Temkin Elizabeth, Bechor Moshe, Lurie-Weinberger Mor N, Keren-Paz Alona, Chen Dafna, Lugassy Carmela, Solter Ester, Schwaber Mitchell J, Carmeli Yehuda
Emerg Infect Dis. 2025 Jan;31(1):66-74. doi: 10.3201/eid3101.240722.
Escherichia coli producing OXA-48-like carbapenemases (OXA-EC) is considered a high-risk pathogen spread primarily in the community in low- and middle-income countries and nosocomially in high-income countries. We investigated the emergence and spread of OXA-EC in Israel, a high-income country with strong carbapenemase-directed infection control in healthcare institutions, by conducting a population-based study using data and isolates from the national surveillance system. A total of 3,510 incident cases of OXA-EC occurred during 2007-2023. During 2016-2023, annual cases rose from 41 to 1,524 and nonnosocomial cases rose from 39% to 57%. Sixty-three sequenced isolates belonged to 20 sequence types (STs) and had 3 bla alleles (bla, bla, and bla); 71% were chromosomally encoded, and 29% were plasmid-encoded. Nosocomially and non-nosocomially acquired isolates belonged to the same STs and alleles. Most outbreaks involved multiple STs and could only partially be explained by plasmid dissemination. Measures for confronting OXA-EC might need reconsideration.
产OXA-48样碳青霉烯酶的大肠杆菌（OXA-EC）被认为是一种高风险病原体，主要在低收入和中等收入国家的社区传播，在高收入国家则在医院内传播。我们通过利用国家监测系统的数据和分离株进行一项基于人群的研究，调查了OXA-EC在以色列的出现和传播情况。以色列是一个高收入国家，医疗机构对碳青霉烯酶感染控制力度较大。2007年至2023年期间共发生3510例OXA-EC感染病例。2016年至2023年期间，年度病例数从41例增至1524例，非医院感染病例比例从39%升至57%。63株测序分离株属于20种序列类型（STs），有3种bla等位基因（bla、bla和bla）；71%由染色体编码，29%由质粒编码。医院感染和非医院感染分离株属于相同的STs和等位基因。大多数暴发涉及多种STs，仅部分可通过质粒传播来解释。应对OXA-EC的措施可能需要重新考虑。
