490. High Prevalence of Rectal Carriage of blaKPC –Mediated Carbapenem-Resistant Enterobacteriaceae Among Community Food Handlers in Kuwait

Abstract

BackgroundCarbapenemases are diverse enzymes which inactivate the carbapenems. KPC-producing carbapenemase-producing Enterobacteriaceae have disseminated to many regions in the world, however, anecdotal reports of KPC-producing CPE in some GCC countries excluding Kuwait. In this study we report the first emergence of the KPC producing CPE isolated from healthy food handlers in our community.MethodsRectal swabs were collected from 405 food handlers. Isolates were identified by VITEK 2 and their susceptibility to 21 antibiotics performed by MIC determination using Etest. Genes encoding carbapenemase production were characterized by PCR and clonality of isolates was determined by MLST.ResultsA total of 36 CPE were isolated from 31 participants, of which 15 (41.7%) were Escherichia coli and 8 (22.2%) Klebsiella pneumoniae. All isolates were susceptible to amikacin and tigecycline but an alarmingly high percentage (38.9%) were non-susceptible to colistin. A very high proportion of the CPE harbored blaKPC (58.3%), followed by blaOXA-48 (25%), blaNDM (5.6%) and blaVIM (2.8%). Carbapenemases were co-produced with ESBLs in 30.6% of the isolates. Sequencing of the KPC revealed that KPC-18 represented 45%, KPC-2 36% and KPC-29 18%. Considerable genetic diversity among the isolates was identified by MLST assays demonstrating the emergence of new clones. Five diverse new CPE clones were detected from three Bangladeshi citizens and 2 Indians.ConclusionOur finding demonstrates a relatively high colonization rate (8.9%) of healthy food handlers by CPE of which KPC-producing CPE were predominant; this is an unusual finding in Kuwait representing the first of such findings in our country and GCC.Disclosures All authors: No reported disclosures.