{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T10:35:28Z","timestamp":1788863728178,"version":"build-2803163510"},"reference-count":33,"publisher":"Public Library of Science (PLoS)","issue":"4","license":[{"start":{"date-parts":[[2022,4,27]],"date-time":"2022-04-27T00:00:00Z","timestamp":1651017600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100016237","name":"Armauer Hansen Research Institute","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100016237","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Infections caused by <jats:italic>Klebsiella pneumoniae<\/jats:italic> have been difficult to control because of the worldwide emergence of carbapenem-resistant isolates mainly due to carbapenemase production. Information regarding carbapenemase-producing <jats:italic>K<\/jats:italic>. <jats:italic>pneumoniae<\/jats:italic> is still scarce in Ethiopia. Therefore, the current study aimed to determine the prevalence of carbapenemase-producing <jats:italic>K<\/jats:italic>. <jats:italic>pneumoniae<\/jats:italic> and to assess the occurrence of <jats:italic>bla<\/jats:italic><jats:sub>NDM<\/jats:sub> and <jats:italic>bla<\/jats:italic><jats:sub>KPC<\/jats:sub> carbapenemase genes<jats:sub>.<\/jats:sub><\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>A cross-sectional study was conducted from September 2018 to February 2019 at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia. A total of 132 non-duplicate <jats:italic>K<\/jats:italic>. <jats:italic>pneumoniae<\/jats:italic> isolates were studied. Phenotypic confirmation of carbapenemase production was done by modified Carbapenem Inactivation Method (mCIM). Multiplex PCR was performed for the detection of carbapenemase-encoding genes <jats:italic>bla<\/jats:italic><jats:sub>KPC<\/jats:sub>, and <jats:italic>bla<\/jats:italic><jats:sub>NDM<\/jats:sub>.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>Out of the total 132 <jats:italic>K<\/jats:italic>. <jats:italic>pneumoniae<\/jats:italic> isolates, 39 (29.6%) were non-susceptible to one or more carbapenems. The prevalence of carbapenemase-producing isolates from the total was 28 (21.2%) with mCIM of which the most dominant gene was <jats:italic>bla<\/jats:italic><jats:sub>NDM<\/jats:sub> 26 (92.9%) and one isolate carried <jats:italic>bla<\/jats:italic><jats:sub>KPC<\/jats:sub> concomitantly. Carbapenemase-producing <jats:italic>K<\/jats:italic>. <jats:italic>pneumoniae<\/jats:italic> isolates were 100% non-susceptible to half of the antimicrobials used in the study, including meropenem and ertapenem. Previous use of carbapenems was associated with carbapenemase production (P = 0.004).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>The prevalence of carbapenemase-producing <jats:italic>K<\/jats:italic>. <jats:italic>pneumoniae<\/jats:italic> isolates was worrying in the study area. To our knowledge, the study described the emergence of <jats:italic>bla<\/jats:italic><jats:sub>NDM<\/jats:sub> and <jats:italic>bla<\/jats:italic><jats:sub>KPC<\/jats:sub> gene carrying <jats:italic>K<\/jats:italic>. <jats:italic>pneumoniae<\/jats:italic> in Ethiopia for the first time. Further large-scale molecular-based studies, including other carbapenemase genes and sequencing of <jats:italic>K<\/jats:italic>. <jats:italic>pneumoniae<\/jats:italic>, are warranted to have a clear awareness about the presence of antimicrobial resistance high-risk clones in Ethiopia.