The emergence of OXA-48-and NDM-1-positive Klebsiella pneumoniae in Riyadh, Saudi Arabia

Objectives: To investigate the emergence of NDM-, OXA-48-, and VIM-producing Klebsiella pneumoniae in Saudi Arabia. Methods: From June to December 2011, we obtained K. pneumoniae isolates with reduced sensitivity to carbapenem identified in Riyadh, Saudi Arabia. Only non-duplicate clinical and surveillance isolates obtained from inpatients were included. PCR amplification was carried out for the detection of extended-spectrum beta-lactamase genes (bla(CTX-M), bla(TEM), bla(SHV)) and carbapenemase genes (bla(KPC), bla(VIM), bla(IMP), bla(NDM), and bla(OXA-48)). Susceptibility to imipenem, meropenem, amikacin, gentamicin, trimethoprim-sulfamethoxazole, and colistin was determined. Results: Of the 60 K. pneumoniae isolates studied, 45 were from patients in the intensive care unit. Forty-seven isolates harbored bla(OXA-48), 12 were positive for bla(NDM), and one for bla(VIM). No isolate harbored a combination of these resistance genes. No isolate harbored bla(KPC) or bla(IMP). All 37 bla(CTX-M)-positive isolates belonged to CTX-M group 1, and 29 were positive for a combination of bla(CTX-M) and bla(OXA-48). bla(TEM) and bla(SHV) genes were found in 17 and 39 isolates, respectively. All isolates were imipenem-and meropenem-resistant, with a high rate of co-resistance to the other antibiotics. Three bla(OXA-48)-positive isolates with colistin resistance were detected. Conclusion: Multidrug-resistant K. pneumoniae isolates harboring bla(OXA-48), bla(NDM), and colistin resistance are emerging in Saudi Arabia. (C) 2013 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.