{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T19:30:33Z","timestamp":1777923033805,"version":"3.51.4"},"reference-count":44,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2021,1,1]],"date-time":"2021-01-01T00:00:00Z","timestamp":1609459200000},"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":[[2021,1]]},"abstract":"<jats:p>\n                    In recent years, nosocomial infections due to multidrug resistant\n                    <jats:italic toggle=\"yes\">Klebsiella pneumoniae<\/jats:italic>\n                    strains have been increasing, associated with growing trend of resistance to beta-lactams and fluoroquinolones (FQs) worldwide. In this study, prevalence of beta-lactamase genes and resistance mechanisms to FQ were analyzed in 191 clinical\n                    <jats:italic toggle=\"yes\">K. pneumoniae<\/jats:italic>\n                    isolates derived from respiratory tract infections in a teaching hospital in Yangon, Myanmar. The major extended-spectrum beta-lactamase gene was\n                    <jats:italic toggle=\"yes\">bla<\/jats:italic>\n                    <jats:sub>CTX-M<\/jats:sub>\n                    , which was detected in 33% of isolates, with CTX-M-15 being dominant. Fourteen isolates (7.3%) harbored carbapenemase genes that were genotyped as\n                    <jats:italic toggle=\"yes\">bla<\/jats:italic>\n                    <jats:sub>NDM-1<\/jats:sub>\n                    ,\n                    <jats:italic toggle=\"yes\">bla<\/jats:italic>\n                    <jats:sub>NDM-5<\/jats:sub>\n                    , or\n                    <jats:italic toggle=\"yes\">bla<\/jats:italic>\n                    <jats:sub>NDM-7<\/jats:sub>\n                    . The most common plasmid-mediated quinolone resistance (PMQR) gene was\n                    <jats:italic toggle=\"yes\">aac6\u2032-Ib-cr<\/jats:italic>\n                    (51.8%), followed by\n                    <jats:italic toggle=\"yes\">qnrB<\/jats:italic>\n                    (41.9%),\n                    <jats:italic toggle=\"yes\">oqxAB<\/jats:italic>\n                    (23%), and\n                    <jats:italic toggle=\"yes\">qnrS<\/jats:italic>\n                    (15.2%). In quinolone-resistance determining region of GyrA, eight different types of mutation were identified for FQ-resistant isolates, with double mutations at two positions (S83F, D87A) being most common (54.6%). Isolates with double mutations (three patterns) showed higher minimal inhibitory concentration to levofloxacin (LVX) (\u226564\u2009\u03bcg\/mL) than those with a single mutation. PMQR gene profiles, including\n                    <jats:italic toggle=\"yes\">aac6\u2032-Ib-cr<\/jats:italic>\n                    and any other gene(s), were generally related to higher resistance level to LVX.\n                    <jats:italic toggle=\"yes\">K. pneumoniae<\/jats:italic>\n                    isolates with different profiles of beta-lactamase genes and FQ-resistance determinants were mostly classified into ST15 or its single-locus variant (SLV). The most common NDM gene,\n                    <jats:italic toggle=\"yes\">bla<\/jats:italic>\n                    <jats:sub>NDM-5<\/jats:sub>\n                    , was detected in ST975 (ST15-SLV) isolates and an ST4000 isolate. The present study revealed the wide spread of FQ-resistant\n                    <jats:italic toggle=\"yes\">K. pneumoniae<\/jats:italic>\n                    clinical isolates acquiring various FQ-resistance determinants and beta-lactamases that were presumably derived from a single clonal lineage in a hospital in Myanmar.\n                  <\/jats:p>","DOI":"10.1089\/mdr.2019.0490","type":"journal-article","created":{"date-parts":[[2020,6,10]],"date-time":"2020-06-10T22:11:47Z","timestamp":1591827107000},"page":"36-43","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":6,"title":["Prevalence of Extended-Spectrum Beta-Lactamase\/Carbapenemase Genes and Quinolone-Resistance Determinants in\n                    <i>Klebsiella pneumoniae<\/i>\n                    Clinical Isolates from Respiratory Infections in Myanmar"],"prefix":"10.1177","volume":"27","author":[{"given":"Meiji Soe","family":"Aung","sequence":"first","affiliation":[{"name":"Department of Hygiene, Sapporo Medical University School of Medicine, Sapporo, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nyein Chan","family":"Win","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Medicine 2, Yangon, Myanmar."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nilar","family":"San","sequence":"additional","affiliation":[{"name":"Department of Microbiology, University of Medicine 2, Yangon, Myanmar."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Myat Su","family":"Hlaing","sequence":"additional","affiliation":[{"name":"Department of Microbiology, University of Medicine 2, Yangon, Myanmar."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yi Yi","family":"Myint","sequence":"additional","affiliation":[{"name":"Department of Microbiology, University of Medicine 2, Yangon, Myanmar."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pyae Phyo","family":"Thu","sequence":"additional","affiliation":[{"name":"Department of Microbiology, University of Medicine 2, Yangon, Myanmar."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Myint Thazin","family":"Aung","sequence":"additional","affiliation":[{"name":"Department of Microbiology, North Okkalapa General Hospital, Yangon, Myanmar."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kyaw Thu","family":"Yaa","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Medicine 2, Yangon, Myanmar."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Win Win","family":"Maw","sequence":"additional","affiliation":[{"name":"Department of Microbiology, University of Medicine 2, Yangon, Myanmar."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Noriko","family":"Urushibara","sequence":"additional","affiliation":[{"name":"Department of Hygiene, Sapporo Medical University School of Medicine, Sapporo, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nobumichi","family":"Kobayashi","sequence":"additional","affiliation":[{"name":"Department of Hygiene, Sapporo Medical University School of Medicine, Sapporo, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2021,1,15]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1093\/femsre\/fux013"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.meegid.2018.04.005"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkx146"},{"key":"e_1_3_4_5_2","doi-asserted-by":"crossref","first-page":"1019","DOI":"10.1128\/JCM.00219-10","article-title":"Extended-spectrum-beta-lactamase, AmpC, and Carbapenemase issues","volume":"48","author":"Thomson, K.S","year":"2010","unstructured":"Thomson, K.S. 2010. 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Specific patterns of gyrA mutations determine the resistance difference to ciprofloxacin and levofloxacin in Klebsiella pneumoniae and Escherichia coli. BMC Infect. Dis. 13:8.","journal-title":"BMC Infect. Dis"},{"key":"e_1_3_4_44_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijantimicag.2011.12.009"},{"key":"e_1_3_4_45_2","first-page":"357","article-title":"Emerging antibiotic resistance: carbapenemase-producing enterobacteria","volume":"27","author":"Spera A.M.","year":"2019","unstructured":"Spera A.M., , Esposito S., , and Pagliano P.. 2019. Emerging antibiotic resistance: carbapenemase-producing enterobacteria. Bad new bugs, still no new drugs. Infez. Med. 27:357\u2013364.","journal-title":"Bad new bugs, still no new drugs. Infez. 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