Whole-Genome Sequencing for Molecular Characterization of Carbapenem-Resistant Enterobacteriaceae Causing Lower Urinary Tract Infection among Pediatric Patients

oleh: Hassan Al Mana, Sathyavathi Sundararaju, Clement K. M. Tsui, Andres Perez-Lopez, Hadi Yassine, Asmaa Al Thani, Khalid Al-Ansari, Nahla O. Eltai

Format: Article
Diterbitkan: MDPI AG 2021-08-01

Deskripsi

Antibiotic resistance is a growing public health problem globally, incurring health and cost burdens. The occurrence of antibiotic-resistant bacterial infections has increased significantly over the years. Gram-negative bacteria display the broadest resistance range, with bacterial species expressing extended-spectrum β-lactamases (ESBLs), AmpC, and carbapenemases. All carbapenem-resistant <i>Enterobacteriaceae</i> (CRE) isolates from pediatric urinary tract infections (UTIs) between October 2015 and November 2019 (<i>n</i> = 30). All isolates underwent antimicrobial resistance phenotypic testing using the Phoenix NMIC/ID-5 panel, and carbapenemase production was confirmed using the NG-Test CARBA 5 assay. Whole-genome sequencing was performed on the CREs. The sequence type was identified using the Achtman multi-locus sequence typing scheme, and antimicrobial resistance markers were identified using ResFinder and the CARD database. The most common pathogens causing CRE UTIs were <i>E. coli</i> (63.3%) and <i>K. pneumoniae</i> (30%). The most common carbapenemases produced were OXA-48-like enzymes (46.6%) and NDM enzymes (40%). Additionally, one <i>E. coli</i> harbored IMP-26, and two <i>K. pneumoniae</i> possessed mutations in <i>ompK37</i> and/or <i>ompK36</i>. Lastly, one <i>E. coli</i> had a mutation in the <i>marA</i> porin and efflux pump regulator. The findings highlight the difference in CRE epidemiology in the pediatric population compared to Qatar’s adult population, where NDM carbapenemases are more common.