{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T11:11:19Z","timestamp":1783941079504,"version":"3.55.0"},"reference-count":41,"publisher":"Public Library of Science (PLoS)","issue":"11","license":[{"start":{"date-parts":[[2025,11,19]],"date-time":"2025-11-19T00:00:00Z","timestamp":1763510400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004484","name":"Tehran University of Medical Sciences and Health Services","doi-asserted-by":"publisher","award":["65902"],"award-info":[{"award-number":["65902"]}],"id":[{"id":"10.13039\/501100004484","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:p>\n                    <jats:italic>Klebsiella pneumoniae<\/jats:italic>\n                    is a pathogen related to nosocomial infections with a high rate of antibiotic resistance. The aim of this study was to understand the impact of the presence of CRISPR-Cas systems and an anti-CRISPR gene on multidrug-resistance in\n                    <jats:italic>K. pneumoniae<\/jats:italic>\n                    isolates. The study analyzed 100 clinical\n                    <jats:italic>K. pneumoniae<\/jats:italic>\n                    isolates obtained from a hospital setting. The investigation involved determining antibiotic resistance profiles, including ESBL production, identifying specific carbapenemase and aminoglycoside resistance genes, detecting the presence of CRISPR-Cas systems, identifying the anti-CRISPR gene\n                    <jats:italic>acrEI10<\/jats:italic>\n                    , and sequencing CRISPR arrays. Correlation analysis between resistance genes and CRISPR-Cas systems was also performed. All isolates in this study were determined to be multidrug-resistant (MDR), with resistance rates exceeding 70% for the majority of antibiotics tested. The most prevalent carbapenemase genes were\n                    <jats:italic>bla<\/jats:italic>\n                    <jats:sub>OXA-48<\/jats:sub>\n                    and\n                    <jats:italic>bla<\/jats:italic>\n                    <jats:sub>NDM<\/jats:sub>\n                    , while aminoglycoside resistance was primarily mediated by\n                    <jats:italic>aac(<\/jats:italic>\n                    6\n                    <jats:italic>\u00b4)-Ia<\/jats:italic>\n                    and\n                    <jats:italic>ant(2\")-Ia<\/jats:italic>\n                    . Only 7% of the isolates harbored CRISPR-Cas systems and the gene\n                    <jats:italic>acrEI10<\/jats:italic>\n                    , which encodes an anti-CRISPR protein, was detected in one of the CRISPR-Cas positive isolates. Sequencing of the CRISPR array from this isolate showed similarities between the spacers and sequences found in plasmids and\n                    <jats:italic>K. pneumoniae<\/jats:italic>\n                    chromosome. No strong correlation was identified between the antibiotic resistance genes and CRISPR-Cas systems. Findings from this study suggest a complex interplay between these factors in MDR isolates of\n                    <jats:italic>K. pneumoniae<\/jats:italic>\n                    and show that further investigations are needed to have a better understanding of the mechanisms related to the coexistence of these elements and their impact on dissemination of antibiotic resistance genes.\n                  <\/jats:p>","DOI":"10.1371\/journal.pone.0335756","type":"journal-article","created":{"date-parts":[[2025,11,19]],"date-time":"2025-11-19T18:25:36Z","timestamp":1763576736000},"page":"e0335756","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":2,"title":["Investigating the impact of type I-E CRISPR-Cas systems and acrEI10 on multidrug-resistance in clinical isolates of Klebsiella pneumoniae"],"prefix":"10.1371","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9884-2702","authenticated-orcid":true,"given":"Maryam","family":"Siroosi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fatemeh","family":"Ghasemi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fereshteh","family":"Jabalameli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad","family":"Emaneini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1987-5929","authenticated-orcid":true,"given":"Mohammadreza","family":"Salehi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reza","family":"Beigverdi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad Ali","family":"Amoozegar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2025,11,19]]},"reference":[{"issue":"2","key":"pone.0335756.ref001","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1093\/femsre\/fuy043","article-title":"Klebsiella pneumoniae infection biology: living to counteract host defences","volume":"43","author":"JA Bengoechea","year":"2019","journal-title":"FEMS Microbiol Rev"},{"issue":"1","key":"pone.0335756.ref002","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12941-019-0343-8","article-title":"Klebsiella pneumoniae: an increasing threat to public health","volume":"19","author":"CY Effah","year":"2020","journal-title":"Ann Clin Microbiol Antimicrob"},{"issue":"12","key":"pone.0335756.ref003","doi-asserted-by":"crossref","first-page":"1508","DOI":"10.3390\/antibiotics10121508","article-title":"Global prevalence of nosocomial multidrug-resistant Klebsiella pneumoniae: a systematic review and meta-analysis","volume":"10","author":"NA Mohd Asri","year":"2021","journal-title":"Antibiotics (Basel)"},{"issue":"11","key":"pone.0335756.ref004","doi-asserted-by":"crossref","first-page":"102544","DOI":"10.1016\/j.jiph.2024.102544","article-title":"The influence of efflux pump, outer membrane permeability and \u03b2-lactamase production on the resistance profile of multi, extensively and pandrug resistant Klebsiella pneumoniae","volume":"17","author":"RA Hussein","year":"2024","journal-title":"J Infect Public Health"},{"key":"pone.0335756.ref005","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1146\/annurev-genet-022120-112523","article-title":"Molecular mechanisms of CRISPR-Cas immunity in bacteria","volume":"54","author":"PM Nussenzweig","year":"2020","journal-title":"Annu Rev Genet"},{"key":"pone.0335756.ref006","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1186\/s13059-015-0816-9","article-title":"Diversity of CRISPR-Cas immune systems and molecular machines","volume":"16","author":"R Barrangou","year":"2015","journal-title":"Genome Biol"},{"issue":"1","key":"pone.0335756.ref007","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1038\/nrmicro.2017.120","article-title":"Anti-CRISPR: discovery, mechanism and function","volume":"16","author":"A Pawluk","year":"2018","journal-title":"Nat Rev Microbiol"},{"key":"pone.0335756.ref008","article-title":"A new anti-CRISPR gene promotes the spread of drug-resistance plasmids in Klebsiella pneumoniae","author":"C Jiang","year":"2024","journal-title":"Nucleic Acids Res"},{"issue":"4","key":"pone.0335756.ref009","doi-asserted-by":"crossref","DOI":"10.1128\/mBio.00227-10","article-title":"Multidrug-resistant enterococci lack CRISPR-cas","volume":"1","author":"KL 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