CTX-M-15 Positive and Outbreak in the Neonatal Intensive Care Unit of a Maternity Hospital in Ha'il, Saudi Arabia.

OBJECTIVE

The aim of this study was to retrospectively characterize and 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 (TEM, SHV, and CTX-M), and genotyping by PFGE and MLST were performed.

RESULTS

A total of 24 and 48 isolates were cultured from neonates that had been admitted to the NICU. Among , 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 co-producers of CTX-M-15 and TEM-1. Among 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 were co-producers of CTX-M-15 and SHV-12, and 88% (37/42) were positive for TEM-1. Furthermore, 85.7% (36/42) were co-producers of CTX-M-15 and TEM-1. The majority of 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, (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 , and 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 SHV-12 conferring high-level resistance to oxyimino-cephalosporins.