• Hail Al-Abdely, Raed AlHababi, Hebah Mahmoud Dada, Hala Roushdy, Mishaal Mohammed Alanazi, Ali Abdullah Alessa, Niveen Mohamed Gad, Abdullah Mohammed Alasmari, Enas Elsabaee Radwan, Hussain Al-Dughmani, Bothina Koura, Mahmoud Mohammed Bader, Hany Mohammed Al Deen, Ahmed Bueid, Khalid Mohammed Elgaher, Majed F Alghoribi, Ahmed M Albarrag, and Ali Mohammed Somily.
• From the Department of Internal Medicine, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.
• Ann Saudi Med. 2021 Mar 1; 41 (2): 637063-70.

BackgroundCarbapenems are the antibiotics of last-resort for the treatment of bacterial infections caused by multidrug-resistant organisms. The emergence of resistance is a critical and worrisome problem for clinicians and patients. Carbapenem-resistant Enterobacterales (CRE) are spreading globally, are associated with an increased frequency of reported outbreaks in many regions, and are becoming endemic in many others.ObjectivesDetermine the molecular epidemiology of CRE isolates from various regions of Saudi Arabia to identify the genes encoding resistance and their clones for a better understanding of the epidemio-logical origin and national spread.DesignMulticenter, cross-sectional, laboratory-based study.SettingSamples were collected from 13 Ministry of Health tertiary-care hospitals from five different regions of Saudi Arabia.MethodsIsolates were tested using the GeneXpert molecular platform to classify CRE.Main Outcome MeasuresPrevalence of various types of CRE in Saudi Arabia.Sample Size519 carbapenem-resistant isolates.ResultOf 519 isolates, 440 (84.7%) were positive for CRE, with Klebsiella pneumoniae (410/456, 90%) being the most commonly isolated pathogen. The distribution of the CRE-positive K pneumoniae resistance genes was as follows: OXA-48 (n=292, 71.2%), NDM-1 (n=85, 20.7%), and NDM+OXA-48 (n=33, 8%). The highest percentage of a single blaOXA-48 gene was detected in the central and eastern regions (77%), while the blaNDM-gene was the predominant type in the northern region (27%). The southern regions showed the lowest percentages for harboring both blaOXA-48 and blaNDM genes (4%), while the western region isolates showed the highest percentage of harboring both genes (14%).ConclusionThe results illustrate the importance of molecular characterization of CRE isolates for patient care and infection prevention and control. Larger multicenter studies are needed to critically evaluate the risk factors and trends over time to understand the dynamics of spread and effective methods of control.LimitationsLack of phenotypic susceptibility and clinical data.Conflict Of InterestNone.

15 keywords...

hide…