scholarly journals Prevalence of Quinolones Resistance Proteins Encoding Genes (qnr genes) and Co-Resistance with β-lactams among Klebsiella pneumoniae Isolates from Iraqi Patients

2020 ◽  
Vol 17 (2) ◽  
pp. 0406
Author(s):  
Mustafa Mustafa et al.
Keyword(s):  
Klebsiella Pneumoniae ◽  
Biochemical Properties ◽  
The Other ◽  
Clinical Isolates ◽  
Clinical Samples ◽  
Missense Mutations ◽  
High Association ◽  
Resistance Proteins ◽  
Major Threat ◽  
Encoding Genes

This study investigated the prevalence of quinolones resistance proteins encoding genes (qnr genes) and co-resistance for fluoroquinolones and β-lactams among clinical isolates of Klebsiella pneumoniae.  Out of 150 clinical samples, 50 isolates of K. pneumoniae were identified according to morphological and biochemical properties. These isolates were collected from different clinical samples, including 15 (30%) urine, 12 (24%) blood, 9 (18%) sputum, 9 (18%) wound, and 5 (10%) burn. The minimum inhibitory concentrations (MICs) assay revealed that 15 (30%) of isolates were resistant to ciprofloxacin (≥4µg/ml), 11 (22%) of isolates were resistant to levofloxacin (≥8 µg/ml), 21 (42%) of isolates were resistant to ertapenem (≥8 µg/ml), 18 (36%) of isolates were resistant to imipenem (4- ≥16µg/ml), 43 (86%) of isolates were resistant to ceftriaxone (4- ≥64 µg/ml), 42 (84%) of isolates were resistant to ceftazidime (16-64 µg/ml), and 40 (80%) of isolates were resistant to cefepime (4- ≥16µg/ml). The results revealed that all fluoroquinolone resistant K. pneumoniae isolates were resistant for β-lactams that used in this study. Genotypic detection of qnr genes revealed that qnrS and qnrB were found in 38 (76%) and 18 (36%) of K. pneumoniae isolates, respectively. On the other hand, qnrA, qnrC, and qnrD were not found among K. pneumoniae isolates. DNA sequencing of qnrB gene revealed that the presence of silent and missense mutations that may have led to increase the resistance values of MICs for ciprofloxacin and levofloxacin. These variants were registered in NCBI at the accession numbers LC373260 and LC381730. The phylogenetic tree of qnrB variants showed a significant deviation of these variants from K. pneumoniae species. The spread of qnr genes among clinical isolates of  K. pneumoniae and high association observed between resistance to fluoroquinolones and β-lactams have led to a major threat to public health through development of MDR K. pneumoniae.  

scholarly journals Detection of 16S rRNA Methylases and Co-Resistance with β-lactams among Klebsiella pneumoniae Isolates from Iraqi Patients

2019 ◽  
Vol 16 (3) ◽  
pp. 0580
Author(s):  
Mustafa Et al.
Keyword(s):  
Amino Acids ◽  
16S Rrna ◽  
Klebsiella Pneumoniae ◽  
Biochemical Properties ◽  
Clinical Samples ◽  
Missense Mutations ◽  
Accession Number ◽  
Beta Lactamases ◽  
Extended Spectrum Beta Lactamases ◽  
Encoding Genes

Out of 150 clinical samples, 50 isolates of Klebsiella pneumoniae were identified according to morphological and biochemical properties. These isolates were collected from different clinical samples, including 15 (30%) urine, 12 (24%) blood, 9 (18%) sputum, 9 (18%) wound, and 5 (10%) burn. The minimum inhibitory concentrations (MICs) assay revealed that 25 (50%) of isolates were resistant to gentamicin (≥16µg/ml), 22 (44%) of isolates were resistant to amikacin (≥64 µg/ml), 21 (42%) of isolates were resistant to ertapenem (≥8 µg/ml), 18 (36%) of isolates were resistant to imipenem (4- ≥16µg/ml), 43 (86%) of isolates were resistant to ceftriaxone (4- ≥64 µg/ml), 42 (84%) of isolates were resistant to ceftazidime (16-64 µg/ml), and 40 (80%) of isolates were resistant to cefepime (4- ≥16µg/ml). Co-Resistance for both β-lactams and aminoglycosides were detected among 25 (50%) of K. pneumoniae isolates. The extended spectrum beta-lactamases (ESBLs) were detected among 25 (50%) of K. pneumoniae isolates. Screening of 16S rRNA methylases  encoding genes revealed that armA was found in 5 (10%) of K. pneumoniae isolates, whereas rmtB was not found among K. pneumoniae isolates. DNA sequencing of armA revealed that the presence of missense mutations in which affected in the translation of protein by substitutions of amino acids, leading to increase the resistance values of MICs for gentamicin and amikacin. These variants were registered in NCBI at the accession number LC373258. The phylogenetic tree of armA variants showed a slight deviation of these variants from K. pneumoniae species.

