A study published late last week in Eurosurveillance describes the identification and rapid growth of a highly resistant Klebsiella pneumoniae strain in France.

The strain was identified from an analysis of clinical and screening specimens received by the French National Reference Center for Antibiotic Resistance (NRC) from June 2014 to June 2022. Of the 431 isolates of K pneumoniae sequence type (ST)147, which has been identified as a major public health threat owing to its high level of antibiotic resistance and increased virulence, 37 were non-duplicate New Delhi metallo-beta-lactamase (NDM)-14–producers.

The isolates were cultured from rectal swabs, urine samples, blood draws, respiratory tract samples, and wounds.

Although many other NDM variants, such as NDM-1 and NDM-5, were commonly found among the carbapenemase-producing K pneumoniae isolates over the study period, the first 6 NDM-14–producers appeared at NRC in 2021, with 31 collected in 2022.

Strain likely originated in Morocco

Whole-genome sequencing revealed that all the NDM-14­–producing isolates were closely related, part of the same cluster, and were associated with several hospital outbreaks in which the index patient was directly repatriated from Morocco, particularly the Casablanca region. Bayesian analysis estimated that the first NDM-14–producing K pneumoniae strain appeared in the country in 2020 and has rapidly evolved since then, with NDM-14 accounting for 41.3% of carbapenemases in K pneumoniae ST147 isolated collected by NRC in 2022.

Highly resistant NDM-14 producing K. pneumoniae can rapidly spread in healthcare settings.

Antimicrobial susceptibility testing showed that all NDM-14–producing isolates were highly resistant to all antimicrobials tested except colistin, cefiderocol, and the combination of aztreonam/avibactam, and 37 of 39 isolates possessed a high virulence score.

"Highly resistant NDM-14 producing K. pneumoniae can rapidly spread in healthcare settings," the study authors wrote. "Surveillance and thorough investigations of hospital outbreaks are critical to evaluate and limit the dissemination of this clone."

Minnesota and South Dakota reported more highly pathogenic avian flu outbreaks on turkey farms, and Iowa reported its first outbreak—also at a turkey farm—since March, according to notifications from federal and state agriculture agencies.

Minnesota reported two new outbreaks at commercial turkey producers, this time in Blue Earth and Redwood counties, according to the US Department of Agriculture (USDA) Animal and Plant Health Inspection Service (APHIS). Also, the state reported an outbreak on a poultry breeding farm in Becker County. As part of a recent small but steady uptick in outbreaks nationally, Minnesota has reported six outbreaks on commercial farms since early October.

South Dakota reported an outbreak at a turkey farm in Spink County, its fourth of the month. Also, the Iowa State Department of Agriculture and Land Stewardship announced on October 20 that high-path avian flu has been confirmed on a commercial turkey farm in Buena Vista County.

In other developments, Montana and Oregon reported outbreaks in poultry flocks, Oregon in Union County and Montana in Park County, apparently involving backyard birds, according to APHIS.

Since early 2022, the outbreaks have led to a record loss of 59.4 million birds across 47 states, including 10 over the past 30 days.

Bulgaria has reported a SARS-CoV-2 outbreak involving mustelids, an animal family that includes minks and other fur-bearing animals, at a farm in Stara Zagora in the central part of the country, according to a notification from the World Organization for Animal Health (WOAH).

The event began on October 20, with 98 cases reported among the 70,000 animals at the location. Tests at the National Diagnostic Research Veterinary Medical Institute in Sofia confirmed the findings the same day.

Bulgarian officials had proposed a ban on the breeding and importing of American mink in 2022 following reports of inhumane conditions on a farm in Stara Zagora, said to be the country’s largest such producer, according to a report in February from the Bulgarian News Agency.  However, the country suspended the plan following a legal appeal, EuroNews reported in June.

Minks are known to be a mixing vessel for respiratory viruses, and recent H5N1 avian flu outbreaks at fur farms in Finland have intensified calls to ban such farms, owing to pandemic risks. SARS-CoV-2 had been previously identified in farmed mink in the Netherlands and Denmark, and scientists have raised concerns about the possibility that wildlife species could be a reservoir for the virus. In 2020, Denmark detected a mutated coronavirus strain that passed from minks to people.