{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T01:06:36Z","timestamp":1790816796108,"version":"4.1.0"},"reference-count":53,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T00:00:00Z","timestamp":1783468800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"vor","delay-in-days":85,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Microbiol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Carbapenem-resistant\n                      <jats:italic>Pseudomonas aeruginosa<\/jats:italic>\n                      (CRPA) and\n                      <jats:italic>Acinetobacter baumannii<\/jats:italic>\n                      (CRAB) were listed on the WHO bacterial priority pathogens list in 2017. These gram-negative bacteria often cause healthcare-associated infections (HAIs), which pose an increasing threat to public health. This study aimed to isolate and identify CRPAs and CRABs from a tertiary care hospital in central Nepal and characterize carbapenem resistance genes at the molecular level.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>\n                      A total of 59 isolates, including 27\n                      <jats:italic>Pseudomonas aeruginosa<\/jats:italic>\n                      and 32\n                      <jats:italic>Acinetobacter baumannii<\/jats:italic>\n                      , were collected from different clinical samples from April 2021 to December 2022. Antibiotic susceptibility was determined via the Kirby disc diffusion method. The modified carbapenem inactivation method (mCIM) was used for phenotypic confirmation of carbapenem resistance. Conventional polymerase chain reaction (PCR) was used to detect carbapenem resistance genes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among the 59 isolates, 76.3% were multidrug resistant (MDR), 63.0% were extended-spectrum beta-lactamase (ESBL), and 62.7% were carbapenem resistant. Among the carbapenem-resistant isolates (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200937), 75.7% of metallo-beta-lactamase (MBL) producers and 70.3% carried at least one carbapenem resistance gene. The\n                      <jats:italic>bla<\/jats:italic>\n                      <jats:sub>CTX\u2212M<\/jats:sub>\n                      gene was predominant among the ESBL-positive isolates, present in 58.8% of the\n                      <jats:italic>P. aeruginosa<\/jats:italic>\n                      isolates and 87.5% of the\n                      <jats:italic>A. baumannii<\/jats:italic>\n                      isolates, whereas 29% of both isolates harbored the\n                      <jats:italic>bla<\/jats:italic>\n                      <jats:sub>TEM<\/jats:sub>\n                      gene. Among the CR-PA isolates, 58.3% carried\n                      <jats:italic>bla<\/jats:italic>\n                      <jats:sub>VIM\u22122<\/jats:sub>\n                      , 16.7% carried\n                      <jats:italic>bla<\/jats:italic>\n                      <jats:sub>NDM\u22121<\/jats:sub>\n                      , and 8.33% carried\n                      <jats:italic>bla<\/jats:italic>\n                      <jats:sub>OXA\u221223<\/jats:sub>\n                      . Among the CR-AB isolates, 56% harbored\n                      <jats:italic>bla<\/jats:italic>\n                      <jats:sub>OXA\u221223<\/jats:sub>\n                      , 32% carried\n                      <jats:italic>bla<\/jats:italic>\n                      <jats:sub>NDM\u22121<\/jats:sub>\n                      , 16% had both\n                      <jats:italic>bla<\/jats:italic>\n                      <jats:sub>NDM\u22121<\/jats:sub>\n                      and\n                      <jats:italic>bla<\/jats:italic>\n                      <jats:sub>OXA\u221223<\/jats:sub>\n                      , and 8% contained both\n                      <jats:italic>bla<\/jats:italic>\n                      <jats:sub>OXA\u221258<\/jats:sub>\n                      and\n                      <jats:italic>bla<\/jats:italic>\n                      <jats:sub>OXA\u221223<\/jats:sub>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      This study highlights a significant burden of MDR and carbapenem-resistant\n                      <jats:italic>P. aeruginosa<\/jats:italic>\n                      and\n                      <jats:italic>A. baumannii<\/jats:italic>\n                      , with the co-occurrence of carbapenem resistance genes, in a clinical setting in Nepal. Our findings suggest that active surveillance of antibiotic resistance in pathogens could inform clinicians and healthcare providers about the treatment of infections.