Skip to main content
Article
Clonal emergence of Klebsiella pneumoniae ST14 co-producing OXA-48-type and NDM carbapenemases with high rate of colistin resistance in Dubai, United Arab Emirates
International Journal of Antimicrobial Agents
  • Carole Ayoub Moubareck, Saint Joseph University; Zayed University
  • Shaimaa F. Mouftah, College of Medicine and Health Sciences United Arab Emirates University
  • Tibor Pál, College of Medicine and Health Sciences United Arab Emirates University
  • Akela Ghazawi, College of Medicine and Health Sciences United Arab Emirates University
  • Dalal H. Halat, Saint Joseph University
  • Anju Nabi, Dubai Hospital
  • Mouza A. AlSharhan, Dubai Hospital
  • Zulfa O. AlDeesi, Rashid Hospital
  • Christabel C. Peters, American Hospital
  • Handan Celiloglu, Mediclinic City Hospital
  • Manjunath Sannegowda, Welcare Hospital
  • Dolla K. Sarkis, Saint Joseph University
  • Ágnes Sonnevend, College of Medicine and Health Sciences United Arab Emirates University
ORCID Identifiers

0000-0002-4143-509X

Document Type
Article
Publication Date
7-1-2018
Abstract

© 2018 Elsevier Ltd Few studies have addressed the molecular epidemiology of carbapenem-resistant Enterobacteriaceae (CRE) isolates in the Arabian Peninsula, and such investigations have been missing from Dubai, a major economical, tourism and medical centre of the region. The antibiotic susceptibility, the carbapenemase type produced, and the clonality of 89 CRE strains isolated in five major Dubai hospitals in June 2015 to June 2016 were determined. Thirty-three percent of the collection of 70 Klebsiella pneumoniae, 13 Escherichia coli and 6 other Enterobacteriaceae were extremely drug resistant, 27% were resistant to colistin, and 4.5% (4 K. pneumoniae isolates) were resistant to all antibiotics tested. The colistin resistance rate in K. pneumoniae was 31.4%. None of the isolates carried mobile colistin resistance genes. Seventy-seven isolates produced carbapenemase: 53.3% OXA-48-like, 24.7% NDM and 22.1% both OXA-48-like and NDM, respectively. Pulsed-field gel electrophoresis clustered 50% of K. pneumoniae into a 35-membered group, which showed significant association with double carbapenemase production, with extreme drug resistance, and with being isolated from Emirati patients. Members of the cluster belonged to sequence type ST14. The rate of colistin resistance in K. pneumoniae ST14 was 37.1% vs. 27.1% of K. pneumoniae isolates outside of the cluster. Two of the panresistant K. pneumoniae isolates also belonged to ST14, whereas the other two were ST15 and ST231, respectively. In conclusion, beyond the overall high colistin resistance rate in CRE, the emergence of a highly resistant clone of K. pneumoniae ST14 in all Dubai hospitals investigated is a serious problem requiring immediate attention.

Publisher
Elsevier B.V.
Disciplines
Keywords
  • Carbapenemase producer Enterobacteriaceae,
  • Colistin resistance,
  • Dubai
Scopus ID

85048526051

Indexed in Scopus
Yes
Open Access
No
https://doi.org/10.1016/j.ijantimicag.2018.03.003
Citation Information
Carole Ayoub Moubareck, Shaimaa F. Mouftah, Tibor Pál, Akela Ghazawi, et al.. "Clonal emergence of Klebsiella pneumoniae ST14 co-producing OXA-48-type and NDM carbapenemases with high rate of colistin resistance in Dubai, United Arab Emirates" International Journal of Antimicrobial Agents Vol. 52 Iss. 1 (2018) p. 90 - 95 ISSN: <p><a href="https://v2.sherpa.ac.uk/id/publication/issn/0924-8579" target="_blank">0924-8579</a></p>
Available at: http://works.bepress.com/carole-ayoubmoubareck/15/