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0267657","type":"journal-article","created":{"date-parts":[[2022,4,27]],"date-time":"2022-04-27T17:36:11Z","timestamp":1651080971000},"page":"e0267657","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":23,"title":["Detection of blaKPC and blaNDM carbapenemase genes among Klebsiella pneumoniae isolates in Addis Ababa, Ethiopia: Dominance of blaNDM"],"prefix":"10.1371","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2493-8461","authenticated-orcid":true,"given":"Tewachew","family":"Awoke","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brhanu","family":"Teka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abraham","family":"Aseffa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shemse","family":"Sebre","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aminu","family":"Seman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Biruk","family":"Yeshitela","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tamrat","family":"Abebe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adane","family":"Mihret","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2022,4,27]]},"reference":[{"issue":"1","key":"pone.0267657.ref001","first-page":"15","article-title":"Carbapenem resistance: overview of the problem and future perspectives","volume":"3","author":"G. Meletis","year":"2016","journal-title":"Ther Adv Infect Dis"},{"key":"pone.0267657.ref002","volume-title":"CLSI supplement M100-S28","author":"CLSI","year":"2018","edition":"28"},{"key":"pone.0267657.ref003","doi-asserted-by":"crossref","first-page":"244","DOI":"10.1016\/j.micpath.2016.10.002","article-title":"Distribution of virulence genes and genotyping of CTX-M-15-producing Klebsiella pneumoniae isolated from patients with community-acquired urinary tract infection (CA-UTI)","volume":"100","author":"R Ranjbar","year":"2016","journal-title":"Microb Pathog"},{"issue":"6","key":"pone.0267657.ref004","first-page":"401","article-title":"Extended-spectrum \u03b2-lactamases: implications for the clinical laboratory and therapy","volume":"28","author":"S Harada","year":"2008","journal-title":"Korean J Lab Med"},{"issue":"suppl_1","key":"pone.0267657.ref005","doi-asserted-by":"crossref","first-page":"S28","DOI":"10.1093\/infdis\/jiw282","article-title":"The Epidemiology of Carbapenem-Resistant Enterobacteriaceae: The Impact and Evolution of a Global Menace","volume":"215","author":"LK Logan","year":"2017","journal-title":"J Infect Dis"},{"issue":"10","key":"pone.0267657.ref006","doi-asserted-by":"crossref","first-page":"5873","DOI":"10.1128\/AAC.01019-15","article-title":"Carbapenemase-producing Klebsiella pneumoniae, a key pathogen set for global nosocomial dominance","volume":"59","author":"JD Pitout","year":"2015","journal-title":"Antimicrob Agents Chemother"},{"key":"pone.0267657.ref007","doi-asserted-by":"crossref","DOI":"10.5772\/intechopen.90100","article-title":"Carbapenem resistance: Mechanisms and drivers of global menace","author":"B Aslam","year":"2020","journal-title":"Pathog Bact"},{"key":"pone.0267657.ref008","doi-asserted-by":"crossref","first-page":"S8","DOI":"10.1016\/S0924-8579(10)70004-2","article-title":"Emerging carbapenemases: a global perspective","volume":"36","author":"TR Walsh","year":"2010","journal-title":"Int J Antimicrob Agents"},{"issue":"10","key":"pone.0267657.ref009","doi-asserted-by":"crossref","first-page":"1791","DOI":"10.3201\/eid1710.110655","article-title":"Global spread of carbapenemase-producing Enterobacteriaceae","volume":"17","author":"P Nordmann","year":"2011","journal-title":"Emerg Infect Dis"},{"issue":"4","key":"pone.0267657.ref010","doi-asserted-by":"crossref","first-page":"499","DOI":"10.1016\/j.jiph.2015.12.012","article-title":"Molecular detection and antimicrobial resistance of Klebsiella pneumoniae from house flies (Musca domestica) in kitchens, farms, hospitals and slaughterhouses","volume":"9","author":"R Ranjbar","year":"2016","journal-title":"J Infect Public Health"},{"issue":"1","key":"pone.0267657.ref011","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12879-017-2289-9","article-title":"First report on bla NDM-1-producing Acinetobacter baumannii in three clinical isolates from Ethiopia","volume":"17","author":"M Pritsch","year":"2017","journal-title":"BMC Infect Dis"},{"key":"pone.0267657.ref012","doi-asserted-by":"crossref","DOI":"10.1017\/CBO9780511543470","volume-title":"District laboratory practice in tropical countries: Part 