{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T00:37:52Z","timestamp":1792629472366,"version":"4.5.0"},"reference-count":59,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T00:00:00Z","timestamp":1784592000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"},{"start":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T00:00:00Z","timestamp":1792627200000},"content-version":"vor","delay-in-days":93,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"funder":[{"DOI":"10.13039\/501100009647","name":"University Grants Commission- Nepal","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100009647","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Microbiol"],"DOI":"10.1186\/s12866-026-05439-0","type":"journal-article","created":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T08:37:24Z","timestamp":1784623044000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Metallo-\u03b2-lactamase mediated resistance and Class 1 integron in carbapenem-resistant Enterobacterales isolates from the clinical specimens of Nepal"],"prefix":"10.1186","volume":"26","author":[{"given":"Manisha","family":"Shrestha","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suchitra","family":"Thapa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Basudha","family":"Shrestha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dev Raj","family":"Joshi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yojana","family":"Pokhrel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jivan","family":"Shakya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reshma","family":"Tuladhar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,21]]},"reference":[{"key":"5439_CR1","doi-asserted-by":"publisher","first-page":"629","DOI":"10.1016\/S0140-6736(21)02724-0","volume":"399","author":"CJL Murray","year":"2022","unstructured":"Murray CJL, Ikuta KS, Sharara F, Swetschinski L, Robles Aguilar G, Gray A, et al. Global burden of bacterial antimicrobial resistance in 2019: a systematic analysis. Lancet. 2022;399:629\u201355. https:\/\/doi.org\/10.1016\/S0140-6736(21)02724-0.","journal-title":"Lancet"},{"key":"5439_CR2","doi-asserted-by":"publisher","first-page":"1199","DOI":"10.1016\/S0140-6736(24)01867-1","volume":"404","author":"M Naghavi","year":"2024","unstructured":"Naghavi M, Vollset SE, Ikuta KS, Swetschinski LR, Gray AP, Wool EE, et al. Global burden of bacterial antimicrobial resistance 1990\u20132021: a systematic analysis with forecasts to 2050. Lancet. 2024;404:1199\u2013226. https:\/\/doi.org\/10.1016\/S0140-6736(24)01867-1.","journal-title":"Lancet"},{"key":"5439_CR3","unstructured":"WHO. WHO Bacterial priority pathogens list. 2024 bacterial pathogens of public health importance, to guide research, development, and strategies to prevent and control antimicrobial resistance. Geneva: World Health Organization; 2024."},{"key":"5439_CR4","doi-asserted-by":"publisher","first-page":"1340","DOI":"10.3390\/molecules25061340","volume":"25","author":"Z Breijyeh","year":"2020","unstructured":"Breijyeh Z, Jubeh B, Karaman R. Resistance of gram-negative bacteria to current antibacterial agents and approaches to resolve it. Molecules. 2020;25:1340. https:\/\/doi.org\/10.3390\/molecules25061340.","journal-title":"Molecules"},{"key":"5439_CR5","doi-asserted-by":"publisher","first-page":"28","DOI":"10.3390\/antibiotics12010028","volume":"12","author":"R Selvarajan","year":"2022","unstructured":"Selvarajan R, Obize C, Sibanda T, Abia ALK, Long H. Evolution and emergence of antibiotic resistance in given ecosystems: possible strategies for addressing the challenge of antibiotic resistance. Antibiotics. 