{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T22:10:26Z","timestamp":1782339026629,"version":"3.54.5"},"reference-count":31,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2021,1,1]],"date-time":"2021-01-01T00:00:00Z","timestamp":1609459200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100007061","name":"Secretar\u00eda Nacional de Ciencia, Tecnolog\u00eda e Innovaci\u00f3n","doi-asserted-by":"publisher","award":["SIstema Nacional de Investigadores (SNI) de Panam"],"award-info":[{"award-number":["SIstema Nacional de Investigadores (SNI) de Panam"]}],"id":[{"id":"10.13039\/501100007061","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Therapeutic Advances in Infection"],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:p>Klebsiella pneumoniae spp ozaenae is a versatile bacterial species able to acquire antimicrobial resistance; the species presents a higher antimicrobial resistance profile compared to Klebsiella pneumoniae spp pneumoniae. Carbapenemase and extended spectrum \u03b2-lactamase (ESBL)-producing bacteria commonly arise in clinical settings where antimicrobial stewardship is limited. Our study aims to report the phenotypical and genetic characteristics of nosocomial Klebsiella pneumoniae spp ozaenae isolates associated with mortality collected from a tertiary-level hospital in Panama City. In October 2020, 11 consecutive multidrug-resistant Gram-negative isolates were recovered from secretions and blood cultures from hospitalized patients. Nearly 90% (10\/11) of these patients died, and bacteria was obtained from six patients for investigation. Biochemical evaluation of the six isolates revealed the presence of multidrug-resistant Klebsiella pneumoniae spp ozaenae. Phenotypic evaluation indicated resistance to carbapenemase and EBSL. In contrast, genetic evaluation by PCR showed that only 30% (2\/6) were resistant to CTX-M-1 (CTX-M group 1), whereas 60.7% (4\/6) presented carbapenemase resistance genes, and 33.3% (2\/6) presented New Delhi metallo-\u03b2-lactamase ( NDM) resistance genes. Klebsiella pneumoniae ST258 was identified in 83.3% (5\/6) of the isolates. Phylogenetic analysis using 16S revealed low homology among the six isolates. These results suggest that antibiotic resistance genes may have been incorporated into these Klebsiella pneumoniae spp ozaenae isolates within the hospital environment. We recommend strengthening the antimicrobial stewardship program and antibiotic control policy, as well as heightened infection control and prevention measures, such as ward sanitation and increased hand washing frequency.<\/jats:p>","DOI":"10.1177\/20499361211054918","type":"journal-article","created":{"date-parts":[[2021,10,30]],"date-time":"2021-10-30T05:30:56Z","timestamp":1635571856000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Phenotypic and genotypic characteristics of carbapenemase- and extended spectrum \u03b2-lactamase-producing\n                    <i>Klebsiella pneumoniae ozaenae<\/i>\n                    clinical isolates within a hospital in Panama City"],"prefix":"10.1177","volume":"8","author":[{"given":"Silvio","family":"Vega","sequence":"first","affiliation":[{"name":"Laboratorio Cl\u00ednico, Complejo Hospitalario Metropolitano Dr. Arnulfo Arias Madrid, Caja de Seguro Social (CHMDrAAM-CSS), Panama City, Panama"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ferm\u00edn","family":"Acosta","sequence":"additional","affiliation":[{"name":"Tuberculosis Biomarker Research Unit at Centro de Biolog\u00eda Molecular y Celular de Enfermedades (CBCME) del Instituto de Investigaciones Cient\u00edficas y Servicios de Alta Tecnolog\u00eda (INDICASAT-AIP), City of Knowledge, Panama"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iv\u00e1n","family":"Landires","sequence":"additional","affiliation":[{"name":"Instituto de Ciencias M\u00e9dicas, Las Tablas, Panama"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitchelle","family":"Mor\u00e1n","sequence":"additional","affiliation":[{"name":"Tuberculosis Biomarker Research Unit at Centro de Biolog\u00eda Molecular y Celular de Enfermedades (CBCME) del Instituto de Investigaciones Cient\u00edficas y Servicios de Alta Tecnolog\u00eda (INDICASAT-AIP), City of Knowledge, Panama"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johanna","family":"Gonzalez","sequence":"additional","affiliation":[{"name":"Laboratorio Cl\u00ednico, Complejo Hospitalario Metropolitano Dr. Arnulfo Arias Madrid, Caja de Seguro Social (CHMDrAAM-CSS), Panama City, Panama"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gumercindo","family":"Pimentel-Peralta","sequence":"additional","affiliation":[{"name":"Instituto de Ciencias M\u00e9dicas, Las Tablas, Panama"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Virginia","family":"N\u00fa\u00f1ez-Samudio","sequence":"additional","affiliation":[{"name":"Instituto de Ciencias M\u00e9dicas, P.O. Box 0710-00043, Las Tablas, Los Santos, Panama"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3910-0482","authenticated-orcid":false,"given":"Amador","family":"Goodridge","sequence":"additional","affiliation":[{"name":"Tuberculosis Biomarker Research Unit, Centro de Biolog\u00eda Molecular y Celular de Enfermedades (CBCME) del Instituto de Investigaciones Cient\u00edficas y Servicios de Alta Tecnolog\u00eda (INDICASAT-AIP), P.O. Box 0843-01103, City of Knowledge, Panama"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2021,10,30]]},"reference":[{"key":"bibr1-20499361211054918","volume":"11","author":"Pishtiwan AH","year":"2019","journal-title":"Mediterr J Hematol Infect Dis"},{"key":"bibr2-20499361211054918","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(18)30414-6"},{"key":"bibr3-20499361211054918","doi-asserted-by":"publisher","DOI":"10.3389\/fmicb.2018.03198"},{"key":"bibr4-20499361211054918","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0091800"},{"key":"bibr5-20499361211054918","doi-asserted-by":"publisher","DOI":"10.3390\/antibiotics3030398"},{"key":"bibr6-20499361211054918","doi-asserted-by":"publisher","DOI":"10.3390\/antibiotics10050586"},{"key":"bibr7-20499361211054918","volume":"7","author":"Bassetti M","year":"2020","journal-title":"Ther Adv Infect Dis"},{"key":"bibr8-20499361211054918","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.39.7.2379-2385.2001"},{"key":"bibr9-20499361211054918","doi-asserted-by":"publisher","DOI":"10.1093\/molbev\/msv280"},{"key":"bibr10-20499361211054918","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmi.2021.03.001"},{"key":"bibr11-20499361211054918","doi-asserted-by":"publisher","DOI":"10.1186\/s12941-020-00366-y"},{"key":"bibr12-20499361211054918","doi-asserted-by":"publisher","DOI":"10.1016\/j.apjtb.2017.01.019"},{"key":"bibr13-20499361211054918","doi-asserted-by":"publisher","DOI":"10.1128\/jcm.35.4.907-914.1997"},{"key":"bibr14-20499361211054918","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0004982"},{"key":"bibr15-20499361211054918","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.43.8.4178-4182.2005"},{"key":"bibr16-20499361211054918","unstructured":"Pasteur I. 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