2","author":"M. Cheesbrough","year":"2006","edition":"2"},{"key":"pone.0267657.ref013","doi-asserted-by":"crossref","first-page":"603","DOI":"10.2147\/IDR.S199639","article-title":"Molecular characterization, serotypes and phenotypic and genotypic evaluation of antibiotic resistance of the Klebsiella pneumoniae strains isolated from different types of hospital-acquired infections","volume":"12","author":"R Ranjbar","year":"2019","journal-title":"Infect Drug Resis"},{"key":"pone.0267657.ref014","first-page":"8050432","article-title":"Molecular identification of aminoglycoside-modifying enzymes and plasmid-mediated quinolone resistance genes among Klebsiella pneumoniae clinical isolates recovered from Egyptian patients","volume":"2017","author":"MF El-Badawy","year":"2017","journal-title":"Int J Microbiol"},{"key":"pone.0267657.ref015","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1016\/j.diagmicrobio.2010.12.002","article-title":"Multiplex PCR for detection of acquired carbapenemase genes","volume":"70","author":"L Poirel","year":"2011","journal-title":"Diagn Microbiol Infect Dis"},{"issue":"1","key":"pone.0267657.ref016","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s13756-015-0054-7","article-title":"Multidrug resistant and carbapenemase producing Enterobacteriaceae among patients with urinary tract infection at referral Hospital, Northwest Ethiopia","volume":"4","author":"S Eshetie","year":"2015","journal-title":"Antimicrob Resist Infect Control"},{"key":"pone.0267657.ref017","doi-asserted-by":"crossref","first-page":"27","DOI":"10.2147\/IDR.S127177","article-title":"Extended-spectrum beta-lactamase-and carbapenemase-producing Enterobacteriaceae among Ethiopian children","volume":"10","author":"MH Legese","year":"2017","journal-title":"Infect Drug Resis"},{"issue":"4","key":"pone.0267657.ref018","doi-asserted-by":"crossref","first-page":"e0215177","DOI":"10.1371\/journal.pone.0215177","article-title":"High prevalence of extended-spectrum beta-lactamase-producing Gram-negative pathogens from patients attending Felege Hiwot Comprehensive Specialized Hospital, Bahir Dar, Amhara region","volume":"14","author":"F Moges","year":"2019","journal-title":"PLoS One"},{"issue":"3","key":"pone.0267657.ref019","article-title":"Resistance Patterns and Phenotypic Detection of \u03b2-lactamase Enzymes among Enterobacteriaceae Isolates from Referral Hospitals in Khartoum State, Sudan","volume":"12","author":"M Dirar","year":"2020","journal-title":"Cureus"},{"issue":"6","key":"pone.0267657.ref020","doi-asserted-by":"crossref","first-page":"547","DOI":"10.1159\/000500311","article-title":"Phenotypic and Genotypic Characterization of ESBL-, AmpC-, and Carbapenemase-Producing Klebsiella pneumoniae and Escherichia coli Isolates","volume":"28","author":"H Kazemian","year":"2019","journal-title":"Med Princ Pract"},{"issue":"07","key":"pone.0267657.ref021","doi-asserted-by":"crossref","first-page":"718","DOI":"10.3855\/jidc.7426","article-title":"Carbapenemases and extended-spectrum \u03b2-lactamases producing Enterobacteriaceae isolated from Tunisian and Libyan hospitals","volume":"10","author":"N Mathlouthi","year":"2016","journal-title":"J Infect Dev Ctries"},{"issue":"1","key":"pone.0267657.ref022","doi-asserted-by":"crossref","first-page":"e0227736","DOI":"10.1371\/journal.pone.0227736","article-title":"Evaluation of current practice of antimicrobial use and clinical outcome of patients with pneumonia at a tertiary care hospital in Ethiopia: A prospective observational study","volume":"15","author":"T Fenta","year":"2020","journal-title":"PLoS One"},{"key":"pone.0267657.ref023","doi-asserted-by":"crossref","first-page":"109","DOI":"10.3389\/fpubh.2020.00109","article-title":"Half of Prescribed Antibiotics Are Not Needed: A Pharmacist-Led Antimicrobial Stewardship Intervention and Clinical Outcomes in a Referral Hospital in Ethiopia","volume":"8","author":"GB Gebretekle","year":"2020","journal-title":"Front public