title: NDM-1-producing Klebsiella pneumoniae isolated in the Sultanate of Oman.
abstract: OBJECTIVE
  To analyse the mechanisms responsible for multidrug resistance in two carbapenem-resistant Klebsiella pneumoniae isolates recovered from patients hospitalized in Oman.
  
  
  METHODS
  PCR and sequencing were used to search for β-lactamase and 16S RNA methylase genes. Multilocus sequence typing was used to determine the sequence type (ST) of each isolate. Clonal relationships were evaluated by PFGE.
  
  
  RESULTS
  Both isolates carried the bla(NDM-1) carbapenemase gene. Isolate 601 was recovered from a patient who was transferred from India, whereas isolate 419 was from an Omani patient who had not travelled abroad. The two isolates were clonally unrelated, and belonged to ST14 (isolate 601) and ST340 (isolate 419). In addition to NDM-1, the ST14 isolate expressed β-lactamases CTX-M-15, SHV-28, OXA-1, OXA-9 and TEM-1, and the aminoglycoside resistance methylase ArmA. The ST340 isolate expressed β-lactamases SHV-11, OXA-1 and ArmA. In both isolates, the bla(NDM-1) gene was located on plasmids that were of similar size (170 kb), but of different incompatibility groups.
  
  
  CONCLUSIONS
  This is the first description of NDM-1 producers in the Arabian peninsula and in the Middle East.
authors.affiliation: Service de Bactériologie-Virologie, INSERM U914 Emerging Resistance to Antibiotics, Hôpital de Bicêtre, Assistance Publique/Hôpitaux de Paris, Faculté de Médecine et Université Paris-Sud, K-Bicêtre, Paris, France.
authors.forename: Laurent
authors.initials: L
authors.lastname: Poirel
authors.forename: Zaina
authors.initials: Z
authors.lastname: Al Maskari
authors.forename: Fatma
authors.initials: F
authors.lastname: Al Rashdi
authors.forename: Sandrine
authors.initials: S
authors.lastname: Bernabeu
authors.forename: Patrice
authors.initials: P
authors.lastname: Nordmann
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001426:Bacterial Proteins / Q000235:genetics; D024901:Drug Resistance, Multiple, Bacterial; D006801:Humans; D007710:Klebsiella Infections / Q000188:drug therapy / Q000382:microbiology*; D007711:Klebsiella pneumoniae / Q000187:drug effects / Q000235:genetics / Q000302:isolation & purification* / Q000378:metabolism; D008826:Microbial Sensitivity Tests; D009850:Oman; D010957:Plasmids / Q000187:drug effects / Q000235:genetics; D016133:Polymerase Chain Reaction; D012336:RNA, Ribosomal, 16S / Q000737:chemistry; D017422:Sequence Analysis, DNA; D001618:beta-Lactamases / Q000096:biosynthesis / Q000235:genetics*
chemical_list: D000900:Anti-Bacterial Agents; D001426:Bacterial Proteins; D012336:RNA, Ribosomal, 16S; D001618:beta-Lactamases; C552864:beta-lactamase NDM-1; C063912:carbapenemase