NDM-1, OXA-48 and OXA-181 carbapenemase-producing Enterobacteriaceae in Sultanate of Oman

Abstract

Twenty-two carbapenem-resistant enterobacterial isolates were recovered from patients hospitalized between October 2010 and March 2011 at the Royal Hospital of Muscat, Sultanate of Oman. Eleven NDM-1, five OXA-48 and one NDM-1 plus OXA-181 producers of diverse ST types were recovered from clinical samples. All carbapenemase genes were located on self-conjugative plasmids and were nearly always associated with other resistance determinants, including extended-spectrum β-lactamases and the ArmA methylase encoding resistance to aminoglycosides. This work highlights the dissemination of NDM-1 and OXA-48-type producers in the Middle East.

Molecular characterisation and epidemiological investigation of an outbreak of blaOXA-181 carbapenemase-producing isolates of Klebsiella pneumoniae in South Africa

“…Resistance to the clinically significant carbapenem antibiotics by enzymatic hydrolysis has been described in Enterobacteriaceae worldwide, and recently the class D β-lactamase, OXA-48 and its variants have been detected more frequently. [4] While the bla OXA-181 gene has previously been identified in several clonally unrelated K. pneumoniae isolates from SA, India, Singapore, the Netherlands and New Zealand, [4][5][6][7][8][9][10][11][12] this is the first report describing an outbreak of bla OXA-181 in SA. To our knowledge this is the first identification of a bla OXA-181 -producing K. oxytoca isolate.…”

“…The co-production of OXA-181 with ESBL enzymes and the accumulation of additional β-lactamase genes in Enterobacteriaceae has been shown to collectively produce an elevated multidrugresistance phenotype. [4,7,9,10] A probable explanation for the uncharacteristically high carbapenem resistance levels observed with these isolates was the presence of additional ESBL genes. Furthermore, the OXA-181 gene was shown to be linked to the ISEcp1B element, which has been shown to up-regulate gene expression and allow for gene mobilisation.…”

“…[7] Several international studies have identified OXA-181-producing Enterobacteriaceae in the UK, the Sultanate of Oman, the Netherlands, Senegal and New Zealand. [7][8][9][10][11][12] The genetic location of bla OXA-181 is typically on a Tn2013 transposon, immediately downstream of the insertion sequence ISEcp1B, carried on a 7.6-Kb, ColE-type plasmid. [7] The prevalence of nosocomial infections in African countries has been under-appreciated in the past, and while such outbreaks occurring internationally are frequently reported in the literature, relatively few of these reports originate from developing countries.…”

Frequency of Carbapenemase Producing Klebsiella pneumoniae in Makkah, Saudi Arabia

“…Recent studies conducted in Middle East countries also suggests that this region might be an additional reservoir of NDM producers as it has been reported from Oman [13], Lebanon [14], Saudi Arabia [15,16], and Qatar [17].…”

“…Molecular detection of carbapenemase genes using polymerase chain reaction (PCR) based methods was found to be quick, accurate and effective in the detection of specific carbapenemases genes, such as KPC, NDM-1, OXA-48, etc. [13][14][15][16][17]. Simple PCR assays targeting a single carbapenemase type have been used successfully in numerous studies.…”