Abstract
Objectives: Patients hospitalised abroad can become colonised with multidrug-resistant bacteria and import them to their home countries. In this study, we characterised 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 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 analysed for phylogenetic relatedness.
Results: The patient was infected with the SARS-CoV-2 B.1.617.2 lineage (VOC Delta), a lineage that began to be reported across Switzerland at that time. He was also colonised with a sequence type 410 (ST410) E. coli strain (L3452210II) producing OXA-484, a single amino acid variant of OXA-181. The bla OXA-484 gene was carried by a 51.5 kb IncX3 plasmid identical to those described in bla OXA-181 -harbouring ST410 E. coli strains. Core genome analysis showed that L3452210II was identical (ΔSNV ≤23) to two ST410 OXA-484 producers recently reported in Qatar and Germany, but differed from other ST410 OXA-181 producers reported worldwide.
Conclusion: 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 bla OXA-484 shared the same plasmid as bla OXA-181 , but its bacterial host differed from most of the pandemic OXA-181-producing ST410 strains reported previously. This case description underlines that the COVID-19 crisis can contribute to the worldwide spread of emerging carbapenemase producers.
Keywords: Carbapenemase; IncX3; OXA-48; OXA-484; Plasmid; SARS-CoV-2.
【저자키워드】 SARS-CoV-2, Carbapenemase, IncX3, OXA-48, OXA-484, Plasmid, 【초록키워드】 SARS-CoV-2, pandemic, VoC, Genome, India, variant, SARS-CoV-2 variant, Delta, B.1.617.2, Spread, Nasopharyngeal swab, Germany, Patient, Lineage, Bacteria, Switzerland, Strains, Admission, Bacterial, Amino acid, Analysis, strain, Plasmid, Escherichia coli, Phylogenetic, E. coli, COVID-19 crisis, sequence, core, genetic background, whole-genome, Host, rectal swab, isolate, hospitalised, multidrug-resistant, described, detect, sequenced, carried, reported, indicated, the patient, analysed, contribute, producing, the SARS-CoV-2, 【제목키워드】 Repatriation, patient with COVID-19, contributed,