Identification of carbapenem-resistant Pseudomonas aeruginosa in selected hospitals of the Gulf Cooperation Council States: dominance of high-risk clones in the region.

Autor:	Zowawi HM; College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.; The University of Queensland, UQ Centre for Clinical Research, Herston, Queensland, Australia.; King Abdullah International Medical Research Centre, Riyadh, Saudi Arabia.; WHO Collaborating Centre for Infection Prevention and Control, and GCC Center for Infection Control, Riyadh, Saudi Arabia., Syrmis MW; Pathology Queensland, Brisbane, Queensland 4029, Australia., Kidd TJ; School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, Queensland 4072, Australia.; Centre for Experimental Medicine, Queen's University Belfast, Belfast BT9 7BL, UK., Balkhy HH; College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.; King Abdullah International Medical Research Centre, Riyadh, Saudi Arabia.; WHO Collaborating Centre for Infection Prevention and Control, and GCC Center for Infection Control, Riyadh, Saudi Arabia., Walsh TR; The University of Queensland, UQ Centre for Clinical Research, Herston, Queensland, Australia.; Department of Medical Microbiology and Infectious Diseases, School of Medicine, Cardiff University, Heath Park, Cardiff, UK., Al Johani SM; College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.; Microbiology, Department of Pathology and Lab Medicine, King Abdulaziz Medical City, Riyadh, Saudi Arabia., Al Jindan RY; Department of Microbiology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia., Alfaresi M; Pathology and Laboratory Medicine Department at Sheikh Khalifa General Hospital, Umm Al Quwain, UAE.; College of Medicine, University of Sharjah, UAE., Ibrahim E; Clinical Microbiology Department, Hamad Medical Corporation, Doha, Qatar., Al-Jardani A; Medical Microbiology Department, The Royal Hospital, Muscat, Oman., Al Salman J; Samlaniya Medical Complex, Infectious Diseases Unit, Manama, Bahrain., Dashti AA; Medical Laboratory Department, Faculty of Allied Health Sciences, Health Science Center, Kuwait University, Kuwait City, Kuwait., Sidjabat HE; The University of Queensland, UQ Centre for Clinical Research, Herston, Queensland, Australia., Baz O; King Abdullah International Medical Research Centre, Riyadh, Saudi Arabia., Trembizki E; The University of Queensland, UQ Centre for Clinical Research, Herston, Queensland, Australia., Whiley DM; The University of Queensland, UQ Centre for Clinical Research, Herston, Queensland, Australia.; Pathology Queensland, Brisbane, Queensland 4029, Australia., Paterson DL; The University of Queensland, UQ Centre for Clinical Research, Herston, Queensland, Australia.
Jazyk:	angličtina
Zdroj:	Journal of medical microbiology [J Med Microbiol] 2018 Jun; Vol. 67 (6), pp. 846-853. Date of Electronic Publication: 2018 Apr 17.
DOI:	10.1099/jmm.0.000730
Abstrakt:	Purpose: The molecular epidemiology and resistance mechanisms of carbapenem-resistant Pseudomonas aeruginosa (CRPA) were determined in hospitals in the countries of the Gulf Cooperation Council (GCC), namely, Saudi Arabia, the United Arab Emirates, Oman, Qatar, Bahrain and Kuwait. Methodology: Isolates were screened for common carbapenem-resistance genes by PCR. Relatedness between isolates was assessed using previously described genotyping methods: an informative-single nucleotide polymorphism MassARRAY iPLEX assay (iPLEX20SNP) and the enterobacterial repetitive intergenic consensus (ERIC)-PCR assay, with selected isolates being subjected to multilocus sequence typing (MLST). Ninety-five non-repetitive isolates that were found to be resistant to carbapenems were subjected to further investigation.Results/Key findings. The most prevalent carbapenemase-encoding gene, blaVIM-type, was found in 37/95 (39 %) isolates, while only 1 isolate (from UAE) was found to have blaIMP-type. None of the CRPA were found to have blaNDM-type or blaKPC-type. We found a total of 14 sequence type (ST) clusters, with 4 of these clusters being observed in more than 1 country. Several clusters belonged to the previously recognized internationally disseminated high-risk clones ST357, ST235, ST111, ST233 and ST654. We also found the less predominant ST316, ST308 and ST823 clones, and novel MLST types (ST2010, ST2011, ST2012 and ST2013), in our collection. Conclusion: Overall our data show that 'high-risk' CRPA clones are now detected in the region and highlight the need for strategies to limit further spread of such organisms, including enhanced surveillance, infection control precautions and further promotion of antibiotic stewardship programmes.
Databáze:	MEDLINE
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