scholarly journals Molecular Investigation of hemolytic phospholipase C Encoding Genes in Clinical Isolates of Pseudomonas aeruginosa

2018 ◽  
Vol 9 (SPL1) ◽  
Author(s):  
Rasha Hadi Saleh ◽  
Habeeb S Naher ◽  
Mohammed AK Al-saadi
Keyword(s):  
Phospholipase C ◽  
Virulence Genes ◽  
Clinical Isolates ◽  
Clinical Samples ◽  
Burn Wound ◽  
Molecular Investigation ◽  
Genes Encoding ◽  
Stool Samples ◽  
Polymerase Chain ◽  
Encoding Genes

This study is aimed to isolate P.aeruginosa from different clinical cases and to detect the prevalence of virulence genes encoding hemolytic phospholipase C(plcH)in these clinical isolates. In this study a total of 422 clinical samples including burn,wound,ear,urine,abscess and stool were aseptically taken from out- and inpatients who admitted into two hospitals in Hilla City (Teaching Al-Hilla Hospital and Babylon Hospital for Maternity and children during a period of three months. All samples were subjected to bacterial cultivation for the isolation of P.aeruginosa. The isolated P.aeruginosa was diagnosed depended on morphological,biochemical and molecular standard characteristics. Hemolytic phospholipase Cencoding genes(plcH) were detected by PCR and the amplification products were separated in 1% agarose gels containing ethidium bromide. Out of 422 samples,P.aeruginosa was isolated from 54 samples (12.8%). The distribution of these isolates were: 22 (55%) from burn samples,2; (50%) from diabitics foot samples,8 (14.8%) from wound samples, 8 (32%) from ear samples,3 (11%) from abscess samples, 7 (4%) from stool samples,4 (4%) from urine samples and 0 sputum samples. The genotypic properties of hemolytic phospholipase C (plcH )toxins was detected by polymerase chain reaction (PCR). The results of this study revealed that(plcH )gene found in 13/20 (65%)of isolates.

scholarly journals Phenotypic and Genotypic Characterisation of Clinical Isolates of Nosocomial Infections

2020 ◽  
Author(s):  
I. S. Korotetskiy ◽  
A. B. Jumagaziyeva ◽  
S. V. Shilov ◽  
Т. V. Kuznetsova ◽  
Z. А. Iskakbayeva ◽  
...  
Keyword(s):  
Nosocomial Infections ◽  
Biochemical Properties ◽  
Clinical Isolates ◽  
Clinical Samples ◽  
Genetic Determinants ◽  
Genome Sequences ◽  
Antimicrobial Drugs ◽  
Taxonomic Affiliation ◽  
Phenotypic Methods ◽  
Genome Scale

The study focuses on identification and characterization of clinical isolates of nosocomial infections with an aim to create a Bank of model microorganisms for further study of mechanisms and prospects of clinical use of novel medicines causing a reversion susceptibility to antibiotics in drug resistant pathogens. Clinical samples of nosocomial infections were collected from phthisiological hospitals in Almaty. Clinical isolates were characterized by morpho-cultural, tinctorial, physiological and biochemical properties and also by susceptibility to antibiotics. Our studies showed that the isolates are characterized by an increased ability to form biofilms that significantly complicates the therapy and prevention of these outbreaks. Moreover, isolates were characterized by varying degrees of susceptibility to antimicrobial drugs. The strains of Citrobacter were resistant to azithromycin, which is considered as a reserve drug. This fact raises a concern about the circulation and the spread in hospitals of microorganisms resistant to the latest generation of antibiotics. Obtained genome-scale contigs were used for taxonomic affiliation of the isolates and for identification of genetic determinants of antibiotic resistance. The search for genetic determinants of drug resistance in the obtained genome sequences confirmed the resistance to some antibiotics obtained by phenotypic methods. Whole genome sequences were obtained for 4 clinical isolates identified as Citrobacter koseri SCAID URN1-2019, Citrobacter freundii SCAID PHRX1-2019, Escherichia coli SCAID URN1-2019 and Streptococcus pneumoniae SCAID PHRX1-2019. The genomes were deposited in the NCBI database under accession numbers CP052059, CP052058, CP052057, and CP052060.

