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Antimicrobial Resistance & Infection Control
Published in: Antimicrobial Resistance & Infection Control 1/2019

Open Access 01-12-2019 | Antibiotic | Short report

First report of Klebsiella quasipneumoniae harboring blaKPC-2 in Saudi Arabia

Authors: Sharif Hala, Chakkiath Paul Antony, Mohammed Alshehri, Abdulhakeem O. Althaqafi, Asim Alsaedi, Areej Mufti, Mai Kaaki, Baraa T. Alhaj-Hussein, Hosam M. Zowawi, Abdulfattah Al-Amri, Arnab Pain

Published in: Antimicrobial Resistance & Infection Control | Issue 1/2019

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Abstract

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 blaKPC-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 blaKPC-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 blaKPC-2 gene, flanked by transposable elements (ISKpn6-blaKPC-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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Metadata
Title
First report of Klebsiella quasipneumoniae harboring blaKPC-2 in Saudi Arabia
Authors
Sharif Hala
Chakkiath Paul Antony
Mohammed Alshehri
Abdulhakeem O. Althaqafi
Asim Alsaedi
Areej Mufti
Mai Kaaki
Baraa T. Alhaj-Hussein
Hosam M. Zowawi
Abdulfattah Al-Amri
Arnab Pain
Publication date
01-12-2019
Publisher
BioMed Central
Published in
Antimicrobial Resistance & Infection Control / Issue 1/2019
Electronic ISSN: 2047-2994
DOI
https://doi.org/10.1186/s13756-019-0653-9

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