Emergence of OXA-48-like Carbapenemase-Producing Escherichia coli in Baranya County, Hungary

Mohamed, Fatma A.; Al-Bulushi, Mohamed; Melegh, Szilvia; Timmer, Bálint; Meszéna, Réka; Freytag, Csongor; Laczkó, Levente; Miló, László; Urbán, Péter; Bőkényné-Tóth, Renáta; Gyenesei, Attila; Kardos, Gábor; Nyul, Adrienn; Urbán, Edit; Pál, Tibor; Sonnevend, Ágnes

doi:10.3390/antibiotics15010044

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Emergence of OXA-48-like Carbapenemase-Producing Escherichia coli in Baranya County, Hungary

by

Fatma A. Mohamed

^1,2

,

Mohamed Al-Bulushi

¹,

Szilvia Melegh

¹

,

Bálint Timmer

^1,3

,

Réka Meszéna

¹,

Csongor Freytag

⁴,

Levente Laczkó

^4,5,

László Miló

³,

Péter Urbán

⁶

,

Renáta Bőkényné-Tóth

⁷,

Attila Gyenesei

⁶,

Gábor Kardos

^3,8,

Adrienn Nyul

¹,

Edit Urbán

¹,

Tibor Pál

¹ and

Ágnes Sonnevend

^1,9,*

¹

Department of Medical Microbiology, University of Pécs Medical School, 7624 Pécs, Hungary

²

Department of Microbiology and Immunology, Faculty of Pharmacy, Zagazig University, Zagazig 44519, Egypt

³

Centre for Metagenomics, Multidisciplinary Health Industry Coordination Institute, University of Debrecen, 4032 Debrecen, Hungary

⁴

Department of Bioinformatics, One Health Institute, Faculty of Health Sciences, University of Debrecen, 4032 Debrecen, Hungary

⁵

HUN-REN-UD Conservation Biology Research Group, University of Debrecen, 4032 Debrecen, Hungary

⁶

Hungarian Centre of Genomics and Bioinformatics, Szentágothai Research Center, University of Pécs, 7624 Pécs, Hungary

⁷

Department of Infection Control and Hospital Epidemiology, One Health Institute, Faculty of Health Sciences, University of Debrecen, 4032 Debrecen, Hungary

⁸

Department of Planetary Health, One Health Institute, Faculty of Health Sciences, University of Debrecen, 4032 Debrecen, Hungary

⁹

Molecular Medicine Research Group, Szentágothai Research Center, University of Pécs, 7624 Pécs, Hungary

^*

Author to whom correspondence should be addressed.

Antibiotics 2026, 15(1), 44; https://doi.org/10.3390/antibiotics15010044

Submission received: 20 November 2025 / Revised: 23 December 2025 / Accepted: 29 December 2025 / Published: 2 January 2026

(This article belongs to the Section Genetic and Biochemical Studies of Antibiotic Activity and Resistance)

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Abstract

Background: Carbapenem-resistant Escherichia coli (CREC) producing OXA-48-like carbapenemase was first detected in Hungary in 2022. The aim of the present study was to characterize such strains isolated in 2022–2025 in Baranya County, Hungary. Methods: Antibiotic susceptibility and the whole-genome sequence (WGS) of E. coli isolates, identified as OXA-48-like carbapenemase producers using the CARBA-5 NG test, were established. The transferability of bla_OXA-48-like plasmids was tested by conjugation. Results: Of the 6722 non-repeat E. coli isolates, 6 produced an OXA-48-like carbapenemase. They exhibited variable resistance to ertapenem and were susceptible to imipenem and meropenem. WGS revealed that all OXA-48-like producer E. coli belonged to high-risk clones: two clonally related OXA-181-producer E. coli ST405 were isolated in Hospital A, three OXA-244-producing E. coli ST38 (two identical via cgMLST from Hospital B), and an OXA-48-producing E. coli ST69. The bla_OXA-48 and bla_OXA-244 genes were chromosomally located, while bla_OXA-181 was on a non-conjugative IncFIB-IncFIC plasmid. So far, the bla_OXA-181-bearing plasmid of this incompatibility type has only been described in Ghana, but all bla_OXA-48-like gene-carrying transposons in this study have already been identified in Europe and other continents. The E. coli ST38 isolates, showing close association based on core genome SNP distances to European and Qatari strains, belonged to Cluster A and harbored bla_CTX-M-27. All but the E. coli ST69 isolate had cephalosporinase gene(s). Conclusions: This study describes small-scale intra-hospital transfers of OXA-48-like carbapenemase-producer E. coli. Interestingly, E. coli ST405 of Hungary carried bla_OXA-181 on an IncFIB-IncFIC plasmid, which has only been reported from Africa so far.

Keywords: OXA-48-like carbapenemases; Escherichia coli; high-risk clones; IncFIB-IncFIC plasmid; Hungary

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MDPI and ACS Style

Mohamed, F.A.; Al-Bulushi, M.; Melegh, S.; Timmer, B.; Meszéna, R.; Freytag, C.; Laczkó, L.; Miló, L.; Urbán, P.; Bőkényné-Tóth, R.; et al. Emergence of OXA-48-like Carbapenemase-Producing Escherichia coli in Baranya County, Hungary. Antibiotics 2026, 15, 44. https://doi.org/10.3390/antibiotics15010044

AMA Style

Mohamed FA, Al-Bulushi M, Melegh S, Timmer B, Meszéna R, Freytag C, Laczkó L, Miló L, Urbán P, Bőkényné-Tóth R, et al. Emergence of OXA-48-like Carbapenemase-Producing Escherichia coli in Baranya County, Hungary. Antibiotics. 2026; 15(1):44. https://doi.org/10.3390/antibiotics15010044

Chicago/Turabian Style

Mohamed, Fatma A., Mohamed Al-Bulushi, Szilvia Melegh, Bálint Timmer, Réka Meszéna, Csongor Freytag, Levente Laczkó, László Miló, Péter Urbán, Renáta Bőkényné-Tóth, and et al. 2026. "Emergence of OXA-48-like Carbapenemase-Producing Escherichia coli in Baranya County, Hungary" Antibiotics 15, no. 1: 44. https://doi.org/10.3390/antibiotics15010044

APA Style

Mohamed, F. A., Al-Bulushi, M., Melegh, S., Timmer, B., Meszéna, R., Freytag, C., Laczkó, L., Miló, L., Urbán, P., Bőkényné-Tóth, R., Gyenesei, A., Kardos, G., Nyul, A., Urbán, E., Pál, T., & Sonnevend, Á. (2026). Emergence of OXA-48-like Carbapenemase-Producing Escherichia coli in Baranya County, Hungary. Antibiotics, 15(1), 44. https://doi.org/10.3390/antibiotics15010044

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Emergence of OXA-48-like Carbapenemase-Producing Escherichia coli in Baranya County, Hungary

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