ArticlePloS one2020
Prevalence of carbapenem-resistant Enterobacteriaceae and emergence of high rectal colonization rates of blaOXA-181-positive isolates in patients admitted to two major hospital intensive care units in Kuwait.
Article in PloS one, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 3 of them syntheses that pooled it.
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Who cites it
15 citing papers in PubMed, 3 syntheses or guidelines pooled it, 26 citations in OpenAlex.
- Prevalence and molecular epidemiology of carbapenem resistance in Asia: a systematic review and meta-analysis.Systematic reviews · 2025Pooled it
- Pooled it
- Prevalence and incidence of carbapenem-resistant K. pneumoniae colonization: systematic review and meta-analysis.Systematic reviews · 2022Pooled it
- Overview of Colistin Resistance in the Middle East and North Africa (MENA) Region.Microorganisms · 2026Review
- Long-Term Trends in Antimicrobial Resistance Among Gram-Negative Clinical Isolates at Mubarak Al-Kabeer Hospital, Kuwait (2007-2022).Antibiotics (Basel, Switzerland) · 2026Article
- Gram-negative gut colonization in children newly diagnosed with malignancy: microbiology, antimicrobial resistance pattern, and clinical implications.Gut pathogens · 2026Article
- Colonization with Carbapenemase producing Enterobacterales (CPE) and associated alteration in microbiota composition in a tertiary care hospital in Egypt.BMC microbiology · 2026Article
- A 15-Year One Health Approach to Antimicrobial Resistance in Kuwait from Hospitals to Environmental Contexts: A Systematic Review.Life (Basel, Switzerland) · 2025Review
- Analysis of rectal carbapenem-resistant Enterobactericeae colonization results first report in Istanbul/Turkiye: Klebsiella pneumoniae co-producing blaBMC infectious diseases · 2025Article
- Genomic characterization of multi drug resistant ESBL-producing Escherichia coli isolates from patients and patient environments in a teaching hospital in Ghana.BMC microbiology · 2024Article
- Multidrug-Resistant and Extensively Drug-ResistantMicroorganisms · 2023Article
- Fecal carriage and genetic characteristics of carbapenem-resistant enterobacterales among adults from four provinces of China.Frontiers in epidemiology · 2023Article
- Extended Spectrum- and Carbapenemase-Based β-Lactam Resistance in the Arabian Peninsula-A Descriptive Review of Recent Years.Antibiotics (Basel, Switzerland) · 2022Review
- Global Threat of Carbapenem-Resistant Gram-Negative Bacteria.Frontiers in cellular and infection microbiology · 2022Review
- Preponderance ofFrontiers in microbiology · 2021Article
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Authors and funding
3 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundFecal colonization by carbapenem-resistant Enterobacteriaceae (CRE) can be the main reservoir for transmission of these resistant organisms especially in the Intensive Care Units (ICUs).
aimThis study was conducted to evaluate the rate of rectal carriage and molecular characterization of CRE in patients hospitalized in the ICUs of 2 major hospitals (Adan and Mubarak Al Kabeer Hospitals) in Kuwait. MATERIALS AND
methodsRectal swabs were collected from all patients at admission, 48 h after admission and once weekly from April 2017- March 2018. Initial CRE screening was carried out on MacConkey agar on which meropenem disc 10μg was placed. Identification of isolates was by API 20E. Susceptibility testing was performed using the E-test method. Polymerase chain reaction (PCR) was used to detect the carbapenemase-encoding genes. Clonal relationship was investigated by pulsed-field electrophoresis (PFGE). Genes of blaOXA-181 and blaNDM-5-carrying plasmids were detected in some strains.
resultsA total of 590 patients were recruited into the study. Of these, 58 were positive for CRE, giving a prevalence of 9.8%; 25/320 (7.8%) in Adan and 33/270 (12.2%) in Mubarak Al Kabeer Hospitals. All isolates were resistant to multiple antibiotics. Resistance rates to colistin and tigecycline were 17% and 83%, respectively. Single genes of blaOXA-181 were detected in isolates from 38 (65.5%) out of 58 patients and in 5 patients colonized by blaOXA-48-positive CRE. A combination of 2 genes was detected in 12 isolates; 5 blaKPC-2 and blaOXA-181, 4 blaVIM-1 and blaOXA-181, and 3 blaNDM-5 and blaOXA-181. PFGE showed an overall level of similarity of 38%. Southern hybridization studies localized the blaOXA-181 and blaNDM-5 genes to a large plasmid of 200kb in 3 K. pneumoniae isolates and a small plasmid of 80kb in 2 E. coli isolates, respectively.
conclusionThe prevalence of CRE colonization in the 2 hospital ICUs was relatively high and the emergence of blaOXA-181-mediated CRE is a cause for concern as there is the possibility of rapid horizontal spread among hospital patients in Kuwait. Active surveillance of CRE in the ICUs is highly recommended to stem its spread.
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