title: 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.
abstract: The molecular epidemiology and mechanisms of resistance of carbapenem-resistant Enterobacteriaceae (CRE) were determined in hospitals in the countries of the Gulf Cooperation Council (GCC), namely, Saudi Arabia, United Arab Emirates, Oman, Qatar, Bahrain, and Kuwait. Isolates were subjected to PCR-based detection of antibiotic-resistant genes and repetitive sequence-based PCR (rep-PCR) assessments of clonality. Sixty-two isolates which screened positive for potential carbapenemase production were assessed, and 45 were found to produce carbapenemase. The most common carbapenemases were of the OXA-48 (35 isolates) and NDM (16 isolates) types; 6 isolates were found to coproduce the OXA-48 and NDM types. No KPC-type, VIM-type, or IMP-type producers were detected. Multiple clones were detected with seven clusters of clonally related Klebsiella pneumoniae. Awareness of CRE in GCC countries has important implications for controlling the spread of CRE in the Middle East and in hospitals accommodating patients transferred from the region.
authors.affiliation: The University of Queensland, UQ Centre for Clinical Research, Herston, Queensland, Australia King Abdulaziz Medical City, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia GCC Center for Infection Control, Riyadh, Saudi Arabia h.zowawi@uq.edu.au.
authors.forename: Hosam M
authors.initials: HM
authors.lastname: Zowawi
authors.affiliation: The University of Queensland, UQ Centre for Clinical Research, Herston, Queensland, Australia.
authors.forename: Anna L
authors.initials: AL
authors.lastname: Sartor
authors.affiliation: King Abdulaziz Medical City, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia GCC Center for Infection Control, Riyadh, Saudi Arabia.
authors.forename: Hanan H
authors.initials: HH
authors.lastname: Balkhy
authors.affiliation: The University of Queensland, UQ Centre for Clinical Research, Herston, Queensland, Australia Department of Medical Microbiology and Infectious Diseases, School of Medicine, Cardiff University, Heath Park, Cardiff, United Kingdom.
authors.forename: Timothy R
authors.initials: TR
authors.lastname: Walsh
authors.affiliation: King Abdulaziz Medical City, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia Microbiology, Department of Pathology and Lab Medicine, King Abdulaziz Medical City, Riyadh, Saudi Arabia.
authors.forename: Sameera M
authors.initials: SM
authors.lastname: Al Johani
authors.affiliation: University of Dammam, College of Medicine, Dammam, Saudi Arabia.
authors.forename: Reem Y
authors.initials: RY
authors.lastname: AlJindan
authors.affiliation: Zayed Military Hospital, Clinical Microbiology Department, Abu Dhabi, United Arab Emirates Pathology and Laboratory Medicine Department at Sheikh Khalifa General Hospital, Umm Al Quwain, United Arab Emirates.
authors.forename: Mubarak
authors.initials: M
authors.lastname: Alfaresi
authors.affiliation: Hamad Medical Cooperation, Clinical Microbiology Department, Doha, Qatar.
authors.forename: Emad
authors.initials: E
authors.lastname: Ibrahim
authors.affiliation: The Royal Hospital, Medical Microbiology Department, Muscat, Oman.
authors.forename: Amina
authors.initials: A
authors.lastname: Al-Jardani
authors.affiliation: GCC Center for Infection Control, Riyadh, Saudi Arabia Department of Medicine, The Royal Hospital, Muscat, Oman.
authors.forename: Seif
authors.initials: S
authors.lastname: Al-Abri
authors.affiliation: GCC Center for Infection Control, Riyadh, Saudi Arabia Samlaniya Medical Complex, Infectious Diseases Unit, Manama, Bahrain.
authors.forename: Jameela
authors.initials: J
authors.lastname: Al Salman
authors.affiliation: Medical Laboratory Department, Faculty of Allied Health Sciences, Health Science Center, Kuwait University, Kuwait City, Kuwait.
authors.forename: Ali A
authors.initials: AA
authors.lastname: Dashti
authors.affiliation: The University of Queensland, UQ Centre for Clinical Research, Herston, Queensland, Australia Faculty of Medicine, Taif University, Taif, Saudi Arabia.
authors.forename: Abdullah H
authors.initials: AH
authors.lastname: Kutbi
authors.affiliation: Microbiology Division, Mater Pathology, Brisbane, Queensland, Australia Molecular and Cellular Pathology Central Clinical Division, School of Medicine, University of Queensland, Brisbane, Queensland, Australia.
authors.forename: Sanmarié
authors.initials: S
authors.lastname: Schlebusch
authors.affiliation: The University of Queensland, UQ Centre for Clinical Research, Herston, Queensland, Australia.
authors.forename: Hanna E
authors.initials: HE
authors.lastname: Sidjabat
authors.affiliation: The University of Queensland, UQ Centre for Clinical Research, Herston, Queensland, Australia.
authors.forename: David L
authors.initials: DL
authors.lastname: Paterson
mesh_terms: D000900:Anti-Bacterial Agents / Q000378:metabolism; D001426:Bacterial Proteins / Q000235:genetics* / Q000378:metabolism; D015780:Carbapenems / Q000378:metabolism; D004926:Escherichia coli / Q000201:enzymology* / Q000235:genetics / Q000302:isolation & purification; D004927:Escherichia coli Infections / Q000453:epidemiology* / Q000382:microbiology; D029968:Escherichia coli Proteins / Q000235:genetics* / Q000378:metabolism; D006801:Humans; D007710:Klebsiella Infections / Q000453:epidemiology* / Q000382:microbiology; D007711:Klebsiella pneumoniae / Q000201:enzymology* / Q000235:genetics / Q000302:isolation & purification; D008826:Microbial Sensitivity Tests; D008877:Middle East / Q000453:epidemiology; D010121:Oxytocin / Q000031:analogs & derivatives / Q000378:metabolism; D001618:beta-Lactamases / Q000235:genetics* / Q000378:metabolism
chemical_list: D000900:Anti-Bacterial Agents; D001426:Bacterial Proteins; D015780:Carbapenems; D029968:Escherichia coli Proteins; D010121:Oxytocin; C015692:oxytocin, Asp(5)-; D001618:beta-Lactamases; C000601047:beta-lactamase OXA-48, E coli; C063912:carbapenemase; C108449:oxacillinase