scholarly journals Ceftazidime-Resistant Klebsiella pneumoniae and Escherichia coli Isolates Producing TEM-10 and TEM-43 β-Lactamases from St. Louis, Missouri

1998 ◽  
Vol 42 (7) ◽  
pp. 1671-1676 ◽  
Author(s):  
Youjun Yang ◽  
Niraja Bhachech ◽  
Patricia A. Bradford ◽  
Bradley D. Jett ◽  
Daniel F. Sahm ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Klebsiella Pneumoniae ◽  
Hydrolytic Activity ◽  
Pulsed Field Gel Electrophoresis ◽  
The Other ◽  
Hydrolysis Rate ◽  
Cloning And Sequencing ◽  
E Coli ◽  
Jewish Hospital ◽  
Encoding Genes

ABSTRACT Ceftazidime-resistant Escherichia coli andKlebsiella pneumoniae (49 and 102 isolates, respectively) were collected from Barnes-Jewish Hospital, St. Louis, Mo., from 1992 to 1996. They were uniformly resistant to ceftazidime, generally resistant to aztreonam, and variably susceptible to cefotaxime. Four representative E. coli strains and 15Klebsiella strains were examined. From one to four β-lactamases were produced per strain, with three possible enzymes related to ceftazidime resistance: enzymes with pI values of 5.6, 6.1, or 7.6. By pulsed-field gel electrophoresis there were at least 13 different Klebsiella strain types and 3 different E. coli strain types, indicating that the outbreak was not clonal. After cloning and sequencing of the β-lactamase-encoding genes, the enzyme with a pI of 5.6 was identified as TEM-10. The enzyme with a pI of 6.1 was a novel TEM variant (TEM-43) with Lys at 104, His at 164, and Thr at 182. TEM-43 showed broad-spectrum hydrolytic activity against all penicillins, with the highest hydrolysis rate for ceftazidime compared to those for the other expanded-spectrum cephalosporins. Aztreonam was also a good substrate for TEM-43, with hydrolytic activity similar to that of ceftazidime and affinity higher than that of ceftazidime. The TEM-43 β-lactamase was well inhibited by clavulanic acid and tazobactam at concentrations of <10 nM. Sulbactam was less effective than the other inhibitors. The Thr182 mutation previously reported in an inhibitor-resistant β-lactamase did not cause the TEM-43 enzyme to become resistant to any of the inhibitors.

scholarly journals Prevalence of pathogenic Klebsiella pneumoniae based on PCR capsular typing harbouring carbapenemases encoding genes in Uganda tertiary hospitals

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Kenneth Ssekatawa ◽  
Denis K. Byarugaba ◽  
Jesca L. Nakavuma ◽  
Charles D. Kato ◽  
Francis Ejobi ◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
Klebsiella Pneumoniae ◽  
Virulence Factors ◽  
Carbapenem Resistance ◽  
Clinical Isolates ◽  
Genotypic Resistance ◽  
Pathogenic Potential ◽  
Phenotypic Resistance ◽  
Tertiary Hospitals ◽  
Encoding Genes

