Prevalence and molecular typing of carbapenem-resistant Enterobacterales in a secondary-care hospital in Jazan region, Saudi Arabia

Abstract

Objectives The aim of this study was to estimate the prevalence of carbapenem-resistant Enterobacterales (CRE) and characterize the distribution of carbapenemase genes among Enterobacterales isolates in the medical microbiology laboratory of Prince Mohammed Bin Nasser Hospital, Jazan, Saudi Arabia. Methods The current cross-sectional study was conducted in a secondary-care center in Jazan, Saudi Arabia, and included consecutive Enterobacterales isolates from clinical specimens of hospitalized patients from June 2023 to April 2024. Demographic data and clinically relevant information were retrieved from electronic medical records. The statistical analyses were performed using the software R and IBM SPSS Statistics. Results A total of 260 Enterobacterales isolates were studied; of these, 26 (10%) fulfilled the criteria for CRE. In the subpopulation of CRE, Klebsiella pneumoniae was the most common (81%), followed by Enterobacter cloacae complex (11%), Escherichia coli (4%), and Klebsiella oxytoca (4%). The most common resistant CRE gene was NDM (58%), followed by a combination of OXA48 and NDM (23%), and then OXA48 (19%). Statistically significant associations existed for admission to a critical care unit, the presence of a central line, and the use of a urinary catheter with the isolation of CRE. Conclusion In this hospital-based cohort, CRE were commonly found among Enterobacterales isolates, mainly K. pneumoniae, and were predominantly driven by the NDM and OXA-48-type carbapenemases. Associations between CRE isolation and exposure to critical care and invasive devices suggest strengthened surveillance, device-related infection-prevention measures, and antimicrobial stewardship should be emphasized in this setting, with a focus on high-risk inpatients.