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Eurosurveillance, Volume 20, Issue 41, 15 October 2015 Rapid communication
ISOLATION OF AN NDM-5-PRODUCING ST16 KLEBSIELLA PNEUMONIAE FROM A DUTCH PATIENT WITHOUT TRAVEL HISTORY ABROAD, AUGUST 2015
A New Delhi Metallo-beta-lactamase-5 (NDM-5)-producing ST16 Klebsiella pneumoniae strain was isolated from a Dutch patient in a long-term care facility without recent travel history abroad. Core genome multilocus sequence typing (cgMLST) revealed that the Dutch isolate was clonally related to isolates detected in four patients in Denmark in 2014. Public health experts and clinicians need to be informed; repetitive screening may be needed in patients without known risk factors for carbapenemases-producing Enterobacteriaceae who have undergone antibiotic treatment.
We report the sporadic detection of an NDM-5-producing K. pneumoniae from a Dutch patient with no risk factors for acquisition. The origin of the strain is unknown. Similar cases have been presented in Denmark with clonally related isolates. There were no known direct epidemiological links between the Danish patients and our case: the Danish positive cases did not travel to the Netherlands, and in our long-term care facility, no Danish patients were hospitalised during the past year. Unknown links or a common source may be the reason for the clonality of this rare isolate.
Another explanation might be that the clonal strains have been acquired from a foodborne source. Escherichia colicarrying bla[SUB]NDM-5[/SUB], bla[SUB]CTX-M[/SUB] and bla[SUB]TEM[/SUB] have been reported as cause of mastitis in cows, suggesting that bla[SUB]NDM-5[/SUB]-carrying plasmids might enter the food chain. Moreover, contamination of retail chicken meat with K. pneumoniaeproducing a combination of NDM, CTX-M-15, TEM, and SHV-1 has recently been reported [16]. Typing of bla[SUB]NDM[/SUB], plasmid, and MLST of these isolates may reveal a link with a foodborne source.
