Early Years of Carbapenem-Resistant Enterobacterales Epidemic in Abu Dhabi

Abstract

Recent studies showed that the current endemic of carbapenem-resistant Enterobacterales (CRE) in the Emirate of Abu Dhabi is dominated by highly resistant Klebsiella pneumoniae clones ST14, ST231, and CC147, respectively. In the absence of continuous, molecular typing-based surveillance, it remained unknown whether they lately emerged and rapidly became dominant, or they had been present from the early years of the endemic. Therefore, antibiotic resistance, the presence of carbapenemase and 16S methylase genes, and the sequence types of CRE strains collected between 2009 and 2015 were compared with those collected between 2018 and 2019. It was found that members of these three clones, particularly those of the most prevalent ST14, started dominating already in the very early years of the CRE outbreak. Furthermore, while severely impacting the overall antibiotic resistance patterns, the effect of these clones was not exclusive: for example, increasing trends of colistin or decreasing rates of tigecycline resistance were also observed among nonclonal isolates. The gradually increasing prevalence of few major, currently dominating clones raises the possibility that timely, systematic, molecular typing-based surveillance could have provided tools to public health authorities for an early interference with the escalation of the local CRE epidemic.

The Impact of Urinary Catheterization on the Antibiotic Susceptibility of ESBL-Producing Enterobacterales: A Challenging Duo

“…In 2017, more than 197,000 cases of ESBL-producing microorganism infections were reported in the United States alone [12]. Broad-spectrum antibiotics, such as carbapenems, are usually required for the treatment of these infections, but carbapenem resistance is also on the rise [13][14][15], an alarming situation also confirmed by our findings.…”

Prevalence of class A ESBL, class B and D carbapenemase encoding genes (CTX-M, TEM, SHV, NDM, IMP, OXA-48) in gram-negative bacterial pathogens isolated from various clinical samples collected from northern region of United Arab Emirates

“…The bacterial growth rate was significant among the collected samples and the overall positivity rate of the bacterial growth was 29.9%. Similarly, a study was carried out in Abu Dhabi [33] reported that the urine sample was the most common sample type (24.2%), followed by sputum, wound and blood respectively and Mahamat et al stated that in their study the predominant clinical samples were urine (72.5%) than other clinical samples and the highest bacterial growth (70.3%) rate was observed from the urine samples [33,34] In this study, 64.3% of the bacterial isolates were gram-negative bacteria and remaining 35.7% were gram positive bacteria (21.5%) and other gram variable bacteria & Candida species (14.2%).…”