Fecal Carriage and Molecular Characterization of Carbapenemase-Producing Enterobacterales in the Pediatric Population in Qatar

• DOI: 10.1128/spectrum.01122-21
• Publication Date: 2021-11-10T15:33:47Z
• Authors: Andrés Pérez-López; Sathyavathi Sunda...; Kin Ming Tsui; Hassan Al-Mana; Mohammad Rubayet ...; Mohammed Suleiman; Eman Al Maslamani; Omar Imam; Diane Roscoe; Patrick Tang
• Keywords: Carriage; Peninsula; Molecular Epidemiology

Whole-genome sequencing was used to characterize carbapenemase-producing Enterobacterales (CPE) strains recovered from rectal screening swab samples obtained children at a tertiary-care pediatric hospital in Qatar during 3-year period. A total of 72 CPE isolates 61 fecal carriers were characterized. Escherichia coli (47 [65.3%]) and Klebsiella pneumoniae (22 [30.6%]) the most common species identified. High levels genetic diversity observed for both species. These produced 78 carbapenemases, characterized as either NDM-type (41 enzymes [52.6%]) or OXA-48-type (37 [47.4%]). NDM-5 (24 [30.8%]), NDM-1 (15 [19.2%]), OXA-181 [19.2%]) variants detected within each type. Twenty-three NDM producers exhibited difficult-to-treat resistance, compared with only 2 OXA-48 producers. Multiple comorbidities identified 88.5% patients, whereas recent travel history countries which are endemic documented 57.4% patients. All 9 blaOXA-48-type-gene-containing E. sequence type 38 (ST38) isolated patients without international history. The mean quarterly incidence carriage decreased more than 6-fold after implementation coronavirus disease 2019 (COVID-19)-related restrictions mid-March 2020. Our data suggest that carbapenemases expressed by large K. genotypes largely dominant population Qatar. Although our indicate successful local expansion ST38 harboring blaOXA-244 genes, least health care settings, blaOXA-48-type blaNDM-type genes appear have been mainly introduced sporadically asymptomatic who visited received some nearby endemic. IMPORTANCE To best knowledge, this is first study addressing molecular characteristics using whole-genome sequencing. Since several Arabian Peninsula share relatively similar demographic patterns links, it plausible children, middle eastern parts region, those study.