Fecal Carriage and Molecular Characterization of Carbapenemase-Producing Enterobacterales in the Pediatric Population in Qatar

Abstract

To the best of our knowledge, this is the first study addressing the molecular characteristics of CPE in a pediatric population in Qatar using whole-genome sequencing. Since several countries in the Arabian Peninsula share relatively similar demographic patterns and international links, it is plausible that the molecular characteristics of CPE in children, at least in the middle and eastern parts of the region, are similar to those observed in our study.

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

“…Genetic characterization of the 72 isolates indicated the presence of bla NDM-5 (30.8%), bla NDM-1 (19.2%), and bla OXA-181 (19.2%). The authors referred to the apparent sporadic introduction of antibiotic resistance within the healthcare setting in the Arabian Peninsula via asymptomatic carriers, particularly, those who visited or received healthcare in (nearby) countries with endemic antibiotic resistance [ 47 ]. In another study, 149 CRE (89 K. pneumoniae and 38 E. coli ) isolates were found between 2014 and 2017, and the associated genes included bla NDM-1 (30.2%) and bla OXA-48 (19.5%) [ 48 ].…”

Genomic epidemiology revealed the emergence and worldwide dissemination of ST383 carbapenem-resistant hypervirulent Klebsiella pneumoniae and hospital acquired infections of ST196 Klebsiella quasipneumoniae in Qatar

“…Our data revealed the presence of diverse STs and lineages in the region, and most were NDM-type and OXA-48-type producers co-haboring CTX-M ESBL genes. Among them, ST231, ST147 and ST11 were the most prevalent clones, which were different from those isolated from screening rectal swabs in local pediatric populations (7). ST147 (CG147) and ST11 (CG258) are international highrisk clones reported mainly from Asia and Europe and have been responsible for nosocomial transmission and various care-centre outbreaks (21,22), while ST231 was considered an endemic clone disseminating OXA-232 in India (23).…”

“…In Qatar, substantial proportions of the population are migrant workers from the Indian subcontinent. Perez-Lopez (7) suggested that CRE in pediatric populations in Qatar were mainly introduced sporadically by asymptomatic carriers who visited or received health care in some nearby countries in which they are endemic. Moreover, consistent with other CRE studies on pediatric and adult patients, genes encoding NDMs and OXA-48 types were widely prevalent in Qatar, the Middle East region, and the Indian subcontinent (7, 22, 24).…”

“…Perez-Lopez (7) suggested that CRE in pediatric populations in Qatar were mainly introduced sporadically by asymptomatic carriers who visited or received health care in some nearby countries in which they are endemic. Moreover, consistent with other CRE studies on pediatric and adult patients, genes encoding NDMs and OXA-48 types were widely prevalent in Qatar, the Middle East region, and the Indian subcontinent (7, 22, 24). Few isolates were found to produce the KPC, VIM, or IMP, although these carbapenemases have been previously detected in Saudi Arabia and Kuwait (25).…”

“…K. pneumoniae is the most common species among CRE. Carbapenem resistance in K. pneumoniae is primarily driven by production of carbapenemases, with extended spectrum beta-lactamases (ESBL) playing a supplementary role (4,(6)(7)(8)(9). In the aforementioned study, genes encoding metalloβ-lactamases were detected in 45.8% of the isolates, and OXA-48-like enzymes in 40.3%.…”