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12866-026-05377-x","type":"journal-article","created":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T06:13:50Z","timestamp":1783491230000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Phenotypic and molecular characterization of carbapenem resistance among clinical isolates of Pseudomonas aeruginosa and Acinetobacter baumannii"],"prefix":"10.1186","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5536-7828","authenticated-orcid":false,"given":"Gopiram","family":"Syangtan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laxmi Kant","family":"Khanal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6885-3881","authenticated-orcid":false,"given":"Shrijana","family":"Bista","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arun Bahadur","family":"Chand","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prabin","family":"Dawadi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Binod","family":"Rayamajhee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reshma","family":"Tuladhar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shiba Kumar","family":"Rai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dev Raj","family":"Joshi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,8]]},"reference":[{"key":"5377_CR1","unstructured":"World Health Organization, Bacterial Priority Pathogens, List. 2017. bacterial pathogens of public health importance to guide research, development, and strategies to prevent and control antimicrobial resistance. 2017. https:\/\/www.who.int\/news\/item\/27-02-2017-who-publishes-list-of-bacteria-for-which-new-antibiotics-are-urgently-needed."},{"issue":"3","key":"5377_CR2","doi-asserted-by":"publisher","first-page":"00181","DOI":"10.1128\/cmr.00181-19","volume":"33","author":"DMP Oliveira","year":"2020","unstructured":"Oliveira DMP, De, Forde BM, Kidd TJ, Harris PNA, Schembri MA, Beatson SA, et al. Antimicrobial Resistance in ESKAPE Pathogens. Clin Microbiol Rev. 2020;33(3):00181\u2013219. https:\/\/doi.org\/10.1128\/cmr.00181-19.","journal-title":"Clin Microbiol Rev"},{"issue":"12","key":"5377_CR3","doi-asserted-by":"publisher","first-page":"e0256556","DOI":"10.1371\/journal.pone.0256556","volume":"16","author":"A Abdeta","year":"2021","unstructured":"Abdeta A, Bitew A, Fentaw S, Tsige E, Assefa D, Lejisa T, et al. Phenotypic characterization of carbapenem nonsusceptible gram-negative bacilli isolated from clinical specimens. PLoS ONE. 2021;16(12):e0256556. https:\/\/doi.org\/10.1371\/journal.pone.0256556.","journal-title":"PLoS ONE"},{"issue":"5","key":"5377_CR4","doi-asserted-by":"publisher","first-page":"873","DOI":"10.1093\/cid\/ciy752","volume":"68","author":"S Tomczyk","year":"2019","unstructured":"Tomczyk S, Zanichelli V, Grayson ML, Twyman A, Abbas M, Pires D, et al. Control of carbapenem-resistant enterobacteriaceae, acinetobacter baumannii, and pseudomonas aeruginosa in healthcare facilities: A systematic review and reanalysis of quasiexperimental studies. Clin Infect Dis. 2019;68(5):873\u201384. https:\/\/doi.org\/10.1093\/cid\/ciy752.","journal-title":"Clin Infect Dis"},{"issue":"6","key":"5377_CR5","doi-asserted-by":"publisher","first-page":"e1004178","DOI":"10.1371\/journal.pmed.1004178","volume":"20","author":"R Balasubramanian","year":"2023","unstructured":"Balasubramanian R, Boeckel TP, Van, Carmeli Y, Cosgrove S, Laxminarayan R. Global incidence in hospital-associated infections resistant to antibiotics: An analysis of point prevalence surveys from 99 countries. PLoS Med. 