Diversification of bla OXA-48-harbouring plasmids among carbapenemase-producing Enterobacterales, 11 years after a large outbreak in a general hospital in the Netherlands

This study investigates the dynamics of the 2011 outbreak-associated bla OXA-48 plasmid among carbapenemase-producing Enterobacterales (CPE) in a large Dutch hospital. A selection of 86 bla OXA-48-carrying CPE isolates was made from 374 isolates collected over an 11-year period. Short-read sequencing and long-read sequencing were performed to reconstruct bla OXA-48-like plasmids and chromosomes of CPE. Results showed that the 2011 outbreak-associated bla OXA-48 plasmid was found in Cfr, Ecl, Eco, Kpn, and Mmo, and was identified as LR025105 as the MASH nearest neighbor. From 2014 onwards, 11 other types of bla OXA-48-carrying plasmids with different antibiotic-resistant genes and replicons were discovered.