Surveillance trends of carbapenem-resistant Enterobacteriaceae from Singapore, 2010-2013

Trends in carbapenem-resistant Enterobacteriaceae (CRE) collected from hospitals nationwide in Singapore over 3 years are presented. Hospital isolates with imipenem or meropenem minimum inhibitory concentrations (MICs) of >1mg/L were sent to the National Public Health Laboratory for further investigation. A total of 400 CRE were submitted, 227 (56.8%) of which carried a carbapenemase gene. bla_NDM was the most common (130/400; 32.5%), followed by bla_OXA-48-like (bla_{OXA-48, -181, -232}) (55/400; 13.8%). Interestingly, four isolates bearing dual carbapenemase genes were also detected. KPC- and OXA-48-like-producing Klebsiella pneumoniae were fingerprinted by DiversiLab^® rep-PCR. Locally, KPC producers do not appear to have clonal dissemination. In contrast, OXA-48-like producers were found to have a greater degree of clustering than KPC producers.