Ctx-m-15 positive escherichia coli and klebsiella pneumoniae outbreak in the neonatal intensive care unit of a maternity hospital in ha’il, saudi arabia

Mohammed Almogbel, Ahmed Altheban, Mohammed Alenezi, Khalid Al-Motair, Godfred A. Menezes, Mohammed Elabbasy, Sahar Hammam, John P. Hays, Mushtaq A. Khan

Research output: Contribution to journalArticlepeer-review

3 Citations (Scopus)

Abstract

Objective: The aim of this study was to retrospectively characterize E. coli and K. pneumoniae isolates obtained from neonates during a suspected NICU outbreak of infection in Ha’il, Saudi Arabia during a period of one month (April 2014). Methods: Antibiotic susceptibility patterns, molecular characterization for antibiotic-resistant genes (blaTEM, blaSHV, and blaCTX-M), and genotyping by PFGE and MLST were performed. Results: A total of 24 E. coli and 48 K. pneumoniae isolates were cultured from neonates that had been admitted to the NICU. Among E. coli, the majority of isolates (19/24) were ESBL-positive and all of these nineteen (100%) harbored the CTX-M-15 gene. A total of 15% (3/19) were co-producers of CTX-M-15 and SHV-12, and 68.4% (13/19) were coproducers of CTX-M-15 and TEM-1. Among K. pneumoniae isolates, 87.5% (42/48) were ESBL positive with 92.85% (39/42) of these isolates containing the CTX-M-15 gene. A total of 97% (38/39) of K. pneumoniae were co-producers of CTX-M-15 and SHV-12, and 88% (37/42) were positive for TEM-1. Furthermore, 85.7% (36/42) K. pneumoniae were coproducers of CTX-M-15 and TEM-1. The majority of E. coli isolates (18/19 isolates) were grouped into two genetic clusters by pulsed field gel electrophoresis (PFGE) and all the isolates were found to be ST-131 type. In contrast, K. pneumoniae (31/42) isolates belonged to a single genotypic lineage, and all (100%) isolates belonged to the ST-14 type. Conclusion: This is the first report of CTX-M-15-positive, ESBL E. coli, and K. pneumo-niae isolates recovered from an outbreak in an NICU in Ha’il, Saudi Arabia. It is alarming to note the high rate of outbreak isolates with simultaneous production of CTX-M-15 and SHV12 conferring high-level resistance to oxyimino-cephalosporins.

Original languageEnglish
Pages (from-to)2843-2849
Number of pages7
JournalInfection and Drug Resistance
Volume14
DOIs
Publication statusPublished - 2021

Keywords

  • CTX-M-15
  • E. coli
  • Extended spectrum β-lactamases
  • K. pneumoniae
  • NICU outbreak

ASJC Scopus subject areas

  • Pharmacology
  • Infectious Diseases
  • Pharmacology (medical)

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