2022;12:28. https:\/\/doi.org\/10.3390\/antibiotics12010028.","journal-title":"Antibiotics"},{"key":"5439_CR6","doi-asserted-by":"publisher","first-page":"421","DOI":"10.3390\/antibiotics11030421","volume":"11","author":"C Aurilio","year":"2022","unstructured":"Aurilio C, Sansone P, Barbarisi M, Pota V, Giaccari LG, Coppolino F, et al. Mechanisms of action of carbapenem resistance. Antibiotics. 2022;11:421. https:\/\/doi.org\/10.3390\/antibiotics11030421.","journal-title":"Antibiotics"},{"key":"5439_CR7","doi-asserted-by":"publisher","first-page":"440","DOI":"10.1128\/CMR.00001-07","volume":"20","author":"AM Queenan","year":"2007","unstructured":"Queenan AM, Bush K. Carbapenemases: the Versatile \u03b2-Lactamases. Clin Microbiol Rev. 2007;20:440\u201358. https:\/\/doi.org\/10.1128\/CMR.00001-07.","journal-title":"Clin Microbiol Rev"},{"key":"5439_CR8","doi-asserted-by":"publisher","first-page":"831","DOI":"10.1111\/1469-0691.12655","volume":"20","author":"SM Diene","year":"2014","unstructured":"Diene SM, Rolain J-M. Carbapenemase genes and genetic platforms in gram-negative bacilli: enterobacteriaceae, pseudomonas and acinetobacter species. Clin Microbiol Infect. 2014;20:831\u20138. https:\/\/doi.org\/10.1111\/1469-0691.12655.","journal-title":"Clin Microbiol Infect"},{"key":"5439_CR9","doi-asserted-by":"publisher","first-page":"e00088","DOI":"10.1128\/CMR.00088-17","volume":"31","author":"SR Partridge","year":"2018","unstructured":"Partridge SR, Kwong SM, Firth N, Jensen SO. Mobile genetic elements associated with antimicrobial resistance. Clin Microbiol Rev. 2018;31:e00088\u201317. https:\/\/doi.org\/10.1128\/CMR.00088-17.","journal-title":"Clin Microbiol Rev"},{"key":"5439_CR10","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, bla NDM-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;53:5046\u201354. https:\/\/doi.org\/10.1128\/AAC.00774-09.","journal-title":"Antimicrob Agents Chemother"},{"key":"5439_CR11","doi-asserted-by":"publisher","first-page":"159","DOI":"10.33314\/jnhrc.v18i2.2039","volume":"18","author":"SP Devkota","year":"2020","unstructured":"Devkota SP, Paudel A, Bhatta DR, Gurung K. Carbapenemase among clinical bacterial isolates in Nepal. J Nepal Health Res Counc. 2020;18:159\u201365. https:\/\/doi.org\/10.33314\/jnhrc.v18i2.2039.","journal-title":"J Nepal Health Res Counc"},{"key":"5439_CR12","doi-asserted-by":"publisher","first-page":"251","DOI":"10.1007\/s10096-024-04993-7","volume":"44","author":"J-A Lee","year":"2025","unstructured":"Lee J-A, Kuo Y-W, Du S-H, Lee T, Liao C-H, Huang Y-T, et al. High diversity of strain clonality and metallo-\u03b2-lactamases genes among carbapenem-resistant Enterobacterales in Taiwan. Eur J Clin Microbiol Infect Dis. 2025;44:251\u201362. https:\/\/doi.org\/10.1007\/s10096-024-04993-7.","journal-title":"Eur J Clin Microbiol Infect Dis"},{"key":"5439_CR13","doi-asserted-by":"publisher","first-page":"1146","DOI":"10.3390\/antibiotics12071146","volume":"12","author":"K Takei","year":"2023","unstructured":"Takei K, Kanamori H, Nakayama A, Chiba M, Takei Y, Seike I, et al. Screening for metallo-beta-lactamases using non-carbapenem agents: effective detection of mbl-producing enterobacterales and differentiation of carbapenem-resistant enterobacterales. Antibiotics. 