First report of Klebsiella quasipneumoniae harboring blaKPC-2 in Saudi Arabia

Background Nosocomial infections caused by multi-drug resistant Enterobacteriaceae are a global public health threat that ought to be promptly identified, reported, and addressed accurately. Many carbapenem-resistant Enterobacteriaceae-associated genes have been identified in Saudi Arabia but not th...

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Published in:Antimicrobial resistance & infection control 2019-12, Vol.8 (1), Article 203
Main Authors: Hala, Sharif, Antony, Chakkiath Paul, Alshehri, Mohammed, Althaqafi, Abdulhakeem O, Alsaedi, Asim, Mufti, Areej, Kaaki, Mai, Alhaj-Hussein, Baraa T, Zowawi, Hosam M, Al-Amri, Abdulfattah, Pain, Arnab
Format: Article
Language:English
Subjects:
Beta lactamases
DNA sequencing
Drug resistance
Earthquakes
Genes
Genomes
Genomics
Health aspects
Infection
Microbial drug resistance
Microbiology
Novels
Pilgrimages
Pneumonia
Public health
Public health movements
Short Report
Technology
Transposons
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Summary:Background Nosocomial infections caused by multi-drug resistant Enterobacteriaceae are a global public health threat that ought to be promptly identified, reported, and addressed accurately. Many carbapenem-resistant Enterobacteriaceae-associated genes have been identified in Saudi Arabia but not the endemic Klebsiella pneumoniae carbapenemases (KPCs), which are encoded by bla.sub.KPC-type genes. KPCs are known for their exceptional spreading potential. Methods We collected n = 286 multi-drug resistant (MDR) Klebsiella spp. isolates as part of screening for resistant patterns from a tertiary hospital in Saudi Arabia between 2014 and 2018. Antimicrobial susceptibility testing was carried out using both VITEK II and the broth microdilution of all collected isolates. Detection of resistance-conferring genes was carried out using Illumina whole-genome shotgun sequencing and PacBio SMRT sequencing protocols. Results A Carbapenem-resistant Enterobacteriaceae (CRE) Klebsiella quasipneumoniae subsp. similipneumoniae strain was identified as a novel ST-3510 carrying a bla.sub.KPC-2 carbapenemase encoding gene. The isolate, designated as NGKPC-421, was obtained from shotgun Whole Genome Sequencing (WGS) surveillance of 286 MDR Klebsiella spp. clinical isolates. The NGKPC-421 isolate was collected from a septic patient in late 2017 and was initially misidentified as K. pneumoniae. The sequencing and assembly of the NGKPC-421 genome resulted in the identification of a putative ~ 39.4 kb IncX6 plasmid harboring a bla.sub.KPC-2 gene, flanked by transposable elements (ISKpn6-bla.sub.KPC-2-ISKpn27). Conclusion This is the first identification of a KPC-2-producing CRE in the Gulf region. The impact on this finding is of major concern to the public health in Saudi Arabia, considering that it is the religious epicenter with a continuous mass influx of pilgrims from across the world. Our study strongly highlights the importance of implementing rapid sequencing-based technologies in clinical microbiology for precise taxonomic classification and monitoring of antimicrobial resistance patterns. Keywords: MDR, Klebsiella quasipneumoniae, Carbapenemases, KPC-2, bla.sub.KPC-2, Tn3
ISSN:2047-2994
2047-2994
DOI:10.1186/s13756-019-0653-9