Emerging OXA-484 carbapenemase involved in a mother-to-child-E. coli infection and detection concerns

Infections transmitted from mother to child involving carbapenemase-producing Enterobacterales, particularly in Europe, are rare and are not well documented globally. The OXA- 48 type carbapenemases, which include widespread variants like OXA-48 and OXA-181, are the most commonly identified, while the newly characterized OXA-484 remains uncommon. This report highlights a case of mother-to-child transmission of an OXA-484-producing Escherichia coli, involving four strains isolated from the mother (from urine and placenta) and the newborn who developped early onset sepsis and later, a urinary tract infection. This case is the first described in France, illustrated the challenges in detecting infections involving the emergent OXA-484 variant and raises concerns about potentially missing similar cases.