2023;20(6):e1004178. https:\/\/doi.org\/10.1371\/journal.pmed.1004178.","journal-title":"PLoS Med"},{"issue":"1","key":"5377_CR6","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1128\/CMR.masthead.30-1","volume":"30","author":"L-Y Hsu","year":"2017","unstructured":"Hsu L-Y, Apisarnthanarak A, Khan E, Suwantarat N, Ghafur A, Tambyah PA. Carbapenem-Resistant Acinetobacter baumannii and Enterobacteriaceae in South and Southeast Asia. Clin Microbiol Rev. 2017;30(1):1\u201322. https:\/\/doi.org\/10.1128\/CMR.masthead.30-1.","journal-title":"Clin Microbiol Rev"},{"key":"5377_CR7","doi-asserted-by":"publisher","first-page":"262","DOI":"10.3389\/fmed.2018.00262","volume":"5","author":"RM Zellweger","year":"2018","unstructured":"Zellweger RM, Basnyat B, Shrestha P, Prajapati KG, Dongol S, Sharma PK, et al. Changing antimicrobial resistance trends in Kathmandu, Nepal: A 23-year retrospective analysis of bacteraemia. Front Med. 2018;5:262. https:\/\/doi.org\/10.3389\/fmed.2018.00262.","journal-title":"Front Med"},{"issue":"1","key":"5377_CR8","doi-asserted-by":"publisher","first-page":"11554","DOI":"10.1038\/s41598-021-90812-4","volume":"11","author":"KR Rijal","year":"2021","unstructured":"Rijal KR, Banjara MR, Dhungel B, Kafle S, Gautam K, Ghimire B, et al. Use of antimicrobials and antimicrobial resistance in Nepal: a nationwide survey. Sci Rep. 2021;11(1):11554. https:\/\/doi.org\/10.1038\/s41598-021-90812-4.","journal-title":"Sci Rep"},{"issue":"1","key":"5377_CR9","doi-asserted-by":"publisher","first-page":"248","DOI":"10.1186\/s12866-022-02660-5","volume":"22","author":"NA Kamel","year":"2022","unstructured":"Kamel NA, Tohamy ST, Yahia IS, Aboshanab KM. Insights on the performance of phenotypic tests versus genotypic tests for the detection of carbapenemase-producing gram-negative bacilli in resource-limited settings. BMC Microbiol. 2022;22(1):248. https:\/\/doi.org\/10.1186\/s12866-022-02660-5.","journal-title":"BMC Microbiol"},{"issue":"1","key":"5377_CR10","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s13756-016-0115-6","volume":"5","author":"N Suwantarat","year":"2016","unstructured":"Suwantarat N, Carroll KC. Epidemiology and molecular characterization of multidrug-resistant gram-negative bacteria in Southeast Asia. Antimicrob Resist Infect Control. 2016;5(1):1\u20138. https:\/\/doi.org\/10.1186\/s13756-016-0115-6.","journal-title":"Antimicrob Resist Infect Control"},{"issue":"10325","key":"5377_CR11","doi-asserted-by":"publisher","first-page":"629","DOI":"10.1016\/S0140-6736(21)02724-0","volume":"399","author":"CJ Murray","year":"2022","unstructured":"Murray CJ, Ikuta KS, Sharara F, Swetsc hinski L, Robles Aguilar G, Gray A, et al. Global burden of bacterial antimicrobial resistance in 2019: a systematic analysis. Lancet. 2022;399(10325):629\u201355. https:\/\/doi.org\/10.1016\/S0140-6736(21)02724-0.","journal-title":"Lancet"},{"issue":"271","key":"5377_CR12","doi-asserted-by":"publisher","first-page":"202","DOI":"10.31729\/jnma.8498","volume":"62","author":"PM Shrestha","year":"2024","unstructured":"Shrestha PM, Kattel HP, Sharma S, Bista P, Basnet BK, Ghimire P, et al. Metallo-\u03b2-lactamase-producing Pseudomonas aeruginosa isolates from two tertiary care centers in a district of Nepal: A descriptive cross-sectional study. J Nepal Med Assoc. 2024;62(271):202\u20136. https:\/\/doi.org\/10.31729\/jnma.8498.","journal-title":"J Nepal Med Assoc"},{"issue":"267","key":"5377_CR13","doi-asserted-by":"publisher","first-page":"868","DOI":"10.31729\/jnma.8330","volume":"61","author":"S Bhatta","year":"2023","unstructured":"Bhatta S, Pradhan M, Chaudhary R. Multidrug-resistant among Non-Fermenting gram-negative bacteria isolated in the department of microbiology of a tertiary care center. J Nepal Med Assoc. 2023;61(267):868\u201370. https:\/\/doi.org\/10.31729\/jnma.8330.","journal-title":"J Nepal Med Assoc"},{"issue":"21","key":"5377_CR14","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s13756-017-0180-5","volume":"6","author":"PR Joshi","year":"2017","unstructured":"Joshi PR, Acharya M, Kakshapati T, Leungtongkam U, Thummeepak R, Sitthisak S. Coexistence of bla OXA-23 and bla NDM-1 genes of Acinetobacter baumannii isolated from Nepal: Antimicrobial resistance and clinical significance. Antimicrob Resist Infect Control. 