{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T22:19:14Z","timestamp":1785795554405,"version":"3.56.0"},"reference-count":53,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2022,9,16]],"date-time":"2022-09-16T00:00:00Z","timestamp":1663286400000},"content-version":"vor","delay-in-days":258,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100005716","name":"Babol University of Medical Sciences","doi-asserted-by":"publisher","award":["724133549"],"award-info":[{"award-number":["724133549"]}],"id":[{"id":"10.13039\/501100005716","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["International Journal of Clinical Practice"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:p><jats:italic>Background<\/jats:italic>. Infections due to carbapenem\u2010resistant <jats:italic>Enterobacteriaceae<\/jats:italic> (CRE) are associated in patients with urinary catheters alarming rate of emergency status. The aim of this study is to investigate the molecular causes of carbapenem resistance among UPEC as well as antimicrobial resistance trends. Additionally, the potential of isolates to produce biofilms, in addition to their clonal and genetic diversity, was investigated. <jats:italic>Material and Methods<\/jats:italic>. A cross\u2010sectional study was accomplished on a collection of 76 non\u2010duplicate UPEC isolates obtained from CAUTIs from May 2021 to September 2021. The modified carbapenem inactivation method (mCIM) and EDTA\u2010modified carbapenem inactivation method (eCIM) test was performed for the detection of carbapenemase and metallo\u2010beta\u2010lactamase activity. Also, the presence of carbapenemase genes was determined using PCR assays. In 96\u2010well microtiter plates, biofilm development was evaluated. ERIC\u2010PCR was used to investigate the clonal and genetic variety of isolates. <jats:italic>Results<\/jats:italic>. A total of 76 confirmed UPEC isolates were obtained from patients mentioned to teaching hospitals in Babol, Iran. The results of antibiotic susceptibility testing revealed a high rate of antibiotic resistance against nalidixic acid (81.6%) and trimethoprim\u2010sulfamethoxazole (80.3%). Among UPEC isolates, 63.2% and 13.2% of UPEC isolates were positive for MBL production. The frequencies of the studied genes are in order of <jats:italic>bla<\/jats:italic><jats:sub>NDM<\/jats:sub> (14.5%), <jats:italic>bla<\/jats:italic><jats:sub>OXA-23<\/jats:sub> (2.6%), and <jats:italic>bla<\/jats:italic><jats:sub>OXA-48<\/jats:sub> (2.6%). Forty\u2010two isolates (55.3%) were positive for biofilm formation. ERIC\u2010PCR revealed that UPEC isolates could be categorized into nine clusters A\u2010I and five isolates were categorized as a singleton. <jats:italic>Conclusion<\/jats:italic>. The high prevalence of MDR and carbapenemase\u2010producing isolates among the UPEC strain in this investigation is concerning. Moreover, the <jats:italic>bla<\/jats:italic><jats:sub>NDM<\/jats:sub> was the most frequent cause of producing metallo\u2010beta\u2010lactamase and carbapenemase. Also, analysis revealed a partial genetic similarity among the studied isolates, indicating that the same UPEC clones may have spread to other hospital units.<\/jats:p>","DOI":"10.1155\/2022\/9520362","type":"journal-article","created":{"date-parts":[[2022,9,16]],"date-time":"2022-09-16T16:05:38Z","timestamp":1663344338000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Genetic Diversity, Carbapenem Resistance Genes, and Biofilm Formation in UPEC Isolated from Patients with Catheter\u2010Associated Urinary Tract Infection in North of Iran"],"prefix":"10.1155","volume":"2022","author":[{"given":"Sina","family":"Nasrollahian","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mehrdad","family":"Halaji","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akramasadat","family":"Hosseini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad","family":"Teimourian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mojtaba Taghizadeh","family":"Armaki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mehdi","family":"Rajabnia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hemmat","family":"Gholinia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6753-5953","authenticated-orcid":false,"given":"Abazar","family":"Pournajaf","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,9,16]]},"reference":[{"key":"e_1_2_11_1_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12941-021-00437-8"},{"key":"e_1_2_11_2_2","doi-asserted-by":"publisher","DOI":"10.1310\/sci2503-228"},{"key":"e_1_2_11_3_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2018-022137"},{"key":"e_1_2_11_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.yexmp.2008.03.007"},{"key":"e_1_2_11_5_2","doi-asserted-by":"publisher","DOI":"10.1155\/2012\/681473"},{"key":"e_1_2_11_6_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12941-021-00470-7"},{"key":"e_1_2_11_7_2","doi-asserted-by":"publisher","DOI":"10.3390\/medsci6010001"},{"key":"e_1_2_11_8_2","doi-asserted-by":"publisher","DOI":"10.1177\/2049936115621709"},{"key":"e_1_2_11_9_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0245290"},{"key":"e_1_2_11_10_2","doi-asserted-by":"publisher","DOI":"10.1128\/jcm.00193-17"},{"key":"e_1_2_11_11_2","doi-asserted-by":"publisher","DOI":"10.1080\/21505594.2016.1185577"},{"key":"e_1_2_11_12_2","doi-asserted-by":"publisher","DOI":"10.1128\/microbiolspec.MB-0011-2014"},{"key":"e_1_2_11_13_2","doi-asserted-by":"publisher","DOI":"10.3390\/molecules14072535"},{"key":"e_1_2_11_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajic.2003.08.005"},{"key":"e_1_2_11_15_2","doi-asserted-by":"publisher","DOI":"10.7554\/eLife.75798"},{"key":"e_1_2_11_16_2","doi-asserted-by":"publisher","DOI":"10.3390\/microorganisms9112384"},{"key":"e_1_2_11_17_2","article-title":"Clinical and laboratory standards institute: performance standards for antimicrobial susceptibility testing: twenty-fourth informational supplement, M100-S31","volume":"41","author":"Wayne P.","year":"2021","journal-title":"Clinical and Laboratory Standards Institute (CLSI)"},{"key":"e_1_2_11_18_2","doi-asserted-by":"publisher","DOI":"10.1093\/nar\/21.9.2260"},{"key":"e_1_2_11_19_2","doi-asserted-by":"crossref","unstructured":"SStepanovi\u0107 CVukovi\u0107 DHola GDi Bonaventura GDjuki\u0107 SCirkovi\u0107 andFRuzicka Quantification of biofilm in microtiter plates: overview of testing conditions and practical recommendations for assessment of biofilm production by staphylococci APMIS 2007 115 no. 8 891\u2013899 https:\/\/doi.org\/10.1016\/s0167-7012(03)00034-4 2-s2.0-0037716358.","DOI":"10.1111\/j.1600-0463.2007.apm_630.x"},{"key":"e_1_2_11_20_2","doi-asserted-by":"publisher","DOI":"10.1128\/cmr.00019-07"},{"key":"e_1_2_11_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.molmed.2016.09.003"},{"key":"e_1_2_11_22_2","doi-asserted-by":"publisher","DOI":"10.3389\/fmicb.2017.01566"},{"key":"e_1_2_11_23_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciz830"},{"key":"e_1_2_11_24_2","first-page":"277","article-title":"The antibiotic resistance crisis: part 1: causes and threats","volume":"40","author":"Ventola C. 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