{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T21:00:20Z","timestamp":1791406820257,"version":"4.3.3"},"reference-count":35,"publisher":"Akademiai Kiado Zrt.","issue":"2","content-domain":{"domain":["akjournals.com"],"crossmark-restriction":true},"short-container-title":["AMicr"],"published-print":{"date-parts":[[2024,7,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    <jats:italic>Klebsiella pneumoniae<\/jats:italic>\n                    is one of the most prevalent bacteria causing urinary tract infections (UTIs). Its increasing resistance to a wide array of antibiotics limits available treatment options. This study investigated the characteristics and trends of antimicrobial resistance in\n                    <jats:italic>K. pneumoniae<\/jats:italic>\n                    isolated from UTIs in Crete, Greece, during 2017 and 2022. Among the 11,946\n                    <jats:italic>Enterobacteriaceae<\/jats:italic>\n                    isolated from urine specimens, a total of 1,771\u2009\n                    <jats:italic>K. pneumoniae<\/jats:italic>\n                    isolates were identified (14.8%), with an isolation frequency secondary to\n                    <jats:italic>Escherichia coli<\/jats:italic>\n                    (66.3%).\n                    <jats:italic>K. pneumoniae<\/jats:italic>\n                    isolates increased over the years, with a peak in the year 2022. Higher resistance rates were detected in ciprofloxacin (41%), trimethoprim\/sulfamethoxazole (TMP\/SMX) (38.1%) and nitrofurantoin (33.9%). Resistance to ciprofloxacin, amoxicillin\/clavulanic acid, tigecycline, and TMP\/SMX significantly increased from 33.7%, 24%, 6%, and 33.1%, respectively, over the years 2017\u20132019, to 47.8%, 34.2%, 14.3% and 42.8%, respectively, over the period 2020\u20132022. ESBL production and carbapenem resistance were decreased by 2.2% and 3.7%, respectively, over the two three-year periods (2017\u20132019 and 2020\u20132022). Among the 278 carbapenem-resistant\n                    <jats:italic>K.\u00a0pneumoniae<\/jats:italic>\n                    (CRKP) isolates, 164 (59%), 66 (23.7%), 18 (6.5%) and 16 (5.8%) were positive for KPC, NDM, VIM and OXA-48 enzymes, respectively. Only 14 (5%) isolates harboured two carbapenemase genes, namely 10 (3.6%) both\n                    <jats:italic>bla<\/jats:italic>\n                    <jats:sub>NDM<\/jats:sub>\n                    and\n                    <jats:italic>bla<\/jats:italic>\n                    <jats:sub>VIM<\/jats:sub>\n                    , and 4 (1.4%) both\n                    <jats:italic>bla<\/jats:italic>\n                    <jats:sub>KPC<\/jats:sub>\n                    and\n                    <jats:italic>bla<\/jats:italic>\n                    <jats:sub>NDM.<\/jats:sub>\n                    Females, inpatients and the elderly were more frequently affected by CRKP. The frequency of multidrug-resistant (MDR) and extensively drug-resistant (XDR) isolates were 32.6% and 7.7%, respectively. Continuous surveillance of local microbial prevalence and monitoring of antimicrobial resistance patterns provide critical information to guide the empiric therapy for UTIs and control the spread of MDR bacteria.\n                  <\/jats:p>","DOI":"10.1556\/030.2024.02297","type":"journal-article","created":{"date-parts":[[2024,5,22]],"date-time":"2024-05-22T08:16:16Z","timestamp":1716365776000},"page":"121-126","update-policy":"https:\/\/doi.org\/10.1556\/policypage.crossmark.crossref.2","source":"Crossref","is-referenced-by-count":13,"title":["Antimicrobial resistance trends among Klebsiella pneumoniae associated with urinary tract infections in Crete, Greece, 2017\u20132022"],"prefix":"10.1556","volume":"71","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0945-1732","authenticated-orcid":true,"given":"Sofia","family":"Maraki","sequence":"first","affiliation":[{"name":"Department of Clinical Microbiology and Microbial Pathogenesis, University Hospital of Heraklion, 71500 Crete, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Viktoria Eirini","family":"Mavromanolaki","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Agios Nikolaos General Hospital, Agios Nikolaos, 72100 Crete, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dimitra","family":"Stafylaki","sequence":"additional","affiliation":[{"name":"Department of Clinical Microbiology and Microbial Pathogenesis, University Hospital of Heraklion, 71500 Crete, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evangelia","family":"Iliaki-Giannakoudaki","sequence":"additional","affiliation":[{"name":"Department of Clinical Microbiology and Microbial Pathogenesis, University Hospital of Heraklion, 71500 Crete, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Kasimati","sequence":"additional","affiliation":[{"name":"Department of Clinical Microbiology and Microbial Pathogenesis, University Hospital of Heraklion, 71500 Crete, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"425","reference":[{"key":"B1","series-title":"J Infect Dis (Suppl)","first-page":"S1","article-title":"Urinary tract infections: disease panorama and challenges","volume":"183","author":"Stamm WE","year":"2001","unstructured":"Stamm WE, Norrby SR. 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Exp Ther Med 2021; 22: 1086."},{"key":"B33","series-title":"Antimicrob Resist Infect Control","first-page":"12","article-title":"Multidrug resistant and carbapenemase producing Enterobacteriaceae among patients with urinary tract infection at referral Hospital, Northwest Ethiopia","volume":"4","author":"Eshetie S","year":"2015","unstructured":"Eshetie S, Unakal C, Gelaw A, Ayelign B, Endris M, Moges F. Multidrug resistant and carbapenemase producing Enterobacteriaceae among patients with urinary tract infection at referral Hospital, Northwest Ethiopia. Antimicrob Resist Infect Control 2015; 4: 12."},{"key":"B34","series-title":"Diagn Microbiol Infect Dis","first-page":"595","article-title":"Increasing prevalence of antimicrobial resistance among Enterobacteriaceae uropathogens in Dakar, Senegal: a multicenter study","volume":"47","author":"Dromigny JA","year":"2003","unstructured":"Dromigny JA, Ndoye B, Macondo EA, Nabeth P, Siby T, Perrier-Gros-Claude JD. Increasing prevalence of antimicrobial resistance among Enterobacteriaceae uropathogens in Dakar, Senegal: a multicenter study. Diagn Microbiol Infect Dis 2003; 47: 595\u2013600."},{"key":"B35","series-title":"Res J Pharm Biol Chem Sci","first-page":"1615","article-title":"Prevalence of multidrug resistant Enterobacteriaceae and extended spectrum \u03b2-lactamase producing Escherichia coli in urinary tract infection","volume":"4","author":"Thakur SPN","year":"2013","unstructured":"Thakur SPN, Sharma M. Prevalence of multidrug resistant Enterobacteriaceae and extended spectrum \u03b2-lactamase producing Escherichia coli in urinary tract infection. 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