{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T00:51:49Z","timestamp":1776387109485,"version":"3.51.2"},"reference-count":60,"publisher":"Wiley","license":[{"start":{"date-parts":[[2019,10,13]],"date-time":"2019-10-13T00:00:00Z","timestamp":1570924800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100012964","name":"Minist\u00e8re de l\u2019Enseignement Sup\u00e9rieur et de la Recherche Scientifique","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100012964","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["BioMed Research International"],"published-print":{"date-parts":[[2019,10,13]]},"abstract":"<jats:p><jats:italic>Background<\/jats:italic>. Extended-spectrum<jats:italic>\u03b2<\/jats:italic>-lactamase-producing organisms causing urinary tract infections are increasing in incidence and pose a major impendence to health-care facility, having limited therapeutic options. This study aimed to assess the prevalence of ESBLs in Enterobacteriaceae isolates causing urinary tract infections in Gaza strip, Palestine, and to characterize<jats:italic>\u03b2<\/jats:italic>-lactamase types and associated resistance genes.<jats:italic>Methods<\/jats:italic>. Eighty-five Enterobacteriaceae isolates were recovered from urinary tract infections within three months in Gaza Strip hospitals. The characterization of<jats:italic>\u03b2<\/jats:italic>-lactamase genes and the genetic environments of CTX-M, the identification of associated resistance genes, and the presence and characterization of integrons were tested by PCR and sequencing.<jats:italic>Results<\/jats:italic>. The occurrence rate of ESBL among tested isolates was 30 (35.3%), and among ESBL-positive isolates,<jats:italic>bla<\/jats:italic><jats:sub>CTX-M<\/jats:sub>was the highest followed by<jats:italic>bla<\/jats:italic><jats:sub>TEM<\/jats:sub>. ESBL-CTX-M-1 group was confirmed in 93.3%, and the remaining carried CTX-M-9 group. CTX-M-15, CTX-M-3, CTX-M-1, CTX-M-14, CTX-M-27, and CTX-M-37 enzymes were demonstrated among the isolates with the majority (73%) being CTX-M-15. IS<jats:italic>Ecp-1<\/jats:italic>was demonstrated in 27 (90%, high incidence) of ESBL isolates. Class 1 integrons have been detected in higher rates (53.3%) in ESBL-positive isolates in comparison with non-ESBL isolates (6, 33.3%). Cassettes of integron-1 contain (<jats:italic>aadA1<\/jats:italic>,<jats:italic>aadA2<\/jats:italic>,<jats:italic>aadA5<\/jats:italic>,<jats:italic>dfrA5<\/jats:italic>,<jats:italic>dfrA7<\/jats:italic>,<jats:italic>dfrA12<\/jats:italic>, and<jats:italic>dfrA17<\/jats:italic>) genes. The<jats:italic>aac(6\u2032)-Ib-cr<\/jats:italic>gene was demonstrated in 36.7% of ESBL-positive isolates.<jats:italic>Conclusions<\/jats:italic>. This study indicates that<jats:italic>bla<\/jats:italic><jats:sub>CTX-M-15<\/jats:sub>was the most prevalent<jats:italic>\u03b2<\/jats:italic>-lactamase in this region. Our study demonstrates for the first time in Palestine the identification of<jats:italic>bla<\/jats:italic><jats:sub>CTX-M-15<\/jats:sub>in<jats:italic>P. rettgeri<\/jats:italic>and<jats:italic>S. liquefaciens<\/jats:italic>, also<jats:italic>bla<\/jats:italic><jats:sub>CTX-M-37<\/jats:sub>in<jats:italic>E. cloacae.<\/jats:italic>The coexpression of multiple<jats:italic>\u03b2<\/jats:italic>-lactamase genes with<jats:italic>aac(6\u2032)-Ib-cr<\/jats:italic>and<jats:italic>qnr<\/jats:italic>in the presence of IS<jats:italic>Ecp-1<\/jats:italic>and integrons in individual strains will increase the dissemination of highly resistant strains. ESBL producers were more resistant than non-ESBLs producers for almost all tested antibiotics.<\/jats:p>","DOI":"10.1155\/2019\/4041801","type":"journal-article","created":{"date-parts":[[2019,10,13]],"date-time":"2019-10-13T23:32:28Z","timestamp":1571009548000},"page":"1-11","source":"Crossref","is-referenced-by-count":22,"title":["Extended-Spectrum<i>\u03b2<\/i>-Lactamases among Enterobacteriaceae Isolated from Urinary Tract Infections in Gaza Strip, Palestine"],"prefix":"10.1155","volume":"2019","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7180-6787","authenticated-orcid":true,"given":"Ghassan","family":"Tayh","sequence":"first","affiliation":[{"name":"Laboratoire des Microorganismes et Biomol\u00e9cules Actives, Facult\u00e9 des Sciences de Tunis, Universit\u00e9 de Tunis El Manar, 2092 Tunis, Tunisia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nahed","family":"Al Laham","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, 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