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Volume 19, Number 1—January 2013

Letter

Carbapenem-hydrolyzing Oxacillinase-48 and Oxacillinase-181 in Canada, 2011

Laura F. Mataseje, David A. Boyd, Linda Hoang, Miguel Imperial, Brigitte Lefebvre, Mark Miller, Susan M. Poutanen, Diane Roscoe, Barbara M. Willey, and Michael R. MulveyComments to Author 
Author affiliations: Author affiliations: National Microbiology Laboratory, Winnipeg, Manitoba, Canada (L.F. Mataseje, D.A. Boyd, M.R. Mulvey); British Columbia Center for Disease Control, Vancouver, British Columbia, Canada (L. Hoang, M. Imperial); Laboratoire de Santé Publique du Québec, Sainte-Anne-de-Bellevue, Quebec, Canada (B. Lefebvre); SMBD–Jewish General Hospital, Montreal, Quebec, Canada (M. Miller); University of Toronto, Toronto, Ontario, Canada (S.M. Poutanen); University Health Network/Mount Sinai Hospital, Toronto (S.M. Poutanen, B.M. Willey); Vancouver General Hospital, Vancouver (D. Roscoe)

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Table

Patient data and antimicrobial drug susceptibility profiles for isolates of Klebsiella pneumoniae and Escherichia coli harboring OXA-type carbapenemases, Canada, 2011*

Variable Bacterial isolate, strain no., OXA-type
E. coli DH10B†
K. pneumoniae
E. coli
Plasmid
11-882, OXA-48 11-2568, OXA-181 11-2720, OXA-48 11-1498, OXA-48 p48-11-882 p181-11-2568
Patient data NA NA NA
Recent travel NK India Lebanon Dubai NA NA NA
Site of bacterial isolation Urine Perirectal Urine Skin swab NA NA NA
Infection/colonization NK Colonization Infection Colonization NA NA NA
Hospitalization
NK
General ward
Outpatient

ICU

NA
NA
NA
Bacterial isolate data
β-lactamase TEM-1, SHV-11 TEM-1, SHV-11, CTX-M-15, OXA-1 SHV-11, OXA-1 TEM-1, CTX-M-24 TEM-1 Neg NA
Sequence type
395
147
831

38

NA
NA
NA
Antimicrobial drug susceptibility test, drug‡
Vitek2,§ MIC μg/mL
Amikacin <2.0 4.0 <2.0 <2.0 <2.0 <2.0 <2.0
Aztreonam <1.0 >64.0 <1.0 32.0 <1.0 <1.0 <1.0
Cefazolin 32.0 >64.0 16.0 >64.0 >64.0 32.0 <4.0
Cefepime <1.0 >64.0 <1.0 <1.0 <1.0 <1.0 <1.0
Ceftriaxone <1.0 >64.0 <1.0 >64.0 <1.0 <1.0 <1.0
Ciprofloxacin >4.0 >4.0 <0.25 <0.25 <0.25 <0.25 <0.25
Ertapenem >8.0 >8.0 4.0 4.0 >8.0 4.0 <0.5
Gentamicin <1.0 >16.0 <1.0 >16.0 <1.0 <1.0 <1.0
Imipenem 4.0 >16.0 <1.0 <1.0 8.0 2.0 <1.0
Meropenem 1.0 >16.0 <0.25 0.5 8.0 <0.25 <0.25
Tigecycline¶ 1.0 2.0 <0.5 <0.5 <0.5 <0.5 <0.5
TMP/SXT >320.0 >320.0 <20.0 >320.0 >320 <20 <20.0
Etest,§ MIC μg/mL
Imipenem 1.0 24.0 0.38 0.38 0.5 0.5 0.19
Meropenem 0.5 24.0 0.19 0.38 0.125 0.19 0.032
Ertapenem 2.0 >32.0 0.5 2.0 0.38 0.75 0.008
Colistin# 0.38 0.5 0.5 0.5 0.125 0.125 ND
Disk diffusion,** zone diameter, mm
Imipenem 20 8 23 22 24 25 33
Meropenem 20 7 23 22 22 28 35
Ertapenem 16 6 19 16 23 22 35

*NK, not known; NA, not applicable; ICU, intensive care unit; Neg, negative; TMP/SXT, trimethoprim/sulfamethoxazole; ND, not done.
†OXA-48–type plasmids were electroporated into E. coli DH10B cells.
‡Additional antimicrobial drugs on panel: ampicillin, ampicillin/sulbactam, nitrofurantoin, piperacillin/tazobactam, tobramycin.
§Test from bioMérieux Canada Inc., St. Laurent, Quebec, Canada.
¶MIC breakpoints for tigecycline were based on the US Food and Drug Administration criteria for Enterobacteriaceae: susceptible, <2 μg/mL; intermediate, 4 μg/mL; resistant, >8 μg/mL.
#MIC breakpoints for colistin followed Clinical Laboratory Standards Institute breakpoint criteria for Acinetobacter spp.: susceptible, MIC <2 μg/mL; resistant, MIC >4 μg/mL.
**Test from Clinical Laboratory Standards Institute (www.clsi.org/source/orders/free/m100-s22.pdf).

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