2023;12:1146. https:\/\/doi.org\/10.3390\/antibiotics12071146.","journal-title":"Antibiotics"},{"key":"5439_CR14","doi-asserted-by":"publisher","first-page":"1439","DOI":"10.1186\/s12879-024-10300-8","volume":"24","author":"A Benbouza","year":"2024","unstructured":"Benbouza A, Kassah-Laouar A, Chelaghma W, Bouziane F, Mebarki Y, Rolain J-M, et al. Epidemiological and genetic characteristics of clinical carbapenemase-producing Enterobacterales isolates from Batna hospitals in Algeria. BMC Infect Dis. 2024;24:1439. https:\/\/doi.org\/10.1186\/s12879-024-10300-8.","journal-title":"BMC Infect Dis"},{"key":"5439_CR15","doi-asserted-by":"publisher","first-page":"e01220","DOI":"10.1128\/jcm.01220-24","volume":"62","author":"S Sabour","year":"2024","unstructured":"Sabour S, Harrington KRV, Martinson E, Bhatnagar AS, Huang JY, Duffy D, et al. Characterization of carbapenem-resistant Enterobacterales and Pseudomonas aeruginosa carrying multiple carbapenemase genes\u2014Antimicrobial Resistance Laboratory Network, 2018\u20132022. J Clin Microbiol. 2024;62:e01220\u201324. https:\/\/doi.org\/10.1128\/jcm.01220-24.","journal-title":"J Clin Microbiol"},{"key":"5439_CR16","doi-asserted-by":"publisher","unstructured":"Mathers A. Mobilization of Carbapenemase-mediated resistance in enterobacteriaceae. Microbiol Spectr. 2016;4. https:\/\/doi.org\/10.1128\/microbiolspec.ei10-0010-2015.","DOI":"10.1128\/microbiolspec.ei10-0010-2015"},{"key":"5439_CR17","doi-asserted-by":"publisher","unstructured":"Malek MM, Amer FA, Allam AA, El-Sokkary RH, Gheith T, Arafa MA. Occurrence of classes I and II integrons in enterobacteriaceae collected from Zagazig University Hospitals, Egypt. Front Microbiol. 2015;6. https:\/\/doi.org\/10.3389\/fmicb.2015.00601.","DOI":"10.3389\/fmicb.2015.00601"},{"key":"5439_CR18","doi-asserted-by":"publisher","unstructured":"Bhat BA, Mir RA, Qadri H, Dhiman R, Almilaibary A, Alkhanani M, et al. Integrons in the development of antimicrobial resistance: critical review and perspectives. Front Microbiol. 2023;14. https:\/\/doi.org\/10.3389\/fmicb.2023.1231938.","DOI":"10.3389\/fmicb.2023.1231938"},{"key":"5439_CR19","doi-asserted-by":"publisher","unstructured":"Rowe-Magnus DA, Davies D, Mazel D. Impact of integrons and transposons on the evolution of resistance and virulence. In: Hacker J, Kaper JB, editors. Pathog Isl Evol Pathog Microbes, vol. 2. Berlin, Heidelberg: Springer; 2002. p. 167\u201388. https:\/\/doi.org\/10.1007\/978-3-642-56031-6_10.","DOI":"10.1007\/978-3-642-56031-6_10"},{"key":"5439_CR20","doi-asserted-by":"publisher","first-page":"608","DOI":"10.1038\/nrmicro1462","volume":"4","author":"D Mazel","year":"2006","unstructured":"Mazel D. Integrons: agents of bacterial evolution. Nat Rev Microbiol. 2006;4:608\u201320. https:\/\/doi.org\/10.1038\/nrmicro1462.","journal-title":"Nat Rev Microbiol"},{"key":"5439_CR21","doi-asserted-by":"publisher","first-page":"257","DOI":"10.1128\/MMBR.00056-13","volume":"78","author":"MR Gillings","year":"2014","unstructured":"Gillings MR. Integrons: past, present, and future. Microbiol Mol Biol Rev MMBR. 2014;78:257\u201377. https:\/\/doi.org\/10.1128\/MMBR.00056-13.","journal-title":"Microbiol Mol Biol Rev MMBR"},{"key":"5439_CR22","doi-asserted-by":"publisher","first-page":"1669","DOI":"10.1111\/j.1365-2958.1989.tb00153.x","volume":"3","author":"HW Stokes","year":"1989","unstructured":"Stokes HW, Hall RM. A novel family of potentially mobile DNA elements encoding site-specific gene-integration functions: integrons. Mol Microbiol. 