{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T15:08:44Z","timestamp":1778771324700,"version":"3.51.4"},"reference-count":31,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2026,1,10]],"date-time":"2026-01-10T00:00:00Z","timestamp":1768003200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/100004319","name":"Pfizer Inc.","doi-asserted-by":"publisher","award":["68858409"],"award-info":[{"award-number":["68858409"]}],"id":[{"id":"10.13039\/100004319","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Zurita & Zurita Laboratorios","award":["MIC-020"],"award-info":[{"award-number":["MIC-020"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,2,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To evaluate the diversity, prevalence, and phenotypic and genotypic characteristics of carbapenem-resistant Gram-negative bacteria (CR-GNB) causing bloodstream infections, and assess the mechanisms driving their dissemination through a multi-center study in nine hospitals of Ecuador.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>Between November 2021 and May 2022, 297 Gram-negative bacteria (GNB) were isolated from 273 patients across nine hospitals in Ecuador. Genotypic characterization of carbapenem-resistant GNB from blood cultures was performed by whole genome sequencing (WGS). CR-GNB accounted for 18.8% (56\/297), predominantly Klebsiella pneumoniae (41.1%), followed by Enterobacter cloacae complex (16.1%), Acinetobacter baumannii (12.5%), and Pseudomonas aeruginosa (7.1%). CR-GNB showed high resistance to cephalosporins (80%\u201395%), piperacillin-tazobactam (85.7%), ampicillin-sulbactam (91.1%), and ciprofloxacin (78.6%). Genomic analysis revealed carbapenemase genes blaKPC-2 (most frequent), blaNDM-1, and blaOXA-181 across high-risk clones (e.g. K. pneumoniae ST307, ST258, ST147; A. baumannii ST1187). Carbapenemase genes were plasmid-borne (IncA\/C, IncM, IncN, IncF, IncHI2, IncX3, and non-typeable) and associated with transposons (Tn4401, Tn125, and Tn3). Also, blaVIM-2 in Pseudomonas spp. was plasmid- and chromosomally encoded.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our findings demonstrate a high burden of CR-GNB, primarily due to K. pneumoniae and E. cloacae complex. Furthermore, the widespread distribution of blaKPC-2, blaNDM-1, and blaOXA-181 in high-risk clones, coupled with the frequent plasmid- and transposon-mediated mobilization of these genes, highlights the crucial role of horizontal gene transfer in the dissemination of resistance.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jambio\/lxag008","type":"journal-article","created":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T12:53:00Z","timestamp":1767963180000},"source":"Crossref","is-referenced-by-count":2,"title":["Clinical, microbiological, and genomic characterization of carbapenem-resistant Gram-negative bacteria in bloodstream infection: a multi-center study in Ecuador"],"prefix":"10.1093","volume":"137","author":[{"given":"Jeannete","family":"Zurita","sequence":"first","affiliation":[{"name":"Unidad de Investigaciones en Biomedicina, Zurita & Zurita Laboratorios , Quito 170104 ,","place":["Ecuador"]},{"name":"Facultad de Medicina, Pontificia Universidad 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170134 ,","place":["Ecuador"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Camilo","family":"Zurita-Salinas","sequence":"additional","affiliation":[{"name":"Unidad de Investigaciones en Biomedicina, Zurita & Zurita Laboratorios , Quito 170104 ,","place":["Ecuador"]},{"name":"C\u00e1tedra de Inmunolog\u00eda, Facultad de Ciencias M\u00e9dicas, Universidad Central del Ecuador , Quito 170136 ,","place":["Ecuador"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cristina","family":"Moreno","sequence":"additional","affiliation":[{"name":"Hospital de Especialidades Fuerzas Armadas No.1 , Quito 170136 ,","place":["Ecuador"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juan Jos\u00e9","family":"Romero","sequence":"additional","affiliation":[{"name":"Hospital Vozandes , Quito 170521 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