2017;6(21):1\u20137. https:\/\/doi.org\/10.1186\/s13756-017-0180-5.","journal-title":"Antimicrob Resist Infect Control"},{"issue":"3","key":"5377_CR15","doi-asserted-by":"publisher","first-page":"303","DOI":"10.18502\/ijm.v13i3.6392","volume":"13","author":"M Ansari","year":"2021","unstructured":"Ansari M, Aryal SC, Rai G, Rai KR, Pyakurel S, Bhandari B, et al. Prevalence of multidrug-resistance and blaVIM and blaIMP genes among gram-negative clinical isolates in tertiary care hospital, Kathmandu, Nepal. Iran J Microbiol. 2021;13(3):303\u201311. https:\/\/doi.org\/10.18502\/ijm.v13i3.6392.","journal-title":"Iran J Microbiol"},{"issue":"7","key":"5377_CR16","doi-asserted-by":"publisher","first-page":"1010","DOI":"10.3855\/jidc.17743","volume":"18","author":"G Syangtan","year":"2024","unstructured":"Syangtan G, Khanal LK, Bista S, Chand AB, Maharajhan BL, Dawadi P, et al. Panton-Valentine leucocidin gene in methicillin resistant Staphylococcus aureus isolated from tertiary care hospital in Nepal. J Infect Dev Ctries. 2024;18(7):1010\u20139. https:\/\/doi.org\/10.3855\/jidc.17743.","journal-title":"J Infect Dev Ctries"},{"key":"5377_CR17","doi-asserted-by":"publisher","first-page":"34","DOI":"10.1017\/CBO9780511543470","volume-title":"District Laboratory Practice in Tropical Countries Part-II. Second Edi","author":"M Cheesbrough","year":"2006","unstructured":"Cheesbrough M. District Laboratory Practice in Tropical Countries Part-II. Second Edi. New York: Cambridge University Press; 2006. pp. 34\u2013234. www.cambridge.org."},{"issue":"1","key":"5377_CR18","doi-asserted-by":"publisher","first-page":"4","DOI":"10.1186\/s13104-020-4890-z","volume":"13","author":"E Kamali","year":"2020","unstructured":"Kamali E, Jamali A, Ardebili A, Ezadi F, Mohebbi A. Evaluation of antimicrobial resistance, biofilm forming potential, and the presence of biofilm-related genes among clinical isolates of Pseudomonas aeruginosa. BMC Res Notes. 2020;13(1):4\u20139. https:\/\/doi.org\/10.1186\/s13104-020-4890-z.","journal-title":"BMC Res Notes"},{"issue":"185","key":"5377_CR19","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s13756-019-0611-6","volume":"8","author":"A Abouelfetouh","year":"2019","unstructured":"Abouelfetouh A, Torky AS, Aboulmagd E. Phenotypic and genotypic characterization of carbapenem-resistant Acinetobacter baumannii isolates from Egypt. Antimicrob Resist Infect Control. 2019;8(185):1\u20139. https:\/\/doi.org\/10.1186\/s13756-019-0611-6.","journal-title":"Antimicrob Resist Infect Control"},{"key":"5377_CR20","unstructured":"CLSI. Performance Standards for Antimicrobial Susceptibility Testing, 30th Edition. The Clinical and Laboratory Standard Institute. USA. 2020. https:\/\/clsi.org\/standards\/products\/microbiology\/documents\/m100\/."},{"issue":"1","key":"5377_CR21","doi-asserted-by":"publisher","first-page":"136","DOI":"10.1186\/s12866-021-02133-1","volume":"21","author":"HS Elbadawi","year":"2021","unstructured":"Elbadawi HS, Elhag KM, Mahgoub E, Altayb HN, Ntoumi F, Elton L, et al. Detection and characterization of carbapenem resistant Gram-negative bacilli isolates recovered from hospitalized patients at Soba University Hospital, Sudan. BMC Microbiol. 2021;21(1):136. https:\/\/doi.org\/10.1186\/s12866-021-02133-1.","journal-title":"BMC Microbiol"},{"issue":"11","key":"5377_CR22","doi-asserted-by":"publisher","first-page":"e01140","DOI":"10.1128\/JCM.01140-18","volume":"56","author":"PD Tamma","year":"2018","unstructured":"Tamma PD, Simner PJ. Phenotypic Detection of Carbapenemase-Producing Organisms from Clinical Isolates. J Clin Microbiol. 2018;56(11):e01140\u201318. https:\/\/doi.org\/10.1128\/JCM.01140-18.","journal-title":"J Clin Microbiol"},{"issue":"10","key":"5377_CR23","doi-asserted-by":"publisher","first-page":"3798","DOI":"10.1128\/JCM.40.10.3798-3801.2002","volume":"40","author":"D Yong","year":"2002","unstructured":"Yong D, Lee K, Yum JH, Shin HB, Rossolini GM, Chong Y. Imipenem-EDTA disk method for differentiation of metallo-\u03b2-lactamase-producing clinical isolates of Pseudomonas spp. and Acinetobacter spp. J Clin Microbiol. 