health"},{"issue":"8","key":"pone.0267657.ref024","doi-asserted-by":"crossref","first-page":"e0161685","DOI":"10.1371\/journal.pone.0161685","article-title":"High gastrointestinal colonization rate with extended-Spectrum \u03b2-lactamase-producing Enterobacteriaceae in hospitalized patients: emergence of Carbapenemase-Producing K. pneumoniae in Ethiopia","volume":"11","author":"K Desta","year":"2016","journal-title":"PLoS One"},{"key":"pone.0267657.ref025","doi-asserted-by":"crossref","first-page":"921","DOI":"10.2147\/IDR.S227955","article-title":"Dissemination Pattern of Multidrug Resistant Carbapenemase Producing Klebsiella pneumoniae Isolates Using Pulsed-Field Gel Electrophoresis in Southwestern Iran","volume":"13","author":"Z Hashemizadeh","year":"2020","journal-title":"Infect Drug Resist"},{"key":"pone.0267657.ref026","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1111\/j.1469-0691.2011.03570.x","article-title":"Multidrug\u2010resistant, extensively drug\u2010resistant and pandrug\u2010resistant bacteria: An international expert proposal for interim standard definitions for acquired resistance","volume":"18","author":"AP Magiorakos","year":"2012","journal-title":"Clin Microbiol Infect"},{"issue":"1","key":"pone.0267657.ref027","doi-asserted-by":"crossref","first-page":"8468","DOI":"10.1038\/s41598-018-26691-z","article-title":"Carbapenem nonsusceptible Klebsiella pneumoniae in Taiwan: dissemination and increasing resistance of carbapenemase producers during 2012\u20132015","volume":"8","author":"SK Chiu","year":"2018","journal-title":"Sci Rep"},{"key":"pone.0267657.ref028","first-page":"1","article-title":"Prevalence of OmpK35 and OmpK36 porin expression in beta-lactamase and non-betalactamase-producing Klebsiella pneumoniae","volume":"6","author":"P Shakib","year":"2012","journal-title":"Biologics"},{"issue":"10","key":"pone.0267657.ref029","doi-asserted-by":"crossref","first-page":"1351","DOI":"10.1517\/14656566.2014.914172","article-title":"Multidrug-resistant and extensively drug-resistant Gram-negative pathogens: current and emerging therapeutic approaches","volume":"15","author":"I Karaiskos","year":"2014","journal-title":"Expert Opin Pharmacother"},{"issue":"1","key":"pone.0267657.ref030","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12866-021-02133-1","article-title":"Detection and characterization of carbapenem resistant Gram\u2010negative bacilli isolates recovered from hospitalized patients at Soba University Hospital, Sudan","volume":"21","author":"HS Elbadawi","year":"2021","journal-title":"BMC Microbiol"},{"issue":"5792","key":"pone.0267657.ref031","first-page":"1","article-title":"Co-occurrence of Plasmid-mediated Quinolone Resistance and Carbapenemases in Klebsiella pneumoniae Isolates in Assiut, Egypt","volume":"38","author":"HA Hammad","year":"2017","journal-title":"Egypt J Med Microbiol"},{"issue":"2","key":"pone.0267657.ref032","doi-asserted-by":"crossref","first-page":"934","DOI":"10.1128\/AAC.01247-10","article-title":"Detection of NDM-1-producing Klebsiella pneumoniae in Kenya","volume":"55","author":"L Poirel","year":"2011","journal-title":"Antimicrob Agents Chemother"},{"issue":"2","key":"pone.0267657.ref033","article-title":"NDM metallo-\u03b2-lactamases and their bacterial producers in health care settings","volume":"32","author":"W Wu","year":"2019","journal-title":"Clin Microbiol Rev"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0267657","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,4,27]],"date-time":"2022-04-27T17:37:02Z","timestamp":1651081022000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0267657"}},"subtitle":[],"editor":[{"given":"Patrick","family":"Butaye","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2022,4,27]]},"references-count":33,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2022,4,27]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0267657","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,4,27]]}}}