Molecular Characterization of Carbapenemase-Producing Escherichia coli and Klebsiella pneumoniae in the Countries of the Gulf Cooperation Council: Dominance of OXA-48 and NDM Producers

Zowawi, Hosam M.; Sartor, Anna L.; Balkhy, Hanan H.; Walsh, Timothy R.; Johani, Sameera M. Al; Aljindan, Reem; Alfaresi, Mubarak; Ibrahim, Emad; Al-Jardani, Amina; Al-Abri, Seif; Salman, Jameela Al; Dashti, Ali A.; Kutbi, Abdullah; Schlebusch, Sanmarié; Sidjabat, Hanna E.; Paterson, David L.

doi:10.1128/aac.02050-13

Cited by 145 publications

(123 citation statements)

References 25 publications

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“…The strain was multidrug-resistant, including to carbapenems and colistin, and evolved in the same patient from susceptible to resistant to tigecycline during the course of treatment. A recent study investigating isolates with reduced susceptibility to ertapenem collected from a hospital in Ryiadh between 2011 and 2013 found NDM in one of the two E. coli isolates (Zowawi et al, 2014). The same study reported OXA-48 in 77.5 % of the 40 K. pneumoniae isolates and NDM in 25 %.…”

Section: Carbapenemase Productionmentioning

confidence: 92%

“…The combination of CTX-M and TEM was detected in some isolates, while no other combinations were noted. Recently, CTX-M-15 was reported in all E. coli with reduced susceptibility to ertapenem isolated from Riyadh between 2011 and 2013 (Zowawi et al, 2014).…”

Section: Enterobacteriaceaementioning

confidence: 99%

“…The study also documented the first report of CTX-M-3, CTX-M-27, CTX-M-57 and CTX-M-82 in K. pneumoniae in the Kingdom. Recently, CTX-M-15 was reported in 70 % of K. pneumoniae with reduced susceptibility to ertapenem isolated from Riyadh between (Zowawi et al, 2014. …”

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confidence: 99%

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The molecular basis of β-lactamase production in Gram-negative bacteria from Saudi Arabia

Yezli

Shibl

Memish

2015

Journal of Medical Microbiology

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Resistance to b-lactams among Gram-negative bacteria is a worldwide issue. Increased prevalence of extended-spectrum b-lactamase (ESBL)-producers and the dissemination of carbapenem-resistance genes are particularly concerning. ESBL-producing strains are common in the Kingdom of Saudi Arabia, particularly among the Enterobacteriaceae, and carbapenem resistance is on the increase, especially among the non-fermenters. b-lactamase production is a major mechanism of resistance to these agents and although b-lactamase-producing strains have been documented in the Kingdom, relatively few reports characterized the molecular basis of this production. Nevertheless, available data suggest that CTX-M (CTX-M-15 in particular) is the predominant ESBL in the Enterobacteriaceae, with SHV also being prevalent in Klebsiella pneumoniae. Carbapenem resistance in the latter is mainly due to OXA-48 and NDM-1. In Pseudomonas aeruginosa, VEB-like enzymes are the most common ESBLs, and VIM is the prevalent metallo-b-lactamase. OXA-10 extended-spectrum enzymes are also frequent. PER and GES ESBLs have been reported in Acinetobacter baumannii, and oxacillinases (OXA-23 in particular) are the dominant carbapanamases in this species. IntroductionInfections due to Gram-negative bacteria are a leading cause of morbidity and mortality worldwide (Giske et al., 2008). Antimicrobial agents are a major therapeutic tool in the treatment of such infections. However, antimicrobial resistance among Gram-negative bacteria, particularly among the Enterobacteriaceae and the non-fermenters, has become one of the most serious public health concerns worldwide (Giske et al., 2008;Livermore, 2012). The global dissemination of resistance has recently received much attention, especially following reports of the international spread of multi-resistant Enterobacteriaceae, particularly strains resistant to cephalosporins due to the production of CTX-M-type extended-spectrum b-lactamases (ESBLs) and strains producing carbapenemases such as KPC and NDM (Nordmann et al., 2011;Johnson & Woodford, 2013). The spread of resistance determinants is facilitated by a number of factors, including presence on genetic mobile elements, antibiotic misuse, poor infection control practices, and increased international travel. In this context Saudi Arabia is particularly relevant as it is annually a host for more than 4 million Muslim pilgrims from over 180 countries worldwide in the Hajj and Umra seasons. In addition, up to 6 million of the Kingdom's population are expatriates, mainly from south and east Asia, where antimicrobial resistance is rife, including to carbapenems (Yong et al., 2009). These factors could potentially make Saudi Arabia a hot spot for the collection of multidrug-resistant strains and the spread of antibiotic resistance around the world.We previously reported on the antimicrobial resistance among the key Gram-negative bacteria in Saudi Arabia and found increased prevalence of b-lactam-resistant strains, including ESBL-producers, and carbapenem resistance (Y...

