Search

Background and objective: The presence of carbapenemase enzymes among Enterobacterales is the main mechanism to reduce susceptibility to a wide range of antibiotics. Carbapenemase enzymes such as the Klebsiella pneumoniae carbapenemase (KPC) hydrolyse beta-lactam antibiotics group, which includes carbapenem, leads to fewer treatment options. We aim to describe the first report of carbapenem-resistant K. pneumoniae (CRKP) sequence type (ST) 11 harbouring KPC in Oman. Material and methods: Five confirmed CRKP isolates were isolated from clinical samples during the period of January 2019 till December 2019. Strains were genotyped by pulse field gel electrophoresis (PFGE) for genetic relatedness. Whole genome sequencing (WGS) was performed to observe relationships with global strains using multilocus sequence typing (MLST). Antimicrobial genes, capsular loci-K-types, plasmids types and virulence genes were also identified using whole genome sequence data. Results: All five CRKP were determined to have blaKPC-2 with or without blaOX-A48 and blaNDM-2. The molecular genotyping by PFGE showed 100% similarity among the five isolates. The MLST allelic profile analysis clonally clustered our strains with SL-258, CG-11 and ST11 mainly reported from South Asia. Further molecular characterization of the capsular K-locus and O-locus genes, revealed the strains to belong to KL-47 type and OL101 type respectively. The core genome typing suggests that our strains were clonally related to Chinese strains with less than five chromosomal nucleotides differences. Conclusion: Epidemiological and molecular analyses confirmed that these KPC-producing K. pneumoniae strains are from a single clone that caused multiple nosocomial infections in one health institution. This finding highlights the importance to sustain the surveillance and infection prevention efforts and to step up active screening to prevent the spread of nosocomial infection.

Background: In Oman, many extended families tend to live in one household. Some families can include 20–30 individuals with the majority of them being children. This study investigates the role of children in spreading SARS-CoV-2 causing COVID-19 within family clusters in Oman. Methods: This retrospective study includes data of 1026 SARS-CoV-2 positive children (≤18 years) collected from the national surveillance database for COVID-19 between 1 February 2020 and 30 May 2020. Results: We included 1026 patients. Most, 842 were Omani (82%), 52% male, and 28.5% asymptomatic. Close to the half of symptomatic 419 (40%), patients presented with fever associated with other respiratory symptoms. Fifty pediatric patients were index cases who transmitted the virus to 107 patients in total (86 adults and 21 children) with a mode of 1. There is no statistical significance of all studied risk factors in the transmission of the SARS-CoV-2 virus including age, gender, and cycle threshold (CT) value. Conclusions: According to this study, children are not to be considered a significant driver of transmission of SARS-CoV-2 in Oman.

Objectives: To investigate the course of a hospital acquired outbreak of Bacillus cereus gastroenteritis outbreak, and the interventions that were taken to prevent such an outbreak from occurring again. Methods: On May 3–5 2008, 58 cases of gastroenteritis were reported among patients and their attendants in a referral hospital in Oman. All affected had eaten meals served by the hospital kitchen the previous day. An outbreak investigation team conducted active surveillance and interviewed people about symptoms and food consumed on the preceding day in the hospital. Food samples from the kitchen and faecal samples from the kitchen staff and those affected were cultured. An environmental audit of the kitchen was conducted. Results: The majority of the 58 persons affected by the outbreak were adult females, predominantly attendants of patients. 90% had diarrhoea and 10% had vomiting, usually mild. All those affected were managed symptomatically except for two patient attendants who required intravenous rehydration. The meal exposure histories implicated at least one meal from the kitchen. Many violations of basic food hygiene standards were observed in the kitchen. Toxin producing B. cereus was isolated from faeces of 3/12 (25%) patients and 19/25 (76%) of food handlers, and 35/61 (57%) of food samples from the kitchen. Conclusion: This is the first report of a nosocomial outbreak of foodborne B. cereus infection from this region. The importance of appropriate epidemiological and microbiological investigation and public relations management is emphasized, in addition to the need for continuing training of food handlers and rigorous enforcement of food hygiene regulations. Keywords: Bacillus cereus, Food poisoning, Nosocomial infection, Outbreak investigation, Oman