CTX-M-15 Positive Escherichia coli and Klebsiella pneumoniae Outbreak in the Neonatal Intensive Care Unit of a Maternity Hospital in Ha’il, Saudi Arabia

Al-Mogbel, Mohammed S.; Altheban, Ahmed; Alenezi, Mohammed N.; Al-Motair, Khalid; Menezes, Godfred Antony; Elabbasy, Mohamed Tharwat; Hammam, Sahar; Hays, John P.; Khan, Mushtaq Ahmad

doi:10.2147/idr.s317079

Cited by 8 publications

(4 citation statements)

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“…CRKP is a serious threat in paediatric patients, particularly newborns, due to limited therapeutic options. 26,27 This pathogen is now considered as a reservoir for virulent and resistant genes, due to the acquisition of β-lactamase (carbapenemase and ESBLs) and the recently reported colistin resistance mcr-1 encoding genes; which make it a serious threat to human and animal. [28][29][30] These data revealed for the first time that NDM carbapenemase is widely spread among CRKP, while CTX-M and SHV were the most prevalent βlactamase in same isolates in Shenzhen's children Hospital, China.…”

Section: Discussionmentioning

confidence: 99%

Emergence of Klebsiella pneumoniae ST307 Co-Producing CTX-M with SHV and KPC from Paediatric Patients at Shenzhen Children’s Hospital, China

Patil

Chen

Guo

et al. 2021

IDR

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Aim:We investigated the clonal diversity of carbapenemase-producing Klebsiella pneumoniae isolates from the Shenzhen Children's Hospital, China, and drew conclusions on the clinical and public health impact of these isolates as multidrug-resistant. Methods: From January 2014 to December 2018, a total number of 36 unique carbapenemase-producing clinical isolates of Klebsiella pneumoniae were collected out of 900 clinical isolates in paediatric patients from the Shenzhen Children's Hospital, China. After carbapenemase production confirmation, antimicrobial susceptibility, resistance determinants and phylogenetic relationship were determined. Results: The isolates showed resistance to ceftazidime, ertapenem, ampicillin, cefazolin, ceftriaxone, cefotetan, ticarcillin, cefaclor, cefpodoxime, azlocillin, cefcapene, mezlocillin and ampicillin-sulbactam. Of the 36 Klebsiella pneumoniae carbapenemase genes coding isolates, bla NDM was the mostly detected 50% (n=18) followed by bla KPC and bla IMP 19% (n=7), bla VIM 17% (n=6), bla OXA-48-like 8% (n=3) and bla SME 5% (n=2), whereas extended-spectrum β-lactamase (bla SHV ) was predominantly detected 92% (n=33) followed by bla CTX-M 53% (n=19) and bla CMY 28% (n=10). Pulsed-field gel electrophoresis typing showed eight different patterns, and twenty-five distinct sequences types were observed with ST307 being predominantly identified 11% (n=4), followed by ST2407 8% (n=3). Plasmid replicon typing results indicated that IncFIS, IncHI2, IncFIC and IncFIA plasmids carry bla CTX-M, bla SHV and bla NDM genes. Conclusion:This study reports on the occurrence and spread of carbapenemase and extended-spectrum β-lactamase encoding genes co-existence in sporadic Klebsiella pneumoniae ST307 in paediatric patients from the Shenzhen Children's Hospital, China.

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Section: Discussionmentioning

confidence: 99%

Emergence of Klebsiella pneumoniae ST307 Co-Producing CTX-M with SHV and KPC from Paediatric Patients at Shenzhen Children’s Hospital, China

Patil

Chen

Guo

et al. 2021

IDR

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“…SAUDI ARABIA: A retrospective research of 72 (24 E. coli and 48 K. pneumoniae ) suspected Neonatal Intensive Care Unit (NICU) outbreaks in Ha’il in 2014 showed that the majority of isolates (61 of E. coli and K. pneumoniae ) were ESBL-positive, with high-level resistance to oxyimino-cephalosporins via the simultaneous production of bla CTX-M-15 and bla SHV-12 . All K. pneumoniae isolates (42) were ST14, and all E. coli isolates (19) were ST131 [ 19 ]. Records from 2016 of a medical complex in Dammam (Eastern region of Saudi Arabia) showed that the ESBL isolates comprised 50% of the 176 E. coli and 42.1% of the 148 K. pneumoniae isolates [ 20 ].…”

Section: Resultsmentioning

confidence: 99%

Extended Spectrum- and Carbapenemase-Based β-Lactam Resistance in the Arabian Peninsula—A Descriptive Review of Recent Years

et al. 2022

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Antimicrobial resistance (AMR) is a global problem that also includes countries of the Arabian Peninsula. Of particular concern, is the continuing development of extended-spectrum β-lactamases (ESBLs) in the countries of this region. Additionally, antibiotic treatment options for ESBL-producing bacteria are becoming limited, primarily due to the continuing development of carbapenem resistance (CR), carbapenems being frequently used to treat such infections. An overview of recent publications (2018–2021) indicates the presence of ESBL and/or CR in patients and hospitals in most countries of the Arabian Peninsula, although the delay between microbial isolation and publication inevitably makes an accurate analysis of the current situation rather difficult. However, there appears to be greater emphasis on CR (including combined ESBL and CR) in recent publications. Furthermore, although publications from Saudi Arabia are the most prevalent, this may simply reflect the increased interest in ESBL and CR within the country. Enhanced ESBL/CR surveillance is recommended for all countries in the Arabian Peninsula.