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Section: Carbapenemase Productionmentioning

confidence: 92%

Section: Enterobacteriaceaementioning

confidence: 99%

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The molecular basis of β-lactamase production in Gram-negative bacteria from Saudi Arabia

Yezli

Shibl

Memish

2015

Journal of Medical Microbiology

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“…Recent studies conducted in Middle East countries also suggests that this region might be an additional reservoir of NDM producers as it has been reported from Oman [13], Lebanon [14], Saudi Arabia [15,16], and Qatar [17].…”

Section: Introductionmentioning

confidence: 83%

“…Molecular detection of carbapenemase genes using polymerase chain reaction (PCR) based methods was found to be quick, accurate and effective in the detection of specific carbapenemases genes, such as KPC, NDM-1, OXA-48, etc. [13][14][15][16][17]. Simple PCR assays targeting a single carbapenemase type have been used successfully in numerous studies.…”

Section: Introductionmentioning

confidence: 99%

Frequency of Carbapenemase Producing Klebsiella pneumoniae in Makkah, Saudi Arabia

Khan¹

2016

Journal of Microbiology and Infectious Diseases

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Objective: Carbapenemase producing Klebsiella pneumoniae is emerging as an important pathogen worldwide which has alarming clinical threat with serious effects on patients' outcome. The aim of our study is to determine prevalence of carbapenemase producing K. pneumoniae and its antibiotic susceptibility pattern in tertiary care hospitals. Methods:A prospective study was performed on 260 clinical isolates of K. pneumoniae collected from five different hospitals of Makkah, Saudi Arabia from January to July 2015. All clinical isolates were confirmed as K. pneumoniae using Vitek 2 system. These isolates were then screened for potential carbapenemase producers by determining reduced susceptibility to carbapenems using representative antibiotic disks of third generation cephalosporins and carbapenems in the disk diffusion test following guidelines of Clinical and Laboratory Standards Institute. Minimum inhibitory concentration of isolates found positive in screening test were determined for cephalosporins, carbapenems, aminoglycosides and tigecycline and colistin using Vitek-2 system. Modified Hodge test was performed to detect carbapenemase production on the isolates suspected for carbapenemase production.Results: Out of 260 K. pneumoniae isolates, 31 (11.9%) have shown 100% resistance to all cephalosporins. Of 31 K. pneumoniae isolates, 15 (48.4%) were found positive for carbapenemase. All carbapenem resistant isolates were sensitive to colistin and tigecycline. However, these isolates have shown resistance to amikacin (41.9%) and gentamicin (51.6%), respectively. Conclusion:This is the first report from Makkah reporting carbapenamse producing K.pneumoniae. Of 12% potential carbapenemase producing K.pneumoniae, 48.4% were found positive for carbapenemase production. Molecular characterization of these strains will help to determine the type of carbapenemase prevalent in this area. J Microbiol Infect Dis 2016;6(3): 121-127

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Occurrence of Imipenem-Resistant Uropathogenic Escherichia coli in Pregnant Women: An Insight into Their Virulence Profile and Clonal Structure

Koley,

Ghosh,

Mukherjee

2024

Curr Microbiol

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Molecular Characterization of Carbapenemase-Producing Escherichia coli and Klebsiella pneumoniae in the Countries of the Gulf Cooperation Council: Dominance of OXA-48 and NDM Producers

Cited by 145 publications

References 25 publications

The molecular basis of β-lactamase production in Gram-negative bacteria from Saudi Arabia

The molecular basis of β-lactamase production in Gram-negative bacteria from Saudi Arabia

Frequency of Carbapenemase Producing Klebsiella pneumoniae in Makkah, Saudi Arabia

Occurrence of Imipenem-Resistant Uropathogenic Escherichia coli in Pregnant Women: An Insight into Their Virulence Profile and Clonal Structure

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