Almogbel Mohammed, Altheban Ahmed, Alenezi Mohammed, Al-Motair Khalid, Menezes Godfred A, Elabbasy Mohammed, Hammam Sahar, Hays John P, Khan Mushtaq A
Molecular Diagnostic and Personalized Therapeutics Unit, College of Applied Medical Sciences, University of Ha'il, Ha'il, Saudi Arabia.
College of Nursing, University of Ha'il, Ha'il, Saudi Arabia.
Infect Drug Resist. 2021 Jul 23;14:2843-2849. doi: 10.2147/IDR.S317079. eCollection 2021.
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).
Antibiotic susceptibility patterns, molecular characterization for antibiotic-resistant genes (TEM, SHV, and CTX-M), and genotyping by PFGE and MLST were performed.
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.
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.
本研究旨在回顾性分析沙特阿拉伯哈伊勒一家新生儿重症监护病房（NICU）在2014年4月为期一个月的疑似感染暴发期间从新生儿身上分离出的菌株，并对其进行特征描述。
进行了抗生素敏感性模式分析、抗生素耐药基因（TEM、SHV和CTX-M）的分子特征分析，以及脉冲场凝胶电泳（PFGE）和多位点序列分型（MLST）基因分型。
从入住NICU的新生儿中总共培养出24株和48株菌株。在这些菌株中，大多数菌株（19/24）为超广谱β-内酰胺酶（ESBL）阳性，并且这19株菌株全部（100%）携带CTX-M-15基因。共有15%（3/19）为CTX-M-15和SHV-12的共同产生菌，68.4%（13/19）为CTX-M-15和TEM-1的共同产生菌。在这些菌株中，87.5%（42/48）为ESBL阳性，其中92.85%（39/42）的菌株含有CTX-M-15基因。共有97%（38/39）的菌株为CTX-M-15和SHV-12的共同产生菌，88%（37/42）的菌株TEM-1呈阳性。此外，85.7%（36/42）的菌株为CTX-M-15和TEM-1的共同产生菌。大多数菌株（18/19株）通过脉冲场凝胶电泳（PFGE）被归入两个基因簇，并且所有菌株均被发现为ST-131型。相比之下，这些菌株（31/42）属于单一基因型谱系，并且所有菌株（100%）均属于ST-14型。
这是沙特阿拉伯哈伊勒一家NICU暴发中分离出CTX-M-15阳性、ESBL菌株和这些菌株的首次报告。值得警惕的是，暴发菌株同时产生CTX-M-15和SHV-12导致对氧亚氨基头孢菌素产生高水平耐药的比例很高。