1989;3:1669\u201383. https:\/\/doi.org\/10.1111\/j.1365-2958.1989.tb00153.x.","journal-title":"Mol Microbiol"},{"key":"5439_CR23","doi-asserted-by":"publisher","first-page":"115","DOI":"10.1007\/BF01435034","volume":"90","author":"RM Hall","year":"1993","unstructured":"Hall RM, Stokes HW, Integrons. Novel DNA elements which capture genes by site-specific recombination. Genetica. 1993;90:115\u201332. https:\/\/doi.org\/10.1007\/BF01435034.","journal-title":"Genetica"},{"key":"5439_CR24","doi-asserted-by":"publisher","first-page":"757","DOI":"10.1111\/j.1574-6976.2009.00175.x","volume":"33","author":"SR Partridge","year":"2009","unstructured":"Partridge SR, Tsafnat G, Coiera E, Iredell JR. Gene cassettes and cassette arrays in mobile resistance integrons. FEMS Microbiol Rev. 2009;33:757\u201384. https:\/\/doi.org\/10.1111\/j.1574-6976.2009.00175.x.","journal-title":"FEMS Microbiol Rev"},{"key":"5439_CR25","doi-asserted-by":"publisher","first-page":"988","DOI":"10.1099\/jmm.0.029868-0","volume":"60","author":"Y Khosravi","year":"2011","unstructured":"Khosravi Y, Tay ST, Vadivelu J. Analysis of integrons and associated gene cassettes of metallo-\u03b2-lactamase-positive Pseudomonas aeruginosa in Malaysia. J Med Microbiol. 2011;60:988\u201394. https:\/\/doi.org\/10.1099\/jmm.0.029868-0.","journal-title":"J Med Microbiol"},{"key":"5439_CR26","doi-asserted-by":"publisher","first-page":"1","DOI":"10.5897\/JMA2020.433","volume":"13","author":"JN Barns","year":"2021","unstructured":"Barns JN, Ezeamagu CO, Nkemjika ME, Akindele TS. Prevalence of integrons in Enterobacteriaceae obtained from clinical samples. J Microbiol Antimicrob. 2021;13:1\u201310. https:\/\/doi.org\/10.5897\/JMA2020.433.","journal-title":"J Microbiol Antimicrob"},{"key":"5439_CR27","doi-asserted-by":"publisher","first-page":"lxag135","DOI":"10.1093\/jambio\/lxag135","volume":"137","author":"VP Shetty","year":"2026","unstructured":"Shetty VP, Rai P, Karunasagar A, Deekshit VK. Integron-mediated gene cassette dynamics in Enterobacterales under selective antibiotic pressure. J Appl Microbiol. 2026;137:lxag135. https:\/\/doi.org\/10.1093\/jambio\/lxag135.","journal-title":"J Appl Microbiol"},{"key":"5439_CR28","doi-asserted-by":"publisher","first-page":"167","DOI":"10.1016\/j.ijantimicag.2017.10.004","volume":"51","author":"M Kaushik","year":"2018","unstructured":"Kaushik M, Kumar S, Kapoor RK, Virdi JS, Gulati P. Integrons in Enterobacteriaceae: diversity, distribution and epidemiology. Int J Antimicrob Agents. 2018;51:167\u201376. https:\/\/doi.org\/10.1016\/j.ijantimicag.2017.10.004.","journal-title":"Int J Antimicrob Agents"},{"key":"5439_CR29","doi-asserted-by":"publisher","first-page":"1041","DOI":"10.1006\/rwgn.2001.0700","volume-title":"Encycl. Genet","author":"RM Hall","year":"2001","unstructured":"Hall RM. Integrons. In: Brenner S, Miller JH, editors. Encycl. Genet. New York: Academic; 2001. pp. 1041\u20135. https:\/\/doi.org\/10.1006\/rwgn.2001.0700."},{"key":"5439_CR30","doi-asserted-by":"publisher","first-page":"2875","DOI":"10.1111\/j.1365-2958.1992.tb01467.x","volume":"6","author":"CM Collis","year":"1992","unstructured":"Collis CM, Hall RM. Gene cassettes from the insert region of integrons are excised as covalently closed circles. Mol Microbiol. 