Characterization of extended-spectrum beta-lactamase-producing Klebsiella pneumoniae from Riyadh, Saudi Arabia.

The objectives of this study were to determine the prevalences, genotypes, and clonal relationships of extended-spectrum beta-lactamase (ESBL)-producing strains in 98 Klebsiella pneumoniae isolates from Riyadh. The prevalence of ESBLs in these strains was 37·75%. All isolates that were confirmed to have ESBLs were completely resistant to amoxicillin/clavulanate, aztreonam, cefotaxime, ceftazidime, cefoxitin, and gentamicin and were susceptible to tigecycline, colistin, and imipenem. In total, 16·6, 77, and 91·6% of isolates were resistant to amikacin, ciprofloxacin, and piperacillin/tazobactam, respectively. The prevalences of isolates producing the beta-lactamases SHV, CTX-M, and TEM were 91·9, 86·5, and 54·05%, respectively. The most frequent ESBL gene detected was blaCTX-M-15, which was observed in 75% of isolates. Other frequent ESBL genes were blaSHV-12 (29·73% of isolates) and blaSHV-5 (5·4% of isolates); additionally, blaCTX-M-3, blaCTX-M-27, blaCTX-M-57, and blaCTX-M-82 were each detected in one isolate. Pulsed-field gel electrophoresis (PFGE) analysis revealed the presence of diverse and unrelated clones. The high prevalence of ESBL producers among the strains examined in our study was not due to the spread of a single clone of bacteria. Clone A was detected in six isolates, indicating intra-hospital spread. Our study documented a high prevalence of the CTX-M-15 product in K. pneumoniae and demonstrated that SHV-12 was also highly prevalent. This study represents the first report of CTX-M-3, CTX-M-27, CTX-M-57, and CTX-M-82 beta-lactamases in K. pneumoniae isolates from Saudi Arabia.