Carbapenemase-producing (OXA-48) Klebsiella pneumoniae ST392 found in travellers previously hospitalised in Gran Canaria, Spain
Thirteen patients with OXA-48-producing Klebsiella pneumoniae ST392 have been reported by Sweden and Norway between January and April 2018 - all returning travellers with prior hospital admission in Gran Canaria. Whole genome sequencing showed tight clustering between the bacterial isolates from the cases.
According to ECDC’s risk assessment published today, the risk for individual travellers to acquire OXA-48-producing K. pneumoniae ST392 of the Gran Canaria cluster without healthcare contact is very low. However, if carriers of the bacteria are admitted to a hospital in their country of origin, there is a high risk for further transmission and outbreaks if carriage is not detected and if adequate infection prevention and control measures are not in place.
Whole genome sequencing analysis indicates a common place of acquisition for the cases. Given the large number of tourists visiting Gran Canaria, one hospital may become the source of spread to other European countries when patients are transferred from one country to another, making this cluster a cross-border threat, states the report.
In 2016, more than 15 million of EU/EEA citizens mainly from Spain, the UK and Germany, travelled to the Canary Islands, according to International Air Transport Association.
OXA-48-producing K. pneumoniae is a resistant bacterium typically acquired in healthcare settings. Hospitalisation abroad and cross-border transfer of patients are well known modes of introduction of carbapenemase-producing Enterobacteriaceae (CPE), including OXA-48-producing K. pneumoniae ST392, into countries with lower prevalence.
The report suggests that hospitals in EU/EEA countries should consider taking, at hospital admission, a detailed history of all travels and hospitalisations of the patient. All patients who are directly transferred or were hospitalised in a foreign country 12 months prior to hospital admission may be considered for screening, regardless of the CPE prevalence at place of hospitalisation.
Read ECDC's risk assessment
Rapid risk assessment: Carbapenemase-producing (OXA-48) Klebsiella pneumoniae ST392 in travellers previously hospitalised in Gran Canaria, Spain
This rapid risk assessment evaluates the risk of transmission and further spread of OXA-48-producing Klebsiella pneumonia e ST392 from travellers having sought medical care in Gran Canaria to healthcare facilities in their country of origin in the EU/EEA.
The European Union Summary Report on Antimicrobial Resistance in zoonotic and indicator bacteria from humans, animals and food in 2017/2018
Rapid risk assessment: Increase in OXA -244 -producing Escherichia coli in the European Union/European Economic Area and the UK since 2013
Combined clonal and plasmid-mediated outbreak of carbapenemase-producing Enterobacterales, Lithuania, 2019–2020
Approximately 4 100 000 patients are estimated to acquire a healthcare-associated infection in the EU each year. The number of deaths occurring as a direct consequence of these infections is estimated to be at least 37 000 and these infections are thought to contribute to an additional 110 000 deaths each year.Read more
Antimicrobial resistance is the ability of a microorganism (e.g., a bacterium, a virus) to resist the action of an antimicrobial agent. The major cause of antimicrobial resistance remains the use of antimicrobials in human medicine.Read more