2002;40(10):3798\u2013801. https:\/\/doi.org\/10.1128\/JCM.40.10.3798-3801.2002.","journal-title":"J Clin Microbiol"},{"key":"5377_CR24","unstructured":"Sambrook J, Russell DW. In: Argentine J, editor. Molecular Cloning A Laboratory Manual. 3 ed. New York: Cold Spring Harbor Laboratory Press; 2001."},{"issue":"7","key":"5377_CR25","doi-asserted-by":"publisher","first-page":"1022","DOI":"10.1016\/j.jiph.2019.11.018","volume":"13","author":"S Vijayakumar","year":"2020","unstructured":"Vijayakumar S, Anandan S, Prabaa D, Kanthan K, Vijayabaskar S, Kapil A, et al. Insertion sequences and sequence types profile of clinical isolates of carbapenem-resistant A. baumannii collected across India over four year period. J Infect Public Health. 2020;13(7):1022\u20138. https:\/\/doi.org\/10.1016\/j.jiph.2019.11.018.","journal-title":"J Infect Public Health"},{"issue":"15","key":"5377_CR26","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3390\/diseases9010015","volume":"9","author":"RSP Sah","year":"2021","unstructured":"Sah RSP, Dhungel B, Yadav BK, Adhikari N, Shrestha UT, Lekhak B, et al. Detection of TEM and CTX-M Genes in Escherichia coli Isolated from Clinical Specimens at Tertiary Care Heart Hospital. Diseases. 2021;9(15):1\u201314. https:\/\/doi.org\/10.3390\/diseases9010015.","journal-title":"Diseases"},{"key":"5377_CR27","doi-asserted-by":"publisher","unstructured":"Schrader SM, Vaubourgeix J, Nathan C. Biology of antimicrobial resistance and approaches to combat it. Sci Transl Med. 2020;12(549). https:\/\/doi.org\/10.1126\/scitranslmed.aaz6992.","DOI":"10.1126\/scitranslmed.aaz6992"},{"issue":"12","key":"5377_CR28","doi-asserted-by":"publisher","first-page":"5046","DOI":"10.1128\/AAC.00774-09","volume":"53","author":"D Yong","year":"2009","unstructured":"Yong D, Toleman MA, Giske CG, Cho HS, Sundman K, Lee K, et al. Characterization of a new metallo-\u03b2-lactamase gene, blaNDM-1, and a novel erythromycin esterase gene carried on a unique genetic structure in Klebsiella pneumoniae sequence type 14 from India. Antimicrob Agents Chemother. 2009;53(12):5046\u201354. https:\/\/doi.org\/10.1128\/AAC.00774-09.","journal-title":"Antimicrob Agents Chemother"},{"issue":"12","key":"5377_CR29","doi-asserted-by":"publisher","first-page":"4329","DOI":"10.1128\/AAC.00810-07","volume":"51","author":"O Guti\u00e9rrez","year":"2007","unstructured":"Guti\u00e9rrez O, Juan C, Cercenado E, Navarro F, Bouza E, Coll P, et al. Molecular epidemiology and mechanisms of carbapenem resistance in Pseudomonas aeruginosa isolates from Spanish hospitals. Antimicrob Agents Chemother. 2007;51(12):4329\u201335. https:\/\/doi.org\/10.1128\/AAC.00810-07.","journal-title":"Antimicrob Agents Chemother"},{"issue":"4","key":"5377_CR30","doi-asserted-by":"publisher","first-page":"351","DOI":"10.1016\/j.ijantimicag.2006.01.004","volume":"27","author":"N Woodford","year":"2006","unstructured":"Woodford N, Ellington MJ, Coelho JM, Turton JF, Ward ME, Brown S, et al. Multiplex PCR for genes encoding prevalent OXA carbapenemases in Acinetobacter spp. Int J Antimicrob Agents. 2006;27(4):351\u20133. https:\/\/doi.org\/10.1016\/j.ijantimicag.2006.01.004.","journal-title":"Int J Antimicrob Agents"},{"issue":"1","key":"5377_CR31","doi-asserted-by":"publisher","first-page":"695","DOI":"10.1186\/s12879-022-07678-8","volume":"22","author":"S Ruekit","year":"2022","unstructured":"Ruekit S, Srijan A, Serichantalergs O, Margulieux KR, Mc Gann P, Mills EG, et al. Molecular characterization of multidrug-resistant ESKAPEE pathogens from clinical samples in Chonburi, Thailand (2017\u20132018). BMC Infect Dis. 2022;22(1):695. https:\/\/doi.org\/10.1186\/s12879-022-07678-8.","journal-title":"BMC Infect Dis"},{"issue":"1","key":"5377_CR32","doi-asserted-by":"publisher","first-page":"67","DOI":"10.3126\/tujm.v7i0.33800","volume":"7","author":"R Maharjan","year":"2020","unstructured":"Maharjan R, Shrestha B, Shrestha S, Angbuhang KB, Lekhak B, Nepal K, et al. Detection of Metallo-\u03b2-Lactamases and carbapenemase production Pseudomonas aeruginosa isolates from burn wound infection. Tribhuvan Univ J Microbiol. 