pThe molecular epidemiology and mechanisms of resistance of carbapenem-resistant Enterobacteriaceae (CRE) were determined in hospitals in the countries of the Gulf Cooperation Council (GCC), namely, Saudi Arabia, United Arab Emirates, Oman, Qatar, Bahrain, and Kuwait. Isolates were subjected to PCR-based detection of antibiotic-resistant genes and repetitive sequence-based PCR (rep-PCR) assessments of clonality. Sixty-two isolates which screened positive for potential carbapenemase production were assessed, and 45 were found to produce carbapenemase. The most common carbapenemases were of the OXA-48 (35 isolates) and NDM (16 isolates) types; 6 isolates were found to coproduce the OXA-48 and NDM types. No KPC-type, VIM-type, or IMP-type producers were detected. Multiple clones were detected with seven clusters of clonally related Klebsiella pneumoniae. Awareness of CRE in GCC countries has important implications for controlling the spread of CRE in the Middle East and in hospitals accommodating patients transferred from the region.

(1). The success of this pathogen is partially due to the high prevalence of a multidrug-resistant phenotype that A. baumannii now demonstrates (2). In the Middle East, particularly in states of the Cooperation Council for the Arab States of the Gulf (Gulf Cooperation Council [GCC]; i.e., Saudi Arabia, United Arab Emirates, Oman, Kuwait, Qatar, and Bahrain), the prevalence of carbapenem-resistant A. baumannii (CRAB) has increased dramatically over the last decade (3). This high prevalence limits treatment options, which can lead to increased morbidity and mortality due to infections caused by CRAB.The phenotypic resistance characteristics of CRAB are mainly due to the expression of class D carbapenemases, called oxacillinases. Moreover, plasmid-mediated metallo-␤-lactamases (MBL) have been associated with the resistance phenotype (2). The existence of ISAba1 elements upstream of the bla OXA-51-type gene is also associated with the carbapenem resistance phenotype in A. baumannii by overexpressing the intrinsic OXA-51 carbapenemase (4). Previous reports on isolates from the GCC states show that the carbapenem resistance phenotype in A. baumannii is often due to the expression of OXA enzymes, particularly OXA-23 (3). However, MBL-encoding genes, including the recently

Summary Due to the introduction of newer, more efficacious treatment options, there is a pressing need for policy makers and public health officials to develop or adapt national hepatitis C virus (HCV) control strategies to the changing epidemiological landscape. To do so, detailed, country‐specific data are needed to characterize the burden of chronic HCV infection. In this study of 17 countries, a literature review of published and unpublished data on HCV prevalence, viraemia, genotype, age and gender distribution, liver transplants and diagnosis and treatment rates was conducted, and inputs were validated by expert consensus in each country. Viraemic prevalence in this study ranged from 0.2% in Hong Kong to 2.4% in Taiwan, while the largest viraemic populations were in Nigeria (2 597 000 cases) and Taiwan (569 000 cases). Diagnosis, treatment and liver transplant rates varied widely across the countries included in this analysis, as did the availability of reliable data. Addressing data gaps will be critical for the development of future strategies to manage and minimize the disease burden of hepatitis C.

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