Intraregional hospital outbreak of OXA-244-producing Escherichia coli ST38 in 2020

Infections with OXA-244-carbapenemaseproducing Escherichia coliwith sequence type (ST)38 have recently increased in Europe. Due to its low-level activity against carbapenems, OXA-244 can be difficult to detect. Previous assessments have not revealed a clear source and route of transmission for OXA-244-producing E. coli, but there are indications of non-healthcare related sources and community spread. Here we report a hospital-associated outbreak of OXA-244-producing E. coliST38 involving three hospitals in Western Norway in 2020. The outbreak occurred over a 5-month period and included 12 cases identified through clinical (n = 6) and screening (n = 6) samples. The transmission chain was unclear; cases were identified in several wards and there was no clear overlap of patient stay. However, all patients had been admitted to the same tertiary hospital in the region, where screening revealed an outbreak in one ward (one clinical case and five screening cases). Outbreak control measures were instigated including contact tracing, isolation, and screening; no further cases were identified in 2021. This outbreak adds another dimension to the spread of OXA-244-producing E. coliST38, illustrating this clone's ability to establish itself in the healthcare setting. Awareness of challenges concerning OXA244-producing E. colidiagnostic is important to prevent further spread.

Automated summary

Infections with OXA-244-carbapenemase-producing Escherichia coli ST38 have increased in Europe. This study reports a hospital-associated outbreak of OXA-244-producing E. coli ST38 in Western Norway in 2020. The outbreak occurred over 5 months, involved 12 cases, and the transmission chain was unclear. Outbreak control measures were implemented and no further cases were identified in 2021.