1992;6:2875\u201385. https:\/\/doi.org\/10.1111\/j.1365-2958.1992.tb01467.x.","journal-title":"Mol Microbiol"},{"key":"5439_CR31","doi-asserted-by":"publisher","first-page":"1034","DOI":"10.1126\/science.1172914","volume":"324","author":"\u00c9 Guerin","year":"2009","unstructured":"Guerin \u00c9, Cambray G, Sanchez-Alberola N, Campoy S, Erill I, Da Re S, et al. The SOS Response Controls Integron Recombination. Science. 2009;324:1034\u20131034. https:\/\/doi.org\/10.1126\/science.1172914.","journal-title":"Science"},{"key":"5439_CR32","doi-asserted-by":"publisher","first-page":"301","DOI":"10.1016\/j.tim.2007.05.004","volume":"15","author":"Y Boucher","year":"2007","unstructured":"Boucher Y, Labbate M, Koenig JE, Stokes HW. Integrons: mobilizable platforms that promote genetic diversity in bacteria. Trends Microbiol. 2007;15:301\u20139. https:\/\/doi.org\/10.1016\/j.tim.2007.05.004.","journal-title":"Trends Microbiol"},{"key":"5439_CR33","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1186\/s12941-015-0100-6","volume":"14","author":"Y Deng","year":"2015","unstructured":"Deng Y, Bao X, Ji L, Chen L, Liu J, Miao J, et al. Resistance integrons: class 1, 2 and 3 integrons. Ann Clin Microbiol Antimicrob. 2015;14:45. https:\/\/doi.org\/10.1186\/s12941-015-0100-6.","journal-title":"Ann Clin Microbiol Antimicrob"},{"key":"5439_CR34","doi-asserted-by":"publisher","DOI":"10.1017\/CBO9780511543470","volume-title":"District Laboratory Practice in Tropical Countries","author":"M Cheesbrough","year":"2006","unstructured":"Cheesbrough M. District Laboratory Practice in Tropical Countries. 2nd ed. Leiden: Cambridge University Press; 2006.","edition":"2"},{"key":"5439_CR35","doi-asserted-by":"publisher","DOI":"10.1007\/978-0-387-68572-4","volume-title":"Bergey\u2019s Manual of Systematic Bacteriology, Volume4: The Bacteroidetes, Spirochaetes, Tenericutes (Mollicutes), Acidobacteria, Fibrobacteres, Fusobacteria, Dictyoglomi, Gemmatimonadetes, Lentisphaerae, Verrucomicrobia, Chlamydiae, and Planctomycetes","year":"2011","unstructured":"Krieg NR, Staley JT, Brown DR, Hedlund BP, Paster BJ, Ward NL, et al. editors. Bergey\u2019s Manual of Systematic Bacteriology, vol. 4: The Bacteroidetes, Spirochaetes, Tenericutes (Mollicutes), Acidobacteria, Fibrobacteres, Fusobacteria, Dictyoglomi, Gemmatimonadetes, Lentisphaerae, Verrucomicrobia, Chlamydiae, and Planctomycetes, vol. 4. 2nd ed. New York: Springer New York; 2011. https:\/\/doi.org\/10.1007\/978-0-387-68572-4.","edition":"2"},{"key":"5439_CR36","volume-title":"Performance Standards for Antimicrobial Susceptibility Testing: Thirty-First Edition M100-S31","author":"CLSI","year":"2021","unstructured":"CLSI. Performance standards for antimicrobial susceptibility testing: thirty-first edition M100-S31. Wayne, PA, USA: Clinical Laboratory and Standards Institute; 2021."},{"key":"5439_CR37","doi-asserted-by":"publisher","first-page":"268","DOI":"10.1111\/j.1469-0691.2011.03570.x","volume":"18","author":"A-P Magiorakos","year":"2012","unstructured":"Magiorakos A-P, Srinivasan A, Carey RB, Carmeli Y, Falagas ME, Giske CG, et al. Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance. Clin Microbiol Infect. 2012;18:268\u201381. https:\/\/doi.org\/10.1111\/j.1469-0691.2011.03570.x.","journal-title":"Clin Microbiol Infect"},{"key":"5439_CR38","doi-asserted-by":"publisher","first-page":"1428","DOI":"10.1128\/jcm.36.5.1428-1429.1998","volume":"36","author":"J Hartas","year":"1998","unstructured":"Hartas J, Hibble M, Sriprakash KS. Simplification of a Locus-Specific DNA Typing Method (Vir Typing) for Streptococcus pyogenes. J Clin Microbiol. 