, Creton E, Bernabeu S, Vogel A, et al. Dissemination of carbapenemase-producing Enterobacteriaceae and Pseudomonas aeruginosa in Romania. Antimicrob Agents Chemother. 2015 Nov; 59(11) 7100-3. DOI: 10.1128/AAC.01512-15

  • 18. Gheorghe I, Czobor I, Chifiriuc MC, Borcan E, Ghita C, Banu O et al. Molecular screening of carbapenemase-producing Gram-negative strains in Romanian intensive care units during a one year survey. J Med Microbiol. 2014 Oct; 63 (Pt 10):1303-10. DOI: 10.1099/jmm.0.074039-0

  • 19. Timofte D, Panzaru CV, Maciuca IE, Dan M, Mare AD, Man A, et al. Active surveillance scheme in three Romanian hospitals reveals a high prevalence and variety of carbapenamase-producing Gram-negative bacteria: a pilot study, December 2014 to May 2015. Euro Surveill. 2016 Jun 23; 21(25): pii=30262. DOI: 10.2807/1560-7917.ES.2016.21.25.30262

  • 20. Van der Bij AK, Pitout JD. The role of international travel in the worldwide spread of multiresistant Enterobacteriaceae. J Antimicrob Chemother. 2012 Sep;67(9):2090-100. DOI: 10.1093/jac/dks214


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