%0 Journal Article
%T Dissemination of extensively drug-resistant NDM-producing Providencia stuartii in Europe linked to patients transferred from Ukraine, March 2022 to March 2023
%A Witteveen, Sandra
%A Hans, Jörg B.
%A Izdebski, Radosław
%A Hasman, Henrik
%A Samuelsen, Ørjan
%A Dortet, Laurent
%A Pfeifer, Yvonne
%A Delappe, Niall
%A Oteo-Iglesias, Jesús
%A Żabicka, Dorota
%A Cormican, Martin
%A Sandfort, Mirco
%A Reichert, Felix
%A Pöntinen, Anna K.
%A Fischer, Martin A.
%A Verkaik, Nelianne
%A Pérez-Vazquez, María
%A Pfennigwerth, Niels
%A Hammerum, Anette M.
%A Hallstrøm, Søren
%A Biedrzycka, Marta
%A Räisänen, Kati
%A Wielders, Cornelia C. H.
%A Urbanowicz, Paweł
%A de Haan, Angela
%A Westmo, Karin
%A Landman, Fabian
%A van der Heide, Han G. J.
%A Lansu, Simon
%A Zwittink, Romy D.
%A Notermans, Daan W.
%A Guzek, Aneta
%A Kondratiuk, Viacheslav
%A Salmanov, Aidyn
%A Haller, Sebastian
%A Linkevicius, Marius
%A Gatermann, Sören
%A Kohlenberg, Anke
%A Gniadkowski, Marek
%A Werner, Guido
%A Hendrick, Antoni P. A.
%D 2024
%G eng
%X Background:

The war in Ukraine led to migration of Ukrainian people. Early 2022, several European national surveillance systems detected multidrug-resistant (MDR) bacteria related to Ukrainian patients.
Aim:

To investigate the genomic epidemiology of New Delhi metallo-β-lactamase (NDM)-producing Providencia stuartii from Ukrainian patients among European countries.
Methods:

Whole-genome sequencing of 66 isolates sampled in 2022–2023 in 10 European countries enabled whole-genome multilocus sequence typing (wgMLST), identification of resistance genes, replicons, and plasmid reconstructions. Five blaNDM-1-carrying-P. stuartii isolates underwent antimicrobial susceptibility testing (AST). Transferability to Escherichia coli of a blaNDM-1-carrying plasmid from a patient strain was assessed. Epidemiological characteristics of patients with NDM-producing P. stuartii were gathered by questionnaire.
Results:

wgMLST of the 66 isolates revealed two genetic clusters unrelated to Ukraine and three linked to Ukrainian patients. Of these three, two comprised blaNDM-1-carrying-P. stuartii and the third blaNDM-5-carrying-P. stuartii. The blaNDM-1 clusters (PstCluster-001, n = 22 isolates; PstCluster-002, n = 8 isolates) comprised strains from seven and four countries, respectively. The blaNDM-5 cluster (PstCluster-003) included 13 isolates from six countries. PstCluster-001 and PstCluster-002 isolates carried an MDR plasmid harbouring blaNDM-1,blaOXA-10, blaCMY-16, rmtC and armA, which was transferrable in vitro and, for some Ukrainian patients, shared by other Enterobacterales. AST revealed PstCluster-001 isolates to be extensively drug-resistant (XDR), but susceptible to cefiderocol and aztreonam–avibactam. Patients with data on age (n = 41) were 19–74 years old; of 49 with information on sex, 38 were male.
Conclusion:

XDR P. stuartii were introduced into European countries, requiring increased awareness and precautions when treating patients from conflict-affected areas.
%K New Delhi metallo-β-lactamase
%K Providencia stuartii
%K Ukrainian patients
%K dissemination
%K war
%K 610 Medizin und Gesundheit
%I Robert Koch-Institut
%J Eurosurveillance - Europe's journal on infectious disease surveillance, epidemiology, prevention and control
%P 1--13
%R 10.2807/1560-7917.ES.2024.29.23.2300616