2020;7(1):67\u201374. https:\/\/doi.org\/10.3126\/tujm.v7i0.33800.","journal-title":"Tribhuvan Univ J Microbiol"},{"issue":"241","key":"5377_CR33","doi-asserted-by":"publisher","first-page":"875","DOI":"10.31729\/jnma.6408","volume":"59","author":"M Shrestha","year":"2021","unstructured":"Shrestha M, Baral R, Shrestha LB. Metallo-\u03b2 lactamase producing nonfermentative gram-negative bacilli from various clinical isolates in a tertiary care hospital: A descriptive cross-sectional study. J Nepal Med Assoc. 2021;59(241):875\u201380. https:\/\/doi.org\/10.31729\/jnma.6408.","journal-title":"J Nepal Med Assoc"},{"key":"5377_CR34","doi-asserted-by":"publisher","first-page":"2201","DOI":"10.2147\/IDR.S306688","volume":"14","author":"R Pandey","year":"2021","unstructured":"Pandey R, Mishra SK, Shrestha A. Characterization of ESKAPE pathogens with special reference to multidrug resistance and biofilm production in a Nepalese hospital. Infect Drug Resist. 2021;14:2201\u201312. https:\/\/doi.org\/10.2147\/IDR.S306688.","journal-title":"Infect Drug Resist"},{"issue":"1","key":"5377_CR35","doi-asserted-by":"publisher","first-page":"8477","DOI":"10.1038\/s41598-022-12471-3","volume":"12","author":"N Kumari","year":"2022","unstructured":"Kumari N, Kumar M, Katiyar A, Kumar A, Priya P, Kumar B, et al. Genome-wide identification of carbapenem-resistant gram-negative bacterial (CR-GNB) isolates retrieved from hospitalized patients in Bihar, India. Sci Rep. 2022;12(1):8477. https:\/\/doi.org\/10.1038\/s41598-022-12471-3.","journal-title":"Sci Rep"},{"issue":"4","key":"5377_CR36","doi-asserted-by":"publisher","first-page":"e113008","DOI":"10.5812\/JJM.113008","volume":"14","author":"N Zahra","year":"2021","unstructured":"Zahra N, Zeshan B, Qadri MMA, Ishaq M, Afzal M, Ahmed N. Phenotypic and genotypic evaluation of antibiotic resistance of Acinetobacter baumannii bacteria isolated from surgical ICU patients in Pakistan. Jundishapur J Microbiol. 2021;14(4):e113008. https:\/\/doi.org\/10.5812\/JJM.113008.","journal-title":"Jundishapur J Microbiol"},{"issue":"2","key":"5377_CR37","doi-asserted-by":"publisher","first-page":"dlad038","DOI":"10.1093\/jacamr\/dlad038","volume":"5","author":"A Olalekan","year":"2023","unstructured":"Olalekan A, Bader BK, Iwalokun B, Wolf S, Lalremruata A, Dike A, et al. High incidence of carbapenemase-producing Pseudomonas aeruginosa clinical isolates from Lagos, Nigeria. JAC-Antimicrobial Resist. 2023;5(2):dlad038. https:\/\/doi.org\/10.1093\/jacamr\/dlad038.","journal-title":"JAC-Antimicrobial Resist"},{"issue":"3","key":"5377_CR38","doi-asserted-by":"publisher","first-page":"e0076622","DOI":"10.1128\/spectrum.00766-22","volume":"10","author":"L Diorio-Toth","year":"2022","unstructured":"Diorio-Toth L, Irum S, Potter RF, Wallace MA, Arslan M, Munir T, et al. Genomic Surveillance of clinical Pseudomonas aeruginosa isolates reveals an additive effect of carbapenemase production on carbapenem resistance. Microbiol Spectr. 2022;10(3):e0076622. https:\/\/doi.org\/10.1128\/spectrum.00766-22.","journal-title":"Microbiol Spectr"},{"issue":"7","key":"5377_CR39","doi-asserted-by":"publisher","first-page":"1606","DOI":"10.1093\/jac\/dkad127","volume":"78","author":"AC Gales","year":"2023","unstructured":"Gales AC, Stone G, Sahm DF, Wise MG, Utt E. Incidence of ESBLs and carbapenemases among Enterobacterales and carbapenemases in Pseudomonas aeruginosa isolates collected globally: results from ATLAS 2017\u20132019. J Antimicrob Chemother. 2023;78(7):1606\u201315. https:\/\/doi.org\/10.1093\/jac\/dkad127.","journal-title":"J Antimicrob Chemother"},{"issue":"4","key":"5377_CR40","doi-asserted-by":"publisher","first-page":"804","DOI":"10.3126\/nje.v9i4.26962","volume":"9","author":"S Baral","year":"2019","unstructured":"Baral S, Pokharel A, Subramanya SH, Nayak N. Clinico-epidemiological profile of Acinetobacter and Pseudomonas infections, and their antibiotic resistant pattern in a tertiary care center, Western Nepal. Nepal J Epidemiol. 