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First report of Klebsiella quasipneumoniae harboring bla(KPC-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 t...

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Autores principales: 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
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6923860/
https://www.ncbi.nlm.nih.gov/pubmed/31890159
http://dx.doi.org/10.1186/s13756-019-0653-9
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author 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
author_facet 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
author_sort Hala, Sharif
collection PubMed
description 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(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(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(KPC-2) gene, flanked by transposable elements (ISKpn6-bla(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.
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spelling pubmed-69238602019-12-30 First report of Klebsiella quasipneumoniae harboring bla(KPC-2) in Saudi Arabia 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 Antimicrob Resist Infect Control Short Report 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(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(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(KPC-2) gene, flanked by transposable elements (ISKpn6-bla(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. BioMed Central 2019-12-19 /pmc/articles/PMC6923860/ /pubmed/31890159 http://dx.doi.org/10.1186/s13756-019-0653-9 Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Short Report
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
First report of Klebsiella quasipneumoniae harboring bla(KPC-2) in Saudi Arabia
title First report of Klebsiella quasipneumoniae harboring bla(KPC-2) in Saudi Arabia
title_full First report of Klebsiella quasipneumoniae harboring bla(KPC-2) in Saudi Arabia
title_fullStr First report of Klebsiella quasipneumoniae harboring bla(KPC-2) in Saudi Arabia
title_full_unstemmed First report of Klebsiella quasipneumoniae harboring bla(KPC-2) in Saudi Arabia
title_short First report of Klebsiella quasipneumoniae harboring bla(KPC-2) in Saudi Arabia
title_sort first report of klebsiella quasipneumoniae harboring bla(kpc-2) in saudi arabia
topic Short Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6923860/
https://www.ncbi.nlm.nih.gov/pubmed/31890159
http://dx.doi.org/10.1186/s13756-019-0653-9
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