Abstract Background Klebsiella pneumoniae is an opportunistic pathogen that has been implicated as one of commonest cause of hospital and community acquired infections. The K. pneumoniae infections have considerably contributed to morbidity and mortality in patients with protracted ailments. The capacity of K. pneumoniae to cause diseases depends on the presence of an array virulence factors. Coexistence and expression of virulence factors and genetic determinants of antibiotic resistance complicates treatment outcomes. Thus, emergence of pathogenic MDR K. pneumoniae poses a great threat to the healthcare system. However, the carriage of antibiotic resistance among pathogenic K. pneumoniae is yet to be investigated in Uganda. We sought to investigate the carbapenem resistance profiles and pathogenic potential based on capsular serotypes of K. pneumoniae clinical isolates. Methods This was a cross sectional study involving use of archived Klebsiella pneumoniae isolates collected between January and December, 2019 at four tertiary hospitals in Uganda. All isolates were subject to antimicrobial susceptibility assays to determine phenotypic antibiotic resistance, pentaplex PCR to detect carbapenemases encoding genes and heptaplex PCR to identify capsular serotypes K1, K2, K3, K5, K20, K54 and K57. Results The study found an overall phenotypic carbapenem resistance of 23.3% (53/227) and significantly higher genotypic resistance prevalence of 43.1% (98/227). Over all, the most prevalent gene was blaOXA-48-like (36.4%), followed by blaIMP-type (19.4%), blaVIM-type (17.1%), blaKPC-type (14.0%) and blaNDM-type (13.2%). blaVIM-type and blaOXA-48-like conferred phenotypic resistance in all isolates and 38.3% of isolates that harbored them respectively. Capsular multiplex PCR revealed that 46.7% (106/227) isolates were pathogenic and the predominantly prevalent pathotype was K5 (18.5%) followed by K20 (15.1%), K3 (7.1%), K2 (3.1%) and K1 (2.2%). Of the 106 capsular serotypes, 37 expressed phenotypic resistance; thus, 37 of the 53 carbapenem resistant K. pneumoniae were pathogenic. Conclusion The high prevalence of virulent and antibiotic resistant K. pneumoniae among clinical isolates obtained from the four tertiary hospital as revealed by this study pose a great threat to healthcare. Our findings underline the epidemiological and public health risks and implications of this pathogen.

scholarly journals Prevalence of Pathogenic Klebsiella Pneumoniae based on PCR Capsular Typing Harbouring Carbapenemases Encoding Genes in Ugandan Tertiary Hospitals

2020 ◽  
Author(s):  
Kenneth Ssekatawa ◽  
Denis K. Byarugaba ◽  
Jesca L. Nakavuma ◽  
Charles D. Kato ◽  
Francis Ejobi ◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
Klebsiella Pneumoniae ◽  
Carbapenem Resistance ◽  
Clinical Isolates ◽  
Genotypic Resistance ◽  
Cross Sectional ◽  
Pathogenic Potential ◽  
Phenotypic Resistance ◽  
Tertiary Hospitals ◽  
Encoding Genes

Abstract Background: Klebsiella pneumoniae is an opportunistic pathogen that has been implicated as one of commonest cause of hospital and community acquired infections. The K. pneumoniae infections have considerably contributed to morbidity and mortality in patients with protracted ailments. The capacity of K. pneumonia to cause diseases depends on presence of an array virulent factors. Coexistence and expression of virulent factors and genetic determinants of antibiotic resistance complicates treatment outcomes. Thus, emergence of pathogenic MDR K. pneumoniae poses a great threat to the healthcare system. However, the carriage of antibiotic resistance among pathogenic K. pneumoniae is yet to be investigated in Uganda. We sought to investigate the carbapenem resistance profiles and pathogenic potential based on capsular serotypes of K. pneumoniae clinical isolates. Methods: This was a cross sectional study involving use of archived Klebsiella pneumoniae isolates collected between January and December, 2019 at four tertiary hospitals in Uganda. All isolates were subject to antimicrobial susceptibility assays to determine phenotypic antibiotic resistance, pentaplex PCR to detect carbapenemases encoding genes and heptaplex PCR to identify capsular serotypes K1, K2, K3, K5, K20, K54 and K57.Results: The study found an overall phenotypic carbapenem resistance of 23.3% (53/227) and significantly higher genotypic resistance prevalence of 43.1% (98/227). Over all, the most prevalent gene was blaOXA-48-like (36.4%), followed by blaIMP-type (19.4%), blaVIM-type (17.1), blaKP-type (14.0%) and blaNDM-type (13.2%). blaVIM-type and blaOXA-48-like conferred phenotypic resistance in all isolates and 38.3% isolates that harbored them respectively. Capsular multiplex PCR revealed that 46.7% (106/227) isolates were pathogenic and the predominantly prevalent pathotype was K5 (18.5%) followed by K20 (14.1%), K3 (7.1%), K2 (3.1%) and K1 (2.2%). Of the 106 capsular serotypes, 37 expressed phenotypic resistance; thus, 37 of the 53 carbapenem resistant K. pneumoniae were pathogenic.Conclusion: The high prevalence of virulent and antibiotic resistant K. pneumoniae among clinical isolates obtained from the four tertiary hospital as revealed by this study pose a great threat to healthcare. Our findings underline the epidemiological and public health risks and implications of this pathogen.

