Outbreak of carbapenemase-producing and colistin-resistant Klebsiella pneumoniae in Germany

05 November 2019

Article: 53/4406

The European Centre for Disease Prevention and Control (ECDC) has reported an outbreak of carbapenemase-producing (NDM-1 and OXA-48) and colistin-resistant Klebsiella pneumoniae sequence type (ST) 307 in North-East Germany.

As of 21 October 2019, 17 patients in three hospitals and one rehabilitation clinic in Mecklenburg-West Pomerania had been affected. Six of the 17 cases presented with clinical symptoms of infection, while 11 were identified as carriers.

This is the first reported outbreak in Germany of K. pneumoniae that produce both NDM-1 and OXA-48 while also involving the emerging clone ST307. The outbreak strain is closely related to a K. pneumoniae ST307 isolate producing the same carbapenemases detected earlier in Finland from a patient previously hospitalised in Russia, yet there is no epidemiological link between the Finnish case and the outbreak in Germany.

K. pneumoniae ST307 is a high-risk clone which is expanding globally, including in the EU/EEA. The specific German outbreak strain carries virulence markers associated with increased ability to cause disease. Genetic characteristics related to a potential survival advantage in the environment have also been described for K. pneumoniae ST307. 

The combination of extensive antimicrobial resistance, increased virulence and capacity to persist in the environment result in a high risk for dissemination and future healthcare-associated outbreaks of this K. pneumoniae ST307 outbreak strain in hospitals and other healthcare settings. 

However, the risk of transmission for individuals outside healthcare settings is low. Enhanced control measures have been implemented in the involved German hospitals, and no further cases have been detected since the end of September 2019.

Source: ECDC, 28 October 2019