Outbreak of aztreonam–avibactam-resistant NDM-5-producing Escherichia coli isolates in a hospital of Paris

Microbiology Spectrum

卷:14

Research Article

Véronique Faraut Derouin¹  Bérénice Souhail^2,3  Caroline Charlier^2,3,4,5  Sébastien Gaultier²  Etienne Canoui²  Anne Sorieul¹  Daria Menuet¹  Hélène Poupet⁶  Laurence Armand-Lefèvre^3,7,8  Eve-Marie Walle^3,7,8  Delphine Desbois⁹  Alexandra Doloy⁶  Philippe C. Morand^3,6,10  Claire Poyart^3,6,10  Romain Coriat^3,11  Asmaa Tazi^3,5,6,10,12  Hedi Mammeri^3,6,10 

[1] FHU PREM’Impact, Paris, France

[2] Department of Gastroenterology and Digestive Oncology, Cochin Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France

[3] Hôpitaux Universitaires Paris Centre, Site Cochin, Service de Bactériologie, Assistance Publique Hôpitaux de Paris, Paris, France

[4] Center hospitalier de Rambouillet, Laboratoire d’analyses de biologie médicale, Rambouillet, France

[5] Centre national de référence français et Centre collaborateur de l’OMS pour la Listeria, Institut Pasteur, Paris, France

[6] Hôpitaux universitaires Paris Nord Val de Seine, Site Bichat, Laboratoire de Bactériologie, Assistance Publique Hôpitaux de Paris, Paris, France

[7] Hôpitaux Universitaires Paris Centre, Site Cochin, Equipe mobile d’infectiologie, Assistance Publique Hôpitaux de Paris, Paris, France

[8] Université Paris Cité, INSERM U1016, CNRS UMR8104, Institut Cochin, Paris, France

[9] Centre National de Référence des Streptocoques, Hôpital Cochin, Paris, France

[10] INSERM UMR 1137 IAME, Université Paris Cité, Paris, France

[11] Hôpitaux Universitaires Paris Centre, Site Cochin, Service d’Hygiène hospitalière, Assistance Publique Hôpitaux de Paris, Paris, France

[12] Université Paris Cité, Paris, France

关键词: duodenoscope;    ERCP;    ST405;    outbreak;    avibactam;    aztreonam;    resistance;    cefiderocol;    carbapenem;    PBP3;    DHA;    NDM-5;    Escherichia coli;   

DOI  :  10.1128/spectrum.01672-26

 received in 2026-05-14, accepted in 2026-07-17,  发布年份 2026

来源: American Society for Microbiology

【 摘 要 】

ABSTRACTThe emergence of aztreonam–avibactam resistance among NDM-producing Escherichia coli represents a major therapeutic and infection control concern. Four cases of aztreonam–avibactam-resistant (AZAR) NDM-producing E. coli, recovered from three blood cultures and one rectal surveillance culture in a hospital of Paris, prompted an investigation based on whole-genome sequencing. The three isolates responsible for bloodstream infection, which were clonally related, belonged to the ST405 and produced NDM-5, DHA-1, CTX-M-15, and TEM-1 β-lactamases. They also had a penicillin-binding protein 3 (PBP3) modified by the insertion of four amino acids (YRIK). On the other hand, the isolate recovered from the rectal swab belonged to another sequence type (ST2083). It produced NDM-5, CMY-42, and TEM-1 β-lactamases and had an altered PBP3 by the insertion of four other residues (YRIN). Epidemiological investigation identified endoscopic retrograde cholangiopancreatography as a potential risk factor, leading to the detection of three additional patients infected with the ST405 clone after exposure to the same duodenoscope. The outcome of the bloodstream infections was favorable except for one patient. In total, seven patients infected or colonized by AZAR NDM-5-producing E. coli were identified over a 5-month period in 2025, six with duodenoscope exposure.IMPORTANCEThis study underlines the emergence of aztreonam–avibactam resistance among NDM-producing Escherichia coli isolates in France. To our knowledge, this report describes the first clonal outbreak due to aztreonam–avibactam-resistant NDM-producing E. coli.

【 授权许可】

CC BY   
Copyright © 2026 Faraut Derouin et al.

【 图 表 】

Figure 1

Figure 8