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“…Among carbapenem-resistant E. coli, a study from Saudi Arabia showed a 60% prevalence rate of ESBL E. coli among E. coli infections (Al-Agamy et al, 2018). Higher prevalence rates were noted in ICU patients, especially among infants, at 79.2% (Almogbel et al, 2021).…”

Section: E Colimentioning

confidence: 99%

Prevalence and genetic characterization of clinically relevant extended-spectrum β-lactamase-producing Enterobacterales in the Gulf Cooperation Council countries

Hadi,

Al-Hail,

Aboidris

et al. 2023

Front. Antibiot.

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IntroductionAmong Gram-negative bacteria (GNB), Enterobacterales (Enterobacterales), such as Escherichia coli (E. coli) and Klebsiella pneumoniae (K. pneumoniae), are the most clinically relevant pathogens in healthcare settings. Infections secondary to these pathogens are widely common but multidrug resistance (MDR) in Enterobacterales has become a significant challenge with increased morbidity, mortality, and cost of management. The escalating global prevalence of MDR in Enterobacterales has led to limited treatment options, raising an urgent need for novel antimicrobial therapy(s) and detailed studies exploring underlying resistance mechanisms. In Enterobacterales, the prime antimicrobial resistance mechanism against β-lactam antibiotics is mainly the production of β-lactamases, particularly extended-spectrum β-lactamases (ESBLs). Although the Gulf region is witnessing major challenges from infections secondary to MDR GNB, the extent of the problem has not been fully evaluated. Therefore, this review aims to address the prevalence and genetic characterization of ESBL-producing Enterobacterales in the Gulf Cooperation Council (GCC) countries.MethodsPubMed® (National Library of Medicine, Bethesda, MD, USA) search was conducted, which looked for academic articles discussing the epidemiology of MDR Enterobacterales in the GCC countries, published in the last 5 years.Results and conclusionsIn GCC countries there is a high prevalence rate of MDR Enterobacterales, particularly ESBLs. Prevalence rates of ESBL-producing Enterobacterales among the Enterobacterales in general clinical samples in the GCC region is 21.6%–29.3%, with a slightly higher prevalence rate in intensive care unit patients (17.3–31.3%) and in patients with urinary tract infections (25.2%–31.7%). ESBL carriers have also been noted in the general community. ESBL-producing Enterobacterales from the GCC region show high levels of resistance to ampicillin, aztreonam, third-/fourth-generation cephalosporins, fluoroquinolones, and trimethoprim-sulfamethoxazole. Intermediate resistance rates are observed against nitrofurantoin, piperacillin/tazobactam, and gentamicin, with increasing resistance observed against tigecycline. The isolates demonstrate low-level resistance to carbapenems, fosfomycin, colistin, and amikacin. Enterobacterales isolates that are concomitant ESBL producers and are carbapenem resistant have been increasingly reported and demonstrate alarmingly increased antibiotic resistance patterns compared with ESBL Enterobacterales. The most prevalent genes for ESBL resistance in the Enterobacterales isolates in the GCC region are: blaCTX-M (subtype group 1) followed by/co-dominated by blaTEM and blaSHV, whereas the most common carbapenem-resistant genes are blaOXA-48 and blaNDM-1.

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CTX-M-15 Positive Escherichia coli and Klebsiella pneumoniae Outbreak in the Neonatal Intensive Care Unit of a Maternity Hospital in Ha’il, Saudi Arabia

Cited by 8 publications

References 30 publications

Emergence of Klebsiella pneumoniae ST307 Co-Producing CTX-M with SHV and KPC from Paediatric Patients at Shenzhen Children’s Hospital, China

Emergence of Klebsiella pneumoniae ST307 Co-Producing CTX-M with SHV and KPC from Paediatric Patients at Shenzhen Children’s Hospital, China

Extended Spectrum- and Carbapenemase-Based β-Lactam Resistance in the Arabian Peninsula—A Descriptive Review of Recent Years

Prevalence and genetic characterization of clinically relevant extended-spectrum β-lactamase-producing Enterobacterales in the Gulf Cooperation Council countries

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