Dissemination of VIM-producing associated with high-risk clone ST654 in a tertiary and quaternary hospital in Makkah, Saudi Arabia.

To the best of our knowledge, no molecular surveillance that has been conducted to identify the most common clones of carbapenem-resistant (CRPA) in western Saudi Arabia. Therefore, this study aimed to identify genetic diversity and the most common CRPA clones in this region. Thirty-five CRPA isolates were collected from a tertiary and quaternary hospital in Makkah. was the most common carbapenemase-encoding gene (11 CRPA isolates), while bla was reported in only three isolates. CRPA isolates were subjected to multi- locus sequence typing and showed relatively high genetic diversity with 20 sequence types. Approximately one-third (31.4%) of the CRPA isolates belonged to two high-risk clones (ST235 and ST654). This troublesome finding raises serious concerns about the emergence and further dissemination of CRPA high-risk clones in local hospitals and suggest that surveillance programs should be established in this region to monitor and control clonal dissemination of all multidrug resistant bacteria, including CRPA.