{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,11]],"date-time":"2025-09-11T17:51:25Z","timestamp":1757613085521,"version":"3.44.0"},"reference-count":32,"publisher":"Public Library of Science (PLoS)","issue":"9","license":[{"start":{"date-parts":[[2025,9,4]],"date-time":"2025-09-04T00:00:00Z","timestamp":1756944000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:p>Effective infection control requires identifying and eliminating carbapenemase-producing (CP) Gram-negative bacteria (GNB) in high-risk groups like intensive care unit (ICU) patients and from contaminated environmental surfaces. This study aimed to describe the diversity of carbapenemase-encoding genes among critical GNB isolates from ICU patients with infection and\/or gastrointestinal (GI) colonization, as well as from ICU environmental surfaces in the Amhara National Regional state, Ethiopia.A total of 169 carbapenem-resistant isolates were identified, including 26 from infections, 82 from GI colonization, and 61 from environmental samples. These comprised <jats:italic><jats:italic>Klebsiellapneumoniae<\/jats:italic><\/jats:italic> (n\u2009=\u2009107), <jats:italic><jats:italic>Escherichia coli<\/jats:italic><\/jats:italic> (n\u2009=\u200916), <jats:italic><jats:italic>Pseudomonas aeruginosa<\/jats:italic><\/jats:italic> (n\u2009=\u20099), and <jats:italic><jats:italic>Acinetobacter<\/jats:italic><\/jats:italic> species (n\u2009=\u200937), of which 147 were analyzed.Singleplex and multiplex PCR were performed to detect predominant carbapenemase-encoding genes, including KPC (<jats:italic><jats:italic>bla<\/jats:italic><\/jats:italic><jats:sub>KPC<\/jats:sub>), MBLs (<jats:italic><jats:italic>bla<\/jats:italic><\/jats:italic><jats:sub>IMP<\/jats:sub>, <jats:italic><jats:italic>bla<\/jats:italic><\/jats:italic><jats:sub>VIM<\/jats:sub>, and <jats:italic><jats:italic>bla<\/jats:italic><\/jats:italic><jats:sub>NDM<\/jats:sub>), and OXA (<jats:italic><jats:italic>bla<\/jats:italic><\/jats:italic><jats:sub>OXA-48<\/jats:sub>, <jats:italic><jats:italic>bla<\/jats:italic><\/jats:italic><jats:sub>OXA-23<\/jats:sub>, and <jats:italic><jats:italic>bla<\/jats:italic><\/jats:italic><jats:sub>OXA-58<\/jats:sub>). PCR analysis revealed that at least one carbapenemase-encoding gene was detected in 133 (78.7%) of the 169 carbapenem-resistant isolates from patients and environmental surfaces. They were detected in 22\/133(16.5%), 70\/133(52.6%), and 41\/133(30.8%) isolates obtained from infection, GI colonization, and environmental samples, respectively. The most prevalent carbapenemase-encoding gene, <jats:italic><jats:italic>bla<\/jats:italic><\/jats:italic><jats:sub>NDM<\/jats:sub>, was found in 101 (75.9%) of the 133 CP isolates. Other detected carbapenemase-encoding genes included <jats:italic><jats:italic>bla<\/jats:italic><\/jats:italic><jats:sub>OXA-23<\/jats:sub> in 5 (3.8%) isolates, <jats:italic><jats:italic>bla<\/jats:italic><\/jats:italic><jats:sub>VIM<\/jats:sub> in 4 (3.0%), <jats:italic><jats:italic>bla<\/jats:italic><\/jats:italic><jats:sub>OXA-48<\/jats:sub> in 1 (0.8%), and <jats:italic><jats:italic>bla<\/jats:italic><\/jats:italic><jats:sub>OXA-58<\/jats:sub> in 1 (0.8%). <jats:italic><jats:italic>K. pneumoniae<\/jats:italic><\/jats:italic> and <jats:italic><jats:italic>Acinetobacter<\/jats:italic><\/jats:italic> spp. harbored all the gene types detected in this study. Co-harboring of two or more carbapenemase-encoding genes, in combination with <jats:italic><jats:italic>bla<\/jats:italic><\/jats:italic><jats:sub>NDM<\/jats:sub>, was observed in 21 of 133 (15.8%) isolates, including 7 <jats:italic><jats:italic>K. pneumoniae<\/jats:italic><\/jats:italic> and 14 <jats:italic><jats:italic>Acinetobacter<\/jats:italic><\/jats:italic> spp. isolates. However, <jats:italic><jats:italic>bla<\/jats:italic><\/jats:italic><jats:sub>KPC<\/jats:sub> and <jats:italic><jats:italic>bla<\/jats:italic><\/jats:italic><jats:sub>IMP<\/jats:sub> were not identified in any of the tested isolates. This study highlights the presence of carbapenemase-encoding genes among critical GNB across all sample source types in the study area. Moreover, the detection of isolates harboring multiple carbapenemase-encoding genes underscores the need for enhanced infection control measures in ICU settings.<\/jats:p>","DOI":"10.1371\/journal.pone.0330613","type":"journal-article","created":{"date-parts":[[2025,9,4]],"date-time":"2025-09-04T17:48:08Z","timestamp":1757008088000},"page":"e0330613","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Carbapenemase-encoding genes in critical gram-negative bacteria isolated from ICU patients with infections and\/or gastrointestinal carriage, and environmental samples in the amhara National Regional state, 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