An outbreak of CTX-M-15 in Klebsiella pneumoniae from Eastern Province, Saudi Arabia

Mohamed Hamed Mohamed Al-Agamy PhD, Atef Mohamed Shibl PhD

Division of Microbiology, College of pharmacy, King Saud University, Riyadh, Saudi Arabia and

Abstract:

Purpose: To characterize the extended-spectrum â-lactamases (ESâLs) in Klebsiella pneumoniae isolated from paediatric patients during an outbreak in neonatal intensive care unit (NICU), Al-qatif hospital, Eastern province in Saudi Arabia.

Methods: A total of 16, K. pneumoniae isolates resistant to cefotaxime were phenotypically screened for production of ESâL using ESâL-E-strips. MIC PCR experiments and DNA sequencing were used to identify â-lactamase (bla_TEM, bla_SHV, and bla_CTX-M) genes. Conjugation experiments were done by filter matting method. MIC was determined for isolates and their transconjugants using E-test.

Results: Phenotypic detection revealed that all 16 K. pneumoniae were found to produce ESâL. However, genotypic detection by PCR and DNA sequencing showed that all isolates contain TEM-1, SHV-1, and CTX-M-15 genes. The tested antibiotic resistant determinates are transferable except ciprofloxacin.

Conclusions: CTX-M-15 is the predominant ESâL gene in all ESâL-producing K. pneumoniae isolates. CTX-M-15 gene is responsible for an outbreak in NICU in the hospital in Eastern province, Saudi Arabia. This study pointed to first description of CTX-M-15 â-lactamase in K. pneumoniae isolates from Saudi Arabia.

Keywords: ESâL, CTX-M-15, Klebsiella pneumoniae, Saudi Arabia

• Corresponding author: M.H.M. Al-Agamy
• Assistant Professor of Microbiology, College of Pharmacy, King Saud University
• Email: elagamy71@yahoo.com