scholarly journals Molecular Detection of Some Capsulargenes of Klebsiella pneumoniaeIsolated from Clinical Samples

2021 ◽  
Vol 26 (4) ◽  
pp. 138-145
Author(s):  
Amina A. Raheem ◽  
Ghaidaa J. Mohammed
Keyword(s):  
Klebsiella Pneumoniae ◽  
Virulence Factors ◽  
Virulence Factor ◽  
Molecular Detection ◽  
Opportunistic Pathogen ◽  
The Other ◽  
Clinical Samples ◽  
Biochemical Tests ◽  
Important Virulence Factor ◽  
Polymerase Chain

Klebsiella pneumoniae is an opportunistic pathogen that has been implicated as one of commonest cause of hospital and community acquired infections.The capsule of Klebsiella pneumoniae is an important virulence factor, involved in pathogenic mechanisms.So, this study aimed to isolateKlebsiella pneumoniae from different clinical samples from patients in Al-Diwaniyah teaching hospital and determine some virulence factors (capsulegenes)that used for serotyping of isolates. The study extended fromAugust  to November 2020.A total of 31 isolates from 80 different clinical samples identified as Klebsiella pneumoniae by traditional biochemical tests ,Vitek system and 16SrRNA gene.The existenceof three genes from7tested capsulargenes wasdetectedby Polymerase chain reaction.The commonness serotype were k2,k54,k57 where K2 detected in 4 (12.9 %), K54 in 12 (38.7 %),k57 in 4 (12.9).But, the other capsular polysaccaride genes k1,k3,k5,k20not detectedin all isolates of this study.

scholarly journals CAPSULAR GENOTYPING OF Klebsiella pneumoniae ISOLATED FROM CLINICAL SAMPLES AT SANGLAH GENERAL HOSPITAL IN 2013

2017 ◽  
Vol 1 (1) ◽  
pp. 21
Author(s):  
I Made Sutha Saskara ◽  
Ni Nengah Dwi Fatmawati ◽  
Ni Nyoman Sri Budayanti ◽  
Ni Nyoman Sri Budayanti ◽  
Wahyu Hidayati
Keyword(s):  
Klebsiella Pneumoniae ◽  
General Hospital ◽  
Clinical Microbiology ◽  
Defense Mechanism ◽  
Wide Spectrum ◽  
Host Cells ◽  
Clinical Isolates ◽  
Clinical Samples ◽  
Clinical Microbiology Laboratory ◽  
Hospital Associated Infections

Klebsiella pneumoniae, one of hospital associated infections agents, become more prevalence in worldwide. It is an opportunistic pathogen that can cause wide spectrum of diseases such as pneumonia and sepsis. Capability of this bacterium in causing diseases is influenced by its virulence factors. Capsule (K) is considered as the major virulence factor responsible in avoiding first defense mechanism of host cells. Almost no study about molecular characterization of capsule is reported in Bali; therefore, this study is aimed to determine the capsular genotype of  K. pneumoniae isolated from clinical specimens at Sanglah General Hospital. Samples were collected between January until Desember 2013 in Sanglah General Hospital at Clinical Microbiology Laboratory. Total of 56 samples were examined taken from blood, urine, pus, sputum, and other sources. All  K. pneumoniae DNA were then subjected to PCR using specific primer pairs against K1, K2 and K5. The results showed that from 56  K. pneumoniae clinical isolates only 12 (21.4%) were PCR positive, and all (100%) of them were positive for K2 capsule gene. Ten (83.3) of them were from blood, 1 (8.3%) from sputum, and 1 (8.3%) from other specimens. Finding of K2 capsule gene in most K. pneumoniae clinical isolates at Clinical Microbiology Laboratory in Sanglah General Hospital might figure out the relationship of capsular type with severity of diseases. However, further study of capsule in Bali with higher isolates number will help in understanding of pathogenicity of K2 capsule in order to treat the infections itself.

scholarly journals Molecular Analysis of Eight Biochemically Unique Glucose-6-Phosphate Dehydrogenase Variants Found in Japan