1998;36:1428\u20139. https:\/\/doi.org\/10.1128\/jcm.36.5.1428-1429.1998.","journal-title":"J Clin Microbiol"},{"key":"5439_CR39","doi-asserted-by":"publisher","first-page":"99","DOI":"10.3390\/microorganisms6040099","volume":"6","author":"R Colello","year":"2018","unstructured":"Colello R, Kr\u00fcger A, Conza JD, Rossen JWA, Friedrich AW, Gutkind G, et al. Antimicrobial resistance in class 1 integron-positive shiga toxin-producing escherichia coli isolated from cattle, pigs, food and farm environment. Microorganisms. 2018;6:99. https:\/\/doi.org\/10.3390\/microorganisms6040099.","journal-title":"Microorganisms"},{"key":"5439_CR40","doi-asserted-by":"publisher","first-page":"718","DOI":"10.1128\/JCM.01773-10","volume":"49","author":"P Nordmann","year":"2011","unstructured":"Nordmann P, Poirel L, Carr\u00ebr A, Toleman MA, Walsh TR. How To Detect NDM-1 Producers. J Clin Microbiol. 2011;49:718\u201321. https:\/\/doi.org\/10.1128\/JCM.01773-10.","journal-title":"J Clin Microbiol"},{"key":"5439_CR41","doi-asserted-by":"publisher","first-page":"2571293","DOI":"10.1155\/2020\/2571293","volume":"2020","author":"NE Mahmoud","year":"2020","unstructured":"Mahmoud NE, Altayb HN, Gurashi RM. Detection of carbapenem-resistant genes in escherichia coli isolated from drinking water in Khartoum, Sudan. J Environ Public Health. 2020;2020:2571293. https:\/\/doi.org\/10.1155\/2020\/2571293.","journal-title":"J Environ Public Health"},{"key":"5439_CR42","unstructured":"WHO. WHO publishes list of bacteria for which new antibiotics are urgently needed. 2017. https:\/\/www.who.int\/news\/item\/27-02-2017-who-publishes-list-of-bacteria-for-which-new-antibiotics-are-urgently-needed. Accessed 25 Dec 2024."},{"key":"5439_CR43","doi-asserted-by":"publisher","first-page":"460","DOI":"10.1080\/21505594.2016.1222343","volume":"8","author":"D van Duin","year":"2016","unstructured":"van Duin D, Doi Y. The global epidemiology of carbapenemase-producing Enterobacteriaceae. Virulence. 2016;8:460\u20139. https:\/\/doi.org\/10.1080\/21505594.2016.1222343.","journal-title":"Virulence"},{"key":"5439_CR44","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1155\/2014\/303104","volume":"2014","author":"MF Mushi","year":"2014","unstructured":"Mushi MF, Mshana SE, Imirzalioglu C, Bwanga F. Carbapenemase Genes among Multidrug Resistant Gram Negative Clinical Isolates from a Tertiary Hospital in Mwanza, Tanzania. BioMed Res Int. 2014;2014:1\u20136. https:\/\/doi.org\/10.1155\/2014\/303104.","journal-title":"BioMed Res Int"},{"key":"5439_CR45","doi-asserted-by":"publisher","unstructured":"Tiseo G, Stefani S, Fasano FR, Falcone M. The burden of infections caused by Metallo-Beta-Lactamase-Producing Enterobacterales in Italy: epidemiology, outcomes, and management. Infez Med n d;33:249\u201360. https:\/\/doi.org\/10.53854\/liim-3303-1","DOI":"10.53854\/liim-3303-1"},{"key":"5439_CR46","doi-asserted-by":"publisher","first-page":"1119","DOI":"10.1186\/s12879-025-11530-0","volume":"25","author":"B Neupane","year":"2025","unstructured":"Neupane B, Devkota MD, Pokhrel BM, Rimal S, Banjara MR. Phenotypic characteristics and carbapenemase genes in Klebsiella pneumoniae from patients at Upendra Devkota Memorial National Institute of Neurological and Allied Sciences, Kathmandu, Nepal. BMC Infect Dis. 2025;25:1119. https:\/\/doi.org\/10.1186\/s12879-025-11530-0.","journal-title":"BMC Infect Dis"},{"key":"5439_CR47","doi-asserted-by":"publisher","first-page":"199","DOI":"10.1159\/000518256","volume":"66","author":"S Thapa","year":"2021","unstructured":"Thapa S, Adhikari N, Shah AK, Lamichhane I, Dhungel B, Shrestha UT, et al. Detection of NDM-1 and VIM Genes in Carbapenem-Resistant Klebsiella pneumoniae Isolates from a Tertiary Health-Care Center in Kathmandu. Nepal Chemother. 