2019;9(4):804\u201311. https:\/\/doi.org\/10.3126\/nje.v9i4.26962.","journal-title":"Nepal J Epidemiol"},{"issue":"1","key":"5377_CR41","doi-asserted-by":"publisher","first-page":"99","DOI":"10.1186\/s12879-023-08017-1","volume":"23","author":"NA El Aila","year":"2023","unstructured":"El Aila NA, Al Laham NA, Ayesh BM. Prevalence of extended spectrum beta-lactamase and molecular detection of blaTEM, blaSHV and blaCTX-M genotypes among gram-negative bacilli isolates from pediatric patient population in Gaza strip. BMC Infect Dis. 2023;23(1):99. https:\/\/doi.org\/10.1186\/s12879-023-08017-1.","journal-title":"BMC Infect Dis"},{"issue":"4","key":"5377_CR42","doi-asserted-by":"publisher","first-page":"470","DOI":"10.18502\/ijm.v13i4.6971","volume":"13","author":"MH Namaei","year":"2021","unstructured":"Namaei MH, Yousefi M, Askari P, Roshanravan B, Hashemi A, Rezaei Y. High prevalence of multidrug-resistant nonfermentative gram-negative bacilli harboring blaIMP-1 and blaVIM-1 metallo-beta-lactamase genes in Birjand, south\u2013east Iran. Iran J Microbiol. 2021;13(4):470\u20139. https:\/\/doi.org\/10.18502\/ijm.v13i4.6971.","journal-title":"Iran J Microbiol"},{"key":"5377_CR43","doi-asserted-by":"publisher","unstructured":"Kumari M, Bhattarai NR, Rai K, Pandit TK, Khanal B, Multidrug-Resistant. Acinetobacter: Detection of ESBL, MBL, blaNDM-1 Genotype, and Biofilm Formation at a Tertiary Care Hospital in Eastern Nepal. Int J Microbiol. 2022;2022: 8168000. https:\/\/doi.org\/10.1155\/2022\/8168000.","DOI":"10.1155\/2022\/8168000"},{"key":"5377_CR44","doi-asserted-by":"publisher","first-page":"725","DOI":"10.2147\/IDR.S239514","volume":"13","author":"SK Yadav","year":"2020","unstructured":"Yadav SK, Bhujel R, Hamal P, Mishra SK, Sharma S, Sherchand JB. Burden of multidrug-resistant Acinetobacter baumannii infection in hospitalized patients in a tertiary care hospital of Nepal. Infect Drug Resist. 2020;13:725\u201332. https:\/\/doi.org\/10.2147\/IDR.S239514.","journal-title":"Infect Drug Resist"},{"issue":"1","key":"5377_CR45","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1128\/spectrum.00383-24","volume":"13","author":"RE Koch","year":"2024","unstructured":"Koch RE, Barth J, Clark AE, Desai D, Kim J, Pybus CA, et al. Antibiotic resistance genotype, phenotype, and clinical outcomes in patients with Gram-negative infections at Rabin Medical. Microbiol Spectr. 2024;13(1):1\u201317. https:\/\/doi.org\/10.1128\/spectrum.00383-24.","journal-title":"Microbiol Spectr"},{"issue":"7","key":"5377_CR46","doi-asserted-by":"publisher","first-page":"1251","DOI":"10.1007\/s10096-020-03839-2","volume":"39","author":"MM Tawfick","year":"2020","unstructured":"Tawfick MM, Alshareef WA, Bendary HA, Elmahalawy H, Abdulall AK. The emergence of carbapenemase bla NDM genotype among carbapenem-resistant Enterobacteriaceae isolates from Egyptian cancer patients. Eur J Clin Microbiol Infect Dis. 2020;39(7):1251\u201359. https:\/\/doi.org\/10.1007\/s10096-020-03839-2.","journal-title":"Eur J Clin Microbiol Infect Dis"},{"issue":"10","key":"5377_CR47","doi-asserted-by":"publisher","first-page":"1275","DOI":"10.1007\/s10096-023-04651-4","volume":"42","author":"LFMJ Pitout","year":"2023","unstructured":"Pitout LFMJ, Croxen M, Dingle MRMTC. Three separate acquisitions of bla NDM\u20131 in three different bacterial species from a single patient. Eur J Clin Microbiol Infect Dis. 2023;42(10):1275\u201380. https:\/\/doi.org\/10.1007\/s10096-023-04651-4.","journal-title":"Eur J Clin Microbiol Infect Dis"},{"issue":"31","key":"5377_CR48","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s12941-016-0146-0","volume":"15","author":"D Paul","year":"2016","unstructured":"Paul D, Dhar D, Maurya AP, Mishra S, Sharma GD, Chakravarty A, et al. Occurrence of coexisting blaVIM-2 and blaNDM-1 in clinical isolates of Pseudomonas aeruginosa from India. Ann Clin Microbiol Antimicrob. 