Blood ◽  
1997 ◽  
Vol 89 (12) ◽  
pp. 4624-4627 ◽  
Author(s):  
Akira Hirono ◽  
Hisaichi Fujii ◽  
Toshikuni Takano ◽  
Yasuko Chiba ◽  
Yoichi Azuno ◽  
...  
Keyword(s):  
Amino Acid ◽  
Amino Acid Change ◽  
Polypeptide Chain ◽  
Biochemical Properties ◽  
The Other ◽  
Amino Acid Substitutions ◽  
Missense Mutations ◽  
Class 1 ◽  
Santiago De Cuba ◽  
Glucose 6 Phosphate Dehydrogenase

Abstract We analyzed the molecular mutations of eight known Japanese glucose-6-phosphate dehydrogenase (G6PD) variants with unique biochemical properties. Three of them were caused by novel missense mutations: G6PD Musashino by 185 C→T, G6PD Asahikawa by 695 G→A, and G6PD Kamiube by 1387 C→T. Predicted amino acid substitutions causing asymptomatic variants G6PD Musashino (62 Pro→Phe) and G6PD Kamiube (463 Arg→Cys) were located in regions near the amino or carboxyl end of the polypeptide chain, whereas an amino acid change 232 Cys→Tyr causing a class 1 variant G6PD Asahikawa was located in the region where amino acid alterations in some class 1 variants were clustered. The other five variants had known missense mutations, namely, G6PD Fukushima, 1246 G→A, G6PD Morioka, 1339 G→A, and G6PD Iwate, G6PD Niigata and G6PD Yamaguchi, 1160 G→A, which cause variants, G6PD Tokyo, G6PD Santiago de Cuba, and G6PD Beverly Hills, respectively.

scholarly journals Investigation for some Aminoglycosides Modifying Enzymes- Encoding Genes and Co-Resistance to Fluoroquinolones among Klebsiella pneumoniae Isolates from Different Clinical Cases

2020 ◽  
pp. 2866-2878
Author(s):  
Mustafa Suhel Mustafa ◽  
Rana Mujahid Abdullah
Keyword(s):  
Klebsiella Pneumoniae ◽  
Dna Sequencing ◽  
Potential Effect ◽  
Clinical Samples ◽  
Resistance Pattern ◽  
Biochemical Characteristics ◽  
Frameshift Mutations ◽  
Minimum Inhibitory Concentrations ◽  
Development Of Resistance ◽  
Encoding Genes

In this study, we investigated the prevalence of aminoglycosides modifying enzymes (AMEs)-encoding genes, including aac(3′)-ΙΙ, ant(3′′)-Ι, aph(3′)-VΙ, and aac(6′)-Ιb-cr and their potential effect on the development of resistance to aminoglycosides and fluoroquinolones in clinical isolates of Klebsiella pneumoniae. According to the phenotypic and biochemical characteristics of 150 clinical samples, 50 (33%) isolates were identified as K. pneumoniae. These isolates were collected from different clinical sources, including urine (15, 30%), blood (12, 24%), sputum (9, 18%), wounds (9, 18%), and burns (5, 10%). The minimum inhibitory concentrations (MICs) assay revealed that the resistance values of isolates were 25 (50%) to gentamicin (≥16µg/ml), 21 (42%) to amikacin (≥64 µg/ml), 15 (30%) to ciprofloxacin (≥4 µg/ml), and 11 (22%) to levofloxacin (≥8 µg/ml). Genotypic detection revealed that aac(3′)-ΙΙ, aac(6′)-Ιb-cr, aph(3′)-VΙ, and ant(3′′)-Ι were found in 47 (94%), 38 (76%), 18 (36%), and 8 (16%) of K. pneumoniae isolates, respectively. The co-resistance pattern for both aminoglycosides and fluoroquinolones was detected in 14 (28%) isolates, of these 10 (71.4%) harbored aac(6′)-Ιb-cr. DNA sequencing for some isolates revealed the presence of point and frameshift mutations in the studied genes. Our study findings suggest that the presence of missense and frameshift mutations may contribute to the elevated resistance to amikacin and gentamicin. The increased prevalence of AMEs-encoding genes among K. pneumoniae isolates could contribute in reducing susceptibility to amikacin and gentamicin. The co-resistance pattern for aminoglycosides and fluoroquinolones was highly associated with the presence of the aac(6′)-Ιb-cr gene.      

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