2021;66:199\u2013209. https:\/\/doi.org\/10.1159\/000518256.","journal-title":"Nepal Chemother"},{"key":"5439_CR48","doi-asserted-by":"publisher","first-page":"94","DOI":"10.1016\/j.tcmj.2016.04.005","volume":"28","author":"N Begum","year":"2016","unstructured":"Begum N, Shamsuzzaman SM. Emergence of carbapenemase-producing urinary isolates at a tertiary care hospital in Dhaka, Bangladesh. Tzu-Chi Med J. 2016;28:94\u20138. https:\/\/doi.org\/10.1016\/j.tcmj.2016.04.005.","journal-title":"Tzu-Chi Med J"},{"key":"5439_CR49","doi-asserted-by":"publisher","first-page":"559","DOI":"10.1038\/s41429-022-00553-3","volume":"75","author":"Y Kikuchi","year":"2022","unstructured":"Kikuchi Y, Matsui H, Asami Y, Kuwae A, Inahashi Y, Hanaki H, et al. Landscape of blaNDM genes in Enterobacteriaceae. J Antibiot (Tokyo). 2022;75:559\u201366. https:\/\/doi.org\/10.1038\/s41429-022-00553-3.","journal-title":"J Antibiot (Tokyo)"},{"key":"5439_CR50","doi-asserted-by":"publisher","first-page":"e0152638","DOI":"10.1371\/journal.pone.0152638","volume":"11","author":"WY Jamal","year":"2016","unstructured":"Jamal WY, Albert MJ, Rotimi VO. High Prevalence of New Delhi Metallo-\u03b2-Lactamase-1 (NDM-1) Producers among Carbapenem-Resistant Enterobacteriaceae in Kuwait. PLoS ONE. 2016;11:e0152638. https:\/\/doi.org\/10.1371\/journal.pone.0152638.","journal-title":"PLoS ONE"},{"key":"5439_CR51","doi-asserted-by":"publisher","first-page":"101204","DOI":"10.1016\/j.drup.2025.101204","volume":"79","author":"D Rolbiecki","year":"2025","unstructured":"Rolbiecki D, Kiedrzy\u0144ska E, Czatzkowska M, Kiedrzy\u0144ski M, Korzeniewska E, Harnisz M. Global dissemination of Klebsiella pneumoniae in surface waters: Genomic insights into drug resistance, virulence, and clinical relevance. Drug Resist Updat. 2025;79:101204. https:\/\/doi.org\/10.1016\/j.drup.2025.101204.","journal-title":"Drug Resist Updat"},{"key":"5439_CR52","doi-asserted-by":"publisher","first-page":"597","DOI":"10.1016\/S1473-3099(10)70143-2","volume":"10","author":"KK Kumarasamy","year":"2010","unstructured":"Kumarasamy KK, Toleman MA, Walsh TR, Bagaria J, Butt F, Balakrishnan R, et al. Emergence of a new antibiotic resistance mechanism in India, Pakistan, and the UK: a molecular, biological, and epidemiological study. Lancet Infect Dis. 2010;10:597\u2013602. https:\/\/doi.org\/10.1016\/S1473-3099(10)70143-2.","journal-title":"Lancet Infect Dis"},{"key":"5439_CR53","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 bla VIM and bla IMP genes among gram-negative clinical isolates in tertiary care hospital, Kathmandu, Nepal. Iran J Microbiol. 2021;13:303\u201311. https:\/\/doi.org\/10.18502\/ijm.v13i3.6392.","journal-title":"Iran J Microbiol"},{"key":"5439_CR54","doi-asserted-by":"publisher","first-page":"189","DOI":"10.1080\/14787210.2024.2311213","volume":"22","author":"J Zakhour","year":"2024","unstructured":"Zakhour J, El Ayoubi LW, Kanj SS. Metallo-beta-lactamases: mechanisms, treatment challenges, and future prospects. Expert Rev Anti Infect Ther. 2024;22:189\u2013201. https:\/\/doi.org\/10.1080\/14787210.2024.2311213.","journal-title":"Expert Rev Anti Infect Ther"},{"key":"5439_CR55","doi-asserted-by":"publisher","unstructured":"Lee