Moser, Aline I.; Campos-Madueno, Edgar I.; Sendi, Parham; Perreten, Vincent; Keller, Peter M.; Ramette, Alban; Endimiani, Andrea (2021). Repatriation of a patient with COVID-19 contributed to the importation of an emerging carbapenemase producer. Journal of global antimicrobial resistance, 27, pp. 267-272. Elsevier 10.1016/j.jgar.2021.10.012
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BACKGROUND
Patients hospitalized abroad can become colonized with multidrug-resistant bacteria and import them to their home countries. In this work, we characterized an OXA-484 carbapenemase-producing Escherichia coli strain from a Swiss patient infected by SARS-CoV-2 and repatriated from India.
METHODS
At admission to Switzerland (April, 2021), the patient undertook a molecular nasopharyngeal swab to search for SARS-CoV-2 and a rectal swab to detect multidrug-resistant bacteria. Both SARS-CoV-2 and E. coli isolates were whole-genome sequenced and analyzed for phylogenetic relatedness.
RESULTS
The patient was infected with the SARS-CoV-2 B.1.617.2 lineage (VOC Delta), a lineage that started to be reported across Switzerland at that time. He was also colonized with a sequence type (ST) 410 E. coli strain (L3452210II) producing the OXA-484, a single amino acid variant of OXA-181. The blaOXA-484 was carried by a 51.5 kb IncX3 plasmid identical to those described in blaOXA-181-harboring ST410 E. coli strains. Core-genome analysis showed that L3452210II was identical (∆SNV ≤23) to two ST410 OXA-484 producers recently reported in Qatar and Germany, but differed from other ST410 OXA-181 producers reported worldwide.
CONCLUSIONS
The patient was infected by an emerging SARS-CoV-2 variant, and also imported an E.coli producing OXA-484, an OXA-48-like carbapenemase not yet reported in Switzerland. The genetic background of L3452210II indicated that the blaOXA-484 shared the same plasmid of blaOXA-181, but its bacterial host differed from most of the pandemic OXA-181-producing ST410 strains previously reported. This case description underlines that the COVID-19 crisis can contribute to the worldwide spread of emerging carbapenemase producers.
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