2016;15(31):1\u20136. https:\/\/doi.org\/10.1186\/s12941-016-0146-0.","journal-title":"Ann Clin Microbiol Antimicrob"},{"issue":"6","key":"5377_CR49","doi-asserted-by":"publisher","first-page":"513","DOI":"10.1016\/j.ijantimicag.2011.02.010","volume":"37","author":"AK Van Der Bij","year":"2011","unstructured":"Van Der Bij AK, Van Mansfeld R, Peirano G, Goessens WHF, Severin JA, Pitout JDD, et al. First outbreak of VIM-2 metallo-\u03b2-lactamase-producing Pseudomonas aeruginosa in the Netherlands: Microbiology, epidemiology and clinical outcomes. Int J Antimicrob Agents. 2011;37(6):513\u20138. https:\/\/doi.org\/10.1016\/j.ijantimicag.2011.02.010.","journal-title":"Int J Antimicrob Agents"},{"issue":"1","key":"5377_CR50","doi-asserted-by":"publisher","first-page":"718","DOI":"10.1186\/s13104-017-3068-9","volume":"10","author":"M Acharya","year":"2017","unstructured":"Acharya M, Joshi PR, Thapa K, Aryal R, Kakshapati T, Sharma S. Detection of metallo-\u03b2-lactamases-encoding genes among clinical isolates of Pseudomonas aeruginosa in a tertiary care hospital, Kathmandu, Nepal. BMC Res Notes. 2017;10(1):718. https:\/\/doi.org\/10.1186\/s13104-017-3068-9.","journal-title":"BMC Res Notes"},{"key":"5377_CR51","doi-asserted-by":"publisher","first-page":"279","DOI":"10.1016\/j.jgar.2021.07.003","volume":"26","author":"T Takahashi","year":"2021","unstructured":"Takahashi T, Tada T, Shrestha S, Hishinuma T, Sherchan JB, Tohya M, et al. Molecular characterization of carbapenem-resistant Pseudomonas aeruginosa clinical isolates in Nepal. J Glob Antimicrob Resist. 2021;26:279\u201384. https:\/\/doi.org\/10.1016\/j.jgar.2021.07.003.","journal-title":"J Glob Antimicrob Resist"},{"issue":"1","key":"5377_CR52","doi-asserted-by":"publisher","first-page":"172","DOI":"10.1186\/s13756-019-0612-5","volume":"8","author":"R Ranjbar","year":"2019","unstructured":"Ranjbar R, Farahani A. Study of genetic diversity, biofilm formation, and detection of Carbapenemase, MBL, ESBL, and tetracycline resistance genes in multidrug-resistant Acinetobacter baumannii isolated from burn wound infections in Iran. Antimicrob Resist Infect Control. 2019;8(1):172. https:\/\/doi.org\/10.1186\/s13756-019-0612-5.","journal-title":"Antimicrob Resist Infect Control"},{"issue":"5","key":"5377_CR53","doi-asserted-by":"publisher","first-page":"526","DOI":"10.1016\/j.ijantimicag.2015.07.012","volume":"46","author":"S Shrestha","year":"2015","unstructured":"Shrestha S, Tada T, Miyoshi-Akiyama T, Ohara H, Shimada K, Satou K, et al. Molecular epidemiology of multidrug-resistant Acinetobacter baumannii isolates in a university hospital in Nepal reveals the emergence of a novel epidemic clonal lineage. Int J Antimicrob Agents. 2015;46(5):526\u201331. https:\/\/doi.org\/10.1016\/j.ijantimicag.2015.07.012.","journal-title":"Int J Antimicrob Agents"}],"container-title":["BMC Microbiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12866-026-05377-x","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12866-026-05377-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12866-026-05377-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:42:41Z","timestamp":1790815361000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s12866-026-05377-x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,8]]},"references-count":53,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["5377"],"URL":"https:\/\/doi.org\/10.1186\/s12866-026-05377-x","relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.3.rs-9231883\/v1","asserted-by":"object"}]},"ISSN":["1471-2180"],"issn-type":[{"value":"1471-2180","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,8]]},"assertion":[{"value":"26 March 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"2 July 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"8 July 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Ethical approval for the study was obtained from the Institutional Review Committee (IRC) of KIST Medical College and Teaching Hospital (Ref. No.: 077\/078\/54). Written consent was obtained from each patient for voluntary participation before collecting demographic data and samples. The Declaration of Helsinki and the guidelines of the Nepal Health Research Council were adhered to throughout the study.","order":1,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"848"}}