ECDC rapid risk assessment: increase in OXA-233 producing E.coli in the EU, EEA and UK since 2013

27 July 2021

Article: 55/3005

The European Centre for Disease Prevention and Control (ECDC) has published an update to an existing risk assessment, first produced in response to evidence of healthcare associated transmission of OXA-244 producing Escherichia coli (E. coli) in the EU and EEA. A doubling of cases in the main cluster, and three new countries detecting cases, confirm the high risk for further spread of OXA-244 producing E. coli.

An urgent enquiry was made to ECDC’s Epidemic Intelligence Information System (EPIS), regarding a healthcare-associated outbreak involving 12 cases of OXA-244 producing E. coli in Norway. Subsequently, national public health reference laboratories in EU and EEA countries were invited to submit to ECDC whole genome sequencing (WGS) data, collected since the previous rapid risk assessment was published on 18 February 2020.

The analysis included WGS data submitted to ECDC from 13 countries, completed with data from the public domain. Among 458 isolates of E. coli ST38, 370 carried the blaOXA-244 gene encoding for the OXA-244 carbapenemase. Several clusters were identified, including one large cluster with 225 closely-related OXA-244-producing E. coli ST38 isolates. Of these, 210 isolates were detected in 11 EU and EEA countries and the UK, and 15 isolates were from other countries.

The source and route of transmission for OXA-244-producing E. coli in the EU, EEA and UK is currently unclear, and there is a need for further investigation to determine this so that control measures can be put in place. The wide geographical dispersion of cases within countries, without cases being linked in place and time, indicates transmission in the community as the main mode of spread.

Source: ECDC, 20 July 2021