1Pathogen Genomics Laboratory, Biological and Environmental Sciences and Engineering, King Abdullah University of Science and Technology, Thuwal, Saudi Arabia.
Clinical Microbiology Department, King Abdullah International Medical Research Centre - Ministry of National Guard Health Affairs, Jeddah, Saudi Arabia.
Antimicrob Resist Infect Control. 2019 Dec 19;8:203. doi: 10.1186/s13756-019-0653-9. eCollection 2019.
Nosocomial infections caused by multi-drug resistant are a global public health threat that ought to be promptly identified, reported, and addressed accurately. Many carbapenem-resistant -associated genes have been identified in Saudi Arabia but not the endemic carbapenemases (KPCs), which are encoded by genes. KPCs are known for their exceptional spreading potential.
We collected = 286 multi-drug resistant (MDR) 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.
A Carbapenem-resistant (CRE) subsp. strain was identified as a novel ST-3510 carrying a carbapenemase encoding gene. The isolate, designated as NGKPC-421, was obtained from shotgun Whole Genome Sequencing (WGS) surveillance of 286 MDR . clinical isolates. The NGKPC-421 isolate was collected from a septic patient in late 2017 and was initially misidentified as . The sequencing and assembly of the NGKPC-421 genome resulted in the identification of a putative ~ 39.4 kb IncX6 plasmid harboring a gene, flanked by transposable elements (IS-IS).
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.
由耐多药引起的医院感染是一种全球公共卫生威胁，应及时准确地识别、报告和处理。在沙特阿拉伯已经发现了许多耐碳青霉烯类抗生素相关基因，但没有地方性碳青霉烯酶（KPCs），KPCs 由 基因编码。KPCs 以其非凡的传播潜力而闻名。
我们收集了 = 286 株多药耐药（MDR） 分离株，作为 2014 年至 2018 年期间在沙特阿拉伯一家三级医院筛查耐药模式的一部分。对所有收集的分离株进行了药敏试验，使用 VITEK II 和肉汤微量稀释法。使用 Illumina 全基因组 shotgun 测序和 PacBio SMRT 测序方案进行耐药基因的检测。
鉴定出一种耐碳青霉烯类抗生素的 （CRE） 亚种 株，携带一种碳青霉烯酶编码基因。该分离株被命名为 NGKPC-421，是从 286 株 MDR 临床分离株的全基因组 shotgun 测序（WGS）监测中获得的。NGKPC-421 分离株从 2017 年底的一名败血症患者中分离得到，最初被错误鉴定为 。NGKPC-421 基因组的测序和组装确定了一个大约 39.4kb 的 IncX6 质粒，该质粒携带一个 基因，由转座元件（IS-IS）侧翼。
这是海湾地区首次发现产 KPC-2 的 CRE。考虑到沙特阿拉伯是宗教圣地，每年都有来自世界各地的大批朝圣者涌入，这一发现对沙特阿拉伯的公共卫生影响非常大。我们的研究强烈强调了在临床微生物学中实施快速基于测序的技术的重要性，以便进行准确的分类学分类和监测抗生素耐药模式。
