{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T19:28:24Z","timestamp":1777922904136,"version":"3.51.4"},"reference-count":36,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2019,1,1]],"date-time":"2019-01-01T00:00:00Z","timestamp":1546300800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Microbial Drug Resistance"],"published-print":{"date-parts":[[2019,1]]},"abstract":"<jats:p>\n                    Nosocomial infections occur worldwide and also in the Kurdistan region. Frequently patients colonized with multiresistant\n                    <jats:italic toggle=\"yes\">Pseudomonas aeruginosa<\/jats:italic>\n                    isolates are encountered in many hospitals. As information is lacking with respect to the mechanisms of resistance responsible for the multiresistant character of the\n                    <jats:italic toggle=\"yes\">P. aeruginosa<\/jats:italic>\n                    isolates and their genetic relationship, isolates were prospectively collected and characterized with respect to their mechanism of resistance. During 2012 and 2013, 81\n                    <jats:italic toggle=\"yes\">P. aeruginosa<\/jats:italic>\n                    isolates were collected from three teaching hospitals in the city of Erbil, Iraq. Susceptibility testing was performed using the VITEK-2 system. Isolates were screened for the presence of extended-spectrum \u03b2-lactamases (ESBLs) and for the presence of metallo \u03b2-lactamases (MBLs). The presence of serine carbapenemases was detected by PCR. The genetic relationship of the isolates was demonstrated by amplified fragment length polymorphism (AFLP). Susceptibility results revealed high rates of resistance against all classes of antibiotics except polymyxins. Genetic characterization demonstrated the presence of ESBL-genes, that is,\n                    <jats:italic toggle=\"yes\">bla<\/jats:italic>\n                    <jats:sub>VEB<\/jats:sub>\n                    (30%) and\n                    <jats:italic toggle=\"yes\">bla<\/jats:italic>\n                    <jats:sub>PER<\/jats:sub>\n                    (17%), also ESBL\n                    <jats:italic toggle=\"yes\">bla<\/jats:italic>\n                    <jats:sub>PME<\/jats:sub>\n                    was detected in four isolates. AFLP typing revealed clonal spread of\n                    <jats:italic toggle=\"yes\">bla<\/jats:italic>\n                    <jats:sub>VEB<\/jats:sub>\n                    ,\n                    <jats:italic toggle=\"yes\">bla<\/jats:italic>\n                    <jats:sub>PER<\/jats:sub>\n                    , and three clusters of\n                    <jats:italic toggle=\"yes\">bla<\/jats:italic>\n                    <jats:sub>OXA-10<\/jats:sub>\n                    -positive isolates. Only one isolate was MBL (\n                    <jats:italic toggle=\"yes\">bla<\/jats:italic>\n                    <jats:sub>VIM<\/jats:sub>\n                    ) positive. Of a selected number of isolates (\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    \u2009=\u200911), whole-genome sequencing analysis revealed that these isolates belonged to \u201chigh-risk\u201d MLSTs ST244, ST235, ST308, and ST654. This study reveals the presence and clonal spread of widely resistant high-risk clones of\n                    <jats:italic toggle=\"yes\">P. aeruginosa<\/jats:italic>\n                    in Iraqi Kurdistan. As far as we are aware, this is the first report of multiple, polyclonal, PME producing\n                    <jats:italic toggle=\"yes\">P. aeruginosa<\/jats:italic>\n                    outside the Arabian Peninsula.\n                  <\/jats:p>","DOI":"10.1089\/mdr.2018.0036","type":"journal-article","created":{"date-parts":[[2018,8,1]],"date-time":"2018-08-01T11:13:52Z","timestamp":1533122032000},"page":"32-38","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":15,"title":["PME and Other ESBL-Positive Multiresistant\n                    <i>Pseudomonas aeruginosa<\/i>\n                    Isolated from Hospitalized Patients in the Region of Kurdistan, Iraq"],"prefix":"10.1177","volume":"25","author":[{"given":"Sebastian","family":"van Burgh","sequence":"first","affiliation":[{"name":"Erasmus University Medical Center Rotterdam","place":["the Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Delshad M.","family":"Maghdid","sequence":"additional","affiliation":[{"name":"Erasmus University Medical Center Rotterdam","place":["the Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aryann R.","family":"Ganjo","sequence":"additional","affiliation":[{"name":"Hawler Medical University","place":["Iraq"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Isam Y.","family":"Mansoor","sequence":"additional","affiliation":[{"name":"Hawler Medical University","place":["Iraq"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dik J.","family":"Kok","sequence":"additional","affiliation":[{"name":"Erasmus University Medical Center Rotterdam","place":["the Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohammed H.","family":"Fatah","sequence":"additional","affiliation":[{"name":"Sulaimani Polytechnic University","place":["Iraq"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abdulkadir A.","family":"Alnakshabandi","sequence":"additional","affiliation":[{"name":"Hawler Medical University","place":["Iraq"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dlnya","family":"Asad","sequence":"additional","affiliation":[{"name":"Sulaimani University","place":["Iraq"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anette M.","family":"Hammerum","sequence":"additional","affiliation":[{"name":"Statens Serum Institut","place":["Denmark"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kim","family":"Ng","sequence":"additional","affiliation":[{"name":"Statens Serum Institut","place":["Denmark"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Corn\u00e9","family":"Klaassen","sequence":"additional","affiliation":[{"name":"Erasmus University Medical Center Rotterdam","place":["the Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wil H.F.","family":"Goessens","sequence":"additional","affiliation":[{"name":"Erasmus University Medical Center Rotterdam","place":["the Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2019,1,8]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.2165\/00003495-200767030-00003"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1099\/jmm.0.009142-0"},{"key":"e_1_3_3_4_2","first-page":"634","article-title":"Multiple mechanisms of antimicrobial resistance in Pseudomonas aeruginosa: our worst nightmare? 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