Nation-wide surveillance of carbapenem resistant Enterobacteriaceae in the United Arab Emirates

While CRE is appreciated as a major problem in countries of the Arabian Peninsula, no nation-wide surveillances have been carried out in the region. Here we report on the first such study from the UAE. Between the 1st of July of 2018 and 31st of March 2019, 504 consecutive non-repeat CRE isolates (75.2% of them Klebsiella pneumoniae) were collected from 15 hospitals of the 7 Emirates and subjected to susceptibility testing, PCR-detection of resistance genes and molecular typing by PFGE and cgMLST. Molecular analysis identified four major K. pneumoniae PFGE groups, members of which belonged to ST14 (and its SLVs: ST2096 and ST78) representing 40.6% of K. pneumoniae strains, ST231, CC147 and ST15. , ST14 group members were significantly more likely to be XDR, PDR or resistant to ceftazidime-avibactam, colistin, tigecycline than other K. pneumoniae, and they were present in all but a small hospital. cgMLST identified multiple clusters within ST14, some widespread in the country while others concentrating in specific hospitals. One of them in Qassimi hospital (Sharjah), produced OXA-48-like carbapenemase, while another one (Saqr hospital (RAK)) produced mostly NDM with consequent resistance to ceftazidime-avibactam.