First Report of an OXA-48-Producing Multidrug-Resistant Proteus

We report the first multidrug-resistant Proteus mirabilis strain producing the carbapenemase OXA-48 (Pm-OXA-48) isolated at Al-Shifa hospital in Gaza, Palestine. Draft genome sequencing of Pm-OXA-48 identified 16 antimicrobial resistance genes, en-coding resistance to-lactams, aminoglycosides, fluoroquinolones, phenicols, streptothricin, tetracycline, and trimethoprim-sulfamethoxazole. Complete sequencing of the blaOXA-48-harboring plasmid revealed that it is a 72 kb long IncL/M plasmid, har-boring carbapenemase gene blaOXA-48, extended spectrum-lactamase gene blaCTX-M-14, and aminoglycoside resistance genes strA, strB, and aph(3=)-VIb. Carbapenemase-producing Enterobacteriaceae (CRE) havespread worldwide and caused a significant public health alert (1, 2). However, our understanding of the dissemination of CRE in isolated regions, including the Palestinian territories, is limited. Here we report an OXA-48 type carbapenemase-producing Pro-teus mirabilis strain from Gaza, Palestine. OXA-48 was first iden-tified in a Klebsiella pneumoniae strain isolated in Turkey in 2001 (3). Recently, OXA-48 has been reported in a number of countries in Europe, North Africa, and theMiddle East, and it is regarded as endemic in certain areas (1, 4). blaOXA-48 has also been found i