TY - JOUR
T1 - Performance of carbapenemase screening algorithms for detection of OXA-244-producing Escherichia coli
AU - Keizer, Keziah N.
AU - Harryvan, Tom J.
AU - Maat, Ianthe
AU - Vainio, Saraa J.
AU - Vlek, Anne L.M.
AU - Melles, Damian C.
AU - Rentenaar, Rob J.
AU - Groothuis, Daphne E.
AU - Kluytmans, Jan A.J.W.
AU - Frakking, Florine N.J.
N1 - Publisher Copyright:
© The Author(s) 2026. Published by Oxford University Press on behalf of British Society for Antimicrobial Chemotherapy. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact [email protected] for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact [email protected].
PY - 2026/8
Y1 - 2026/8
N2 - Objectives: OXA-244-producing Escherichia coli emerge in Europe and are difficult to detect. We evaluated the performance of different carbapenemase-producing Enterobacterale (CPE) screening and confirmation protocols used across five clinical microbiology laboratories in the Netherlands for the detection of OXA-244-producing E. coli isolates. Methods: Twelve E. coli isolates (CPE n = 9, non-CPE-ESBL n = 3) containing blaOXA-244 (n = 5), blaOXA-48(n = 1), blaOXA-181 (n = 1), blaKPC-2 (n = 1) and blaNDM-5 (n = 1) were distributed to five laboratories. Laboratories performed identification, susceptibility tests and subsequent additional tests for resistance mechanisms in accordance with their local CPE screening and confirmation protocol which all adhered to the current Dutch guideline for CPE detection. Results: All laboratories correctly detected no carbapenemase in three E. coli isolates without carbapenemase genes and correctly determined the E. coli isolates with blaKPC-2 and blaNDM-5 as CPE. Detection rates of carbapenemase among the five E. coli isolates with blaOXA-244 ranged from 0/5 (0%) to 4/5 (80%) isolates. One E. coli isolate with blaOXA-244, a meropenem MIC ≤0.125 mg/L and an imipenem MIC ≤0.25 mg/L was not detected by any laboratory. Discussion: Differences in CPE screening and confirmation protocols across five laboratories contributed to inconsistent detection of OXA-244-producing E. coli. Laboratories that used a gradient strip test confirmed meropenem minimum inhibitory concentration (MIC) >0.25 mg/L CPE screening breakpoint detected fewer or no OXA-244-producing E. coli strains than laboratories that implemented additional measures in their CPE screening protocols. A key recommendation is that laboratories evaluate whether the performance of their CPE screening protocol remains adequate, considering the current epidemiology of emerging difficult-to-detect OXA-244-producing E. coli.
AB - Objectives: OXA-244-producing Escherichia coli emerge in Europe and are difficult to detect. We evaluated the performance of different carbapenemase-producing Enterobacterale (CPE) screening and confirmation protocols used across five clinical microbiology laboratories in the Netherlands for the detection of OXA-244-producing E. coli isolates. Methods: Twelve E. coli isolates (CPE n = 9, non-CPE-ESBL n = 3) containing blaOXA-244 (n = 5), blaOXA-48(n = 1), blaOXA-181 (n = 1), blaKPC-2 (n = 1) and blaNDM-5 (n = 1) were distributed to five laboratories. Laboratories performed identification, susceptibility tests and subsequent additional tests for resistance mechanisms in accordance with their local CPE screening and confirmation protocol which all adhered to the current Dutch guideline for CPE detection. Results: All laboratories correctly detected no carbapenemase in three E. coli isolates without carbapenemase genes and correctly determined the E. coli isolates with blaKPC-2 and blaNDM-5 as CPE. Detection rates of carbapenemase among the five E. coli isolates with blaOXA-244 ranged from 0/5 (0%) to 4/5 (80%) isolates. One E. coli isolate with blaOXA-244, a meropenem MIC ≤0.125 mg/L and an imipenem MIC ≤0.25 mg/L was not detected by any laboratory. Discussion: Differences in CPE screening and confirmation protocols across five laboratories contributed to inconsistent detection of OXA-244-producing E. coli. Laboratories that used a gradient strip test confirmed meropenem minimum inhibitory concentration (MIC) >0.25 mg/L CPE screening breakpoint detected fewer or no OXA-244-producing E. coli strains than laboratories that implemented additional measures in their CPE screening protocols. A key recommendation is that laboratories evaluate whether the performance of their CPE screening protocol remains adequate, considering the current epidemiology of emerging difficult-to-detect OXA-244-producing E. coli.
UR - https://www.scopus.com/pages/publications/105045225403
U2 - 10.1093/jacamr/dlag139
DO - 10.1093/jacamr/dlag139
M3 - Article
C2 - 42488792
AN - SCOPUS:105045225403
SN - 2632-1823
VL - 8
JO - JAC-antimicrobial resistance
JF - JAC-antimicrobial resistance
IS - 4
M1 - dlag139
ER -