{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T18:15:01Z","timestamp":1788459301640,"version":"build-2803163510"},"reference-count":35,"publisher":"Public Library of Science (PLoS)","issue":"7","license":[{"start":{"date-parts":[[2023,7,13]],"date-time":"2023-07-13T00:00:00Z","timestamp":1689206400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Institute for Health Research, Medical Research Council and the Department of Health and Social Care, UK","award":["MR\/S004785\/1"],"award-info":[{"award-number":["MR\/S004785\/1"]}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"\n Background<\/jats:title>\n \n The accumulation of resistance genes in\n Escherichia coli<\/jats:italic>\n (\n E<\/jats:italic>\n .\n coli)<\/jats:italic>\n strains imposes limitations in the therapeutic options available for the treatment of infections caused by\n E<\/jats:italic>\n .\n coli<\/jats:italic>\n . Production of\n Klebsiella pneumoniae<\/jats:italic>\n carbapenemase (KPC) by\n E<\/jats:italic>\n .\n coli<\/jats:italic>\n renders it resistant to broad-spectrum \u03b2-lactam antibiotics. Globally there is existing evidence of spread of carbapenem-resistant\n E<\/jats:italic>\n .\n coli<\/jats:italic>\n in both humans and livestock driven by acquisition of the several other carbapenemase genes. Overall, there is little information regarding the extent of KPC gene distribution in\n E<\/jats:italic>\n .\n coli<\/jats:italic>\n . We set out to determine the prevalence, and evaluate the phenotypic and genotypic patterns of KPC in\n E<\/jats:italic>\n .\n coli<\/jats:italic>\n isolated from humans and their livestock in rural south western Uganda.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n A laboratory-based, descriptive cross-sectional study was conducted involving 96 human and 96 livestock isolates collected from agro-pastoralist communities in Mbarara district in south western Uganda. Phenotypic and molecular methods (PCR) were used for presence and identification of KPC genes in the\n E<\/jats:italic>\n .\n coli<\/jats:italic>\n isolates. A chi-square test of independence was used to evaluate the differences in resistant patterns between carbapenems and isolates.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n The overall prevalence of carbapenem resistance by disk diffusion susceptibility testing (DST) for both humans and livestock isolates were 41.7% (80\/192). DST-based resistance was identical in both human and livestock isolates (41.7%). The prevalence of carbapenem resistance based on Modified Hodge Test (MHT) was 5% (2\/40) and 10% (4\/40) for humans and livestock isolates respectively. Both human and livestock isolates, 48.7% (95\/192) had the KPC gene, higher than phenotypic expression; 41.7% (80\/192).\n bla<\/jats:italic>\n KPC gene prevalence was overall similar in human isolates (51%; 49\/96) vs livestock isolates (47.9%; 46\/96). Approximately, 19% (15\/80) of the isolates were phenotypically resistant to carbapenems and over 70% (79\/112) of the phenotypically sensitive strains harbored the\n bla<\/jats:italic>\n KPC gene.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n \n Our results suggest that both human and livestock isolates of\n E<\/jats:italic>\n .\n coli<\/jats:italic>\n in our setting carry the\n bla<\/jats:italic>\n KPC gene with a high percentage of strains not actively expressing the blaKPC gene. The finding of fewer isolates carrying the KPC gene than those phenotypically resistant to carbapenems suggests that other mechanisms are playing a role in this phenomenon, calling for further researcher into this phenomenon.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1371\/journal.pone.0288243","type":"journal-article","created":{"date-parts":[[2023,7,13]],"date-time":"2023-07-13T13:28:14Z","timestamp":1689254894000},"page":"e0288243","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":19,"title":["Klebsiella pneumoniae carbapenamases in Escherichia coli isolated from humans and livestock in rural south-western Uganda"],"prefix":"10.1371","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1243-4901","authenticated-orcid":true,"given":"Barbra","family":"Tuhamize","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benon B.","family":"Asiimwe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2097-4622","authenticated-orcid":true,"given":"Kennedy","family":"Kasaza","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wilber","family":"Sabiiti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mathew","family":"Holden","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7600-7514","authenticated-orcid":true,"given":"Joel","family":"Bazira","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2023,7,13]]},"reference":[{"issue":"3","key":"pone.0288243.ref001","doi-asserted-by":"crossref","first-page":"166","DOI":"10.3947\/ic.2016.48.3.166","article-title":"Carbapenem-resistant Enterobacteriaceae: prevalence and risk factors in a single community-based hospital in Korea","volume":"48","author":"H-J Lee","year":"2016","journal-title":"Infection & chemotherapy"},{"issue":"5","key":"pone.0288243.ref002","doi-asserted-by":"crossref","first-page":"S20","DOI":"10.1016\/j.ajic.2006.05.238","article-title":"Resistance in gram-negative bacteria: Enterobacteriaceae","volume":"34","author":"DL Paterson","year":"2006","journal-title":"American journal of infection control"},{"issue":"5","key":"pone.0288243.ref003","doi-asserted-by":"crossref","first-page":"447","DOI":"10.1080\/87559129.2017.1326934","article-title":"Emerging issue of antibiotic resistance from food producing animals in India: Perspective and legal framework","volume":"34","author":"P Moudgil","year":"2018","journal-title":"Food reviews international"},{"issue":"12","key":"pone.0288243.ref004","doi-asserted-by":"crossref","first-page":"1241","DOI":"10.1016\/j.cmi.2018.04.004","article-title":"Carbapenem-resistant Enterobacteriaceae in wildlife, food-producing, and companion animals: a systematic review","volume":"24","author":"R K\u00f6ck","year":"2018","journal-title":"Clinical Microbiology and Infection"},{"issue":"4","key":"pone.0288243.ref005","doi-asserted-by":"crossref","first-page":"477","DOI":"10.1099\/jmm.0.000452","article-title":"Occurrence of qnrB1 and qnrB12 genes, mutation in gyrA and ramR, and expression of efflux pumps in isolates of Klebsiella pneumoniae carriers of bla KPC-2","volume":"66","author":"AML Scavuzzi","year":"2017","journal-title":"Journal of Medical Microbiology"},{"key":"pone.0288243.ref006","article-title":"An analysis of the epidemic of kpc-producing Klebsiella pneumoniae: convergence of two evolutionary mechanisms creates the \u201cPerfect Storm","author":"LJ Rojas","year":"2017","journal-title":"The Journal of infectious diseases"},{"issue":"2","key":"pone.0288243.ref007","doi-asserted-by":"crossref","first-page":"e01882","DOI":"10.1128\/AAC.01882-17","article-title":"Epidemiology of carbapenem-resistant Enterobacteriaceae infections: report from the China CRE Network","volume":"62","author":"Y Zhang","year":"2018","journal-title":"Antimicrobial agents and chemotherapy"},{"issue":"2","key":"pone.0288243.ref008","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1111\/j.1469-0691.2009.03114.x","article-title":"The emerging threat of acquired carbapenemases in Gram-negative bacteria","volume":"16","author":"G Cornaglia","year":"2010","journal-title":"Clinical microbiology and infection"},{"issue":"1","key":"pone.0288243.ref009","doi-asserted-by":"crossref","first-page":"1308","DOI":"10.1186\/s40064-016-2986-7","article-title":"Carbapenem resistant Pseudomonas aeruginosa and Acinetobacter baumannii at Mulago Hospital in Kampala, Uganda","volume":"5","author":"DP Kateete","year":"2016","journal-title":"SpringerPlus"},{"key":"pone.0288243.ref010","article-title":"Performance Standards for Antimicrobial Susceptibility Testing. 29 ed. 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