Contaminated dicloxacillin capsules as the source of an NDM-5/OXA-48-producing Enterobacter hormaechei ST79 outbreak, Denmark and Iceland, 2022 and 2023
Charlotte Nielsen Agergaard, Lone Jannok Porsbo, Thomas Vognbjerg Sydenham, S. Hansen, Kat Steinke, Sanne Løkkegaard Larsen, Kristján Orri Helgason, Frank Hansen, Kasper Thystrup Karstensen, Anna Emilie Henius, Barbara Juliane Holzknecht, Lillian Marie Søes, Kristian Schønning, Mikala Wang, Nina Ank, Anna Margrét Halldórsdóttir, Ólafur Guðlaugsson, Anette M. Hammerum, Anne Kjerulf, Brian Kristensen, Henrik Hasman, Ulrik Stenz Justesen
Abstract
From October 2022 through January 2023, nine patients with NDM-5/OXA-48-carbapenemase-producing Enterobacter hormaechei ST79 were detected in Denmark and subsequently one patient in Iceland. There were no nosocomial links between patients, but they had all been treated with dicloxacillin capsules. An NDM-5/OXA-48-carbapenemase-producing E. hormaechei ST79, identical to patient isolates, was cultured from the surface of dicloxacillin capsules in Denmark, strongly implicating them as the source of the outbreak. Special attention is required to detect the outbreak strain in the microbiology laboratory.