Denmark: Outbreak of carbapenemase-producing ST79 Enterobacter hormaechei, May be linked to Dicillin antibiotic


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11 patients were found positive with a unique type of bacteria intestinal hormone . What the patients had in common was that they took dicloxacillin in capsules from the same manufacturer.


Carbapenemase-producing organisms (CPO) are a group of bacteria that are difficult to treat because they are resistant to antibiotics that are commonly used to treat serious infections.

From October 2022 to January 2023, 9 CPO patients with the same unique epitype were enrolled: 2 cases in October 2022, 2 cases in December 2022 and 5 cases in January 2023. The cases are unrelated to each other, there was no suspicion that the infection occurred in the hospital or while traveling. The detected epitype was so unique and distinctive that clinical microbiology departments were contacted to clarify the cause of the outbreak.

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The Department of Clinical Microbiology at Odense University Hospital then noted that 3 patients who had tested positive in their laboratory had received treatment with Decillin. ® capsules shortly before the outbreak was discovered. They checked unopened packets of Dicillin ® And it found that CPO bacteria can grow from the surface of a capsule of Dicillin ® 500 mg. Furthermore, other clinical microbiology departments and the SSI were able to confirm that all patients had been prescribed Dicillin ® From the same manufacturer prior to the positive test result for the epitype.

On this basis, the manufacturer of the drug Sandoz recalled Decylene ® .

The Statens Serum Institute (SSI) has not recorded any more cases with the outbreak strain, other than the two additional results in fall 2020.

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