Emergence of OXA-48 and OXA-181 Carbapenemases among Enterobacteriaceae in South Africa and Evidence of In Vivo Selection of Colistin Resistance as a Consequence of Selective Decontamination of the Gastrointestinal Tract

This study reports on the emergence of OXA-48-like carbapenemases among isolates of Enterobacteriaceaein South Africa. In addition, the emergence during therapy of a colistin-resistant OXA-181-producing Klebsiella pneumoniaeisolate was documented following selective digestive tractdecontamination with oral colistin, which is therefore strongly discouraged.