Hosam M Zowawi1,2,3,4, Melanie W Syrmis5, Timothy J Kidd6,7, Hanan H Balkhy1,3,4, Timothy R Walsh2,8, Sameera M Al Johani1,9, Reem Y Al Jindan10, Mubarak Alfaresi11,12, Emad Ibrahim13, Amina Al-Jardani14, Jameela Al Salman15, Ali A Dashti16, Hanna E Sidjabat2, Omar Baz3, Ella Trembizki2, David M Whiley2,5, David L Paterson2. 1. 2College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia. 2. 1The University of Queensland, UQ Centre for Clinical Research, Herston, Queensland, Australia. 3. 3King Abdullah International Medical Research Centre, Riyadh, Saudi Arabia. 4. 4WHO Collaborating Centre for Infection Prevention and Control, and GCC Center for Infection Control, Riyadh, Saudi Arabia. 5. 5Pathology Queensland, Brisbane, Queensland 4029, Australia. 6. 6School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, Queensland 4072, Australia. 7. 7Centre for Experimental Medicine, Queen's University Belfast, Belfast BT9 7BL, UK. 8. 8Department of Medical Microbiology and Infectious Diseases, School of Medicine, Cardiff University, Heath Park, Cardiff, UK. 9. 9Microbiology, Department of Pathology and Lab Medicine, King Abdulaziz Medical City, Riyadh, Saudi Arabia. 10. 10Department of Microbiology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia. 11. 11Pathology and Laboratory Medicine Department at Sheikh Khalifa General Hospital, Umm Al Quwain, UAE. 12. 12College of Medicine, University of Sharjah, UAE. 13. 13Clinical Microbiology Department, Hamad Medical Corporation, Doha, Qatar. 14. 14Medical Microbiology Department, The Royal Hospital, Muscat, Oman. 15. 15Samlaniya Medical Complex, Infectious Diseases Unit, Manama, Bahrain. 16. 16Medical Laboratory Department, Faculty of Allied Health Sciences, Health Science Center, Kuwait University, Kuwait City, Kuwait.
Abstract
PURPOSE: The molecular epidemiology and resistance mechanisms of carbapenem-resistant Pseudomonas aeruginosa (CRPA) were determined in hospitals in the countries of the Gulf Cooperation Council (GCC), namely, Saudi Arabia, the United Arab Emirates, Oman, Qatar, Bahrain and Kuwait. METHODOLOGY: Isolates were screened for common carbapenem-resistance genes by PCR. Relatedness between isolates was assessed using previously described genotyping methods: an informative-single nucleotide polymorphism MassARRAY iPLEX assay (iPLEX20SNP) and the enterobacterial repetitive intergenic consensus (ERIC)-PCR assay, with selected isolates being subjected to multilocus sequence typing (MLST). Ninety-five non-repetitive isolates that were found to be resistant to carbapenems were subjected to further investigation.Results/Key findings. The most prevalent carbapenemase-encoding gene, blaVIM-type, was found in 37/95 (39 %) isolates, while only 1 isolate (from UAE) was found to have blaIMP-type. None of the CRPA were found to have blaNDM-type or blaKPC-type. We found a total of 14 sequence type (ST) clusters, with 4 of these clusters being observed in more than 1 country. Several clusters belonged to the previously recognized internationally disseminated high-risk clones ST357, ST235, ST111, ST233 and ST654. We also found the less predominant ST316, ST308 and ST823 clones, and novel MLST types (ST2010, ST2011, ST2012 and ST2013), in our collection. CONCLUSION: Overall our data show that 'high-risk' CRPA clones are now detected in the region and highlight the need for strategies to limit further spread of such organisms, including enhanced surveillance, infection control precautions and further promotion of antibiotic stewardship programmes.
PURPOSE: The molecular epidemiology and resistance mechanisms of carbapenem-resistant Pseudomonas aeruginosa (CRPA) were determined in hospitals in the countries of the Gulf Cooperation Council (GCC), namely, Saudi Arabia, the United Arab Emirates, Oman, Qatar, Bahrain and Kuwait. METHODOLOGY: Isolates were screened for common carbapenem-resistance genes by PCR. Relatedness between isolates was assessed using previously described genotyping methods: an informative-single nucleotide polymorphism MassARRAY iPLEX assay (iPLEX20SNP) and the enterobacterial repetitive intergenic consensus (ERIC)-PCR assay, with selected isolates being subjected to multilocus sequence typing (MLST). Ninety-five non-repetitive isolates that were found to be resistant to carbapenems were subjected to further investigation.Results/Key findings. The most prevalent carbapenemase-encoding gene, blaVIM-type, was found in 37/95 (39 %) isolates, while only 1 isolate (from UAE) was found to have blaIMP-type. None of the CRPA were found to have blaNDM-type or blaKPC-type. We found a total of 14 sequence type (ST) clusters, with 4 of these clusters being observed in more than 1 country. Several clusters belonged to the previously recognized internationally disseminated high-risk clones ST357, ST235, ST111, ST233 and ST654. We also found the less predominant ST316, ST308 and ST823 clones, and novel MLST types (ST2010, ST2011, ST2012 and ST2013), in our collection. CONCLUSION: Overall our data show that 'high-risk' CRPA clones are now detected in the region and highlight the need for strategies to limit further spread of such organisms, including enhanced surveillance, infection control precautions and further promotion of antibiotic stewardship programmes.
Entities:
Keywords:
Gulf; Pseudomonas aeruginosa; Saudi Arabia; carbapenem; resistant
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