SS-J, Hsia H-L, Lee Y, Lin H-H. P-1368. High prevalence of class 1 integrons in carbapenem resistant Enterobacterales in Taiwan. Open Forum Infect Dis. 2025;12. https:\/\/doi.org\/10.1093\/ofid\/ofae631.1545. :ofae631.1545.","DOI":"10.1093\/ofid\/ofae631.1545"},{"key":"5439_CR56","doi-asserted-by":"publisher","first-page":"106051","DOI":"10.1016\/j.micpath.2023.106051","volume":"177","author":"T Wang","year":"2023","unstructured":"Wang T, Zhu Y, Zhu W, Cao M, Wei Q. Molecular characterization of class 1 integrons in carbapenem-resistant Enterobacterales isolates. Microb Pathog. 2023;177:106051. https:\/\/doi.org\/10.1016\/j.micpath.2023.106051.","journal-title":"Microb Pathog"},{"key":"5439_CR57","doi-asserted-by":"publisher","first-page":"141","DOI":"10.1146\/annurev-genet-102209-163504","volume":"44","author":"A-M Guillaume Cambray","year":"2010","unstructured":"Guillaume Cambray A-M, Guerout, Mazel D, Integrons. Annu Rev Genet. 2010;44:141\u201366. https:\/\/doi.org\/10.1146\/annurev-genet-102209-163504.","journal-title":"Annu Rev Genet"},{"key":"5439_CR58","doi-asserted-by":"publisher","first-page":"873","DOI":"10.2217\/fmb.15.18","volume":"10","author":"W-H Zhao","year":"2015","unstructured":"Zhao W-H, Hu Z-Q. Acquired Metallo-\u03b2-Lactamases and Their Genetic Association with Class 1 Integrons and ISCR Elements in Gram-negative Bacteria. Future Microbiol. 2015;10:873\u201387. https:\/\/doi.org\/10.2217\/fmb.15.18.","journal-title":"Future Microbiol"},{"key":"5439_CR59","doi-asserted-by":"publisher","first-page":"276","DOI":"10.1097\/PAT.0000000000000237","volume":"47","author":"SR Partridge","year":"2015","unstructured":"Partridge SR. Resistance mechanisms in Enterobacteriaceae. Pathol (Phila). 2015;47:276\u201384. https:\/\/doi.org\/10.1097\/PAT.0000000000000237.","journal-title":"Pathol (Phila)"}],"container-title":["BMC Microbiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12866-026-05439-0","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12866-026-05439-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12866-026-05439-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T23:38:04Z","timestamp":1792625884000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12866-026-05439-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,21]]},"references-count":59,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["5439"],"URL":"https:\/\/doi.org\/10.1186\/s12866-026-05439-0","relation":{},"ISSN":["1471-2180"],"issn-type":[{"value":"1471-2180","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,21]]},"assertion":[{"value":"19 April 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 July 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"21 July 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Ethical approval for this study was granted by the Institutional Review Committee of the Public Health Concern Trust, Nepal (phect-NEPAL), Kathmandu Model Hospital, Kathmandu (Approval ID: 038-2022). All the experiments in this study were conducted in accordance with the Declaration of Helsinki. The research team maintained no direct contact with or follow-up on the patients, and minimal risk was posed to the patients. For this reason, the Ethics Committee of phect-NEPAL, Kathmandu Model Hospital, Kathmandu, waived informed consent in compliance with national regulations and the Declaration of Helsinki.","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":"908"}}