{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T09:32:55Z","timestamp":1771234375967,"version":"3.50.1"},"reference-count":0,"publisher":"Instituto Nacional de Salud (Peru)","license":[{"start":{"date-parts":[[2025,6,23]],"date-time":"2025-06-23T00:00:00Z","timestamp":1750636800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Rev Peru Med Exp Salud Publica"],"abstract":"<jats:p>Objectives. To describe the whole genome sequencing of double-carbapenemase-producing\u00a0 Enterobacteriaceae isolates circulating in Paraguay.\u00a0 Materials and methods. We conducted genomic studies on seven Enterobacteriaceae isolates,\u00a0 previously confirmed as double-carbapenemase\u00a0 producers by PCR, from patients with extended hospital stays and broad-spectrum antimicrobial treatment in seven hospitals in Paraguay. Genome sequencing included Unicycler assembly and multilocus sequence typing (MLST). Results. Of the seven Enterobacterales isolates producing dual carbapenemases, six were Klebsiella pneumoniae subsp. pneumoniae and one\u00a0 was Enterobacter cloacae subsp. cloacae. The co-production of blaKPC-2\/blaNDM-1 and blaKPC-2\/blaNDM-5 was confirmed in K. pneumoniae. We found co-production of blaNDM-1\/blaOXA-163 in E. cloacae, along with other antimicrobial resistance\u00a0 genes of chromosomal and plasmid origin. The MLST\u00a0 sequence types of the K. pneumoniae isolates were ST11, ST15, ST133, ST273, and ST1303, and that of E. cloacae was ST976. Two of the six K. pneumoniae ST11 isolates, from two different hospitals in the capital, were genetically related and both carried blaKPC-2 and blaNDM-5. Conclusions. We report the first genome sequencing of double-carbapenemase-producing Enterobacterales from patients with extended hospital stays in Paraguay. The analysis revealed diverse resistance profiles and clones, carriage of multiple carbapenemases, and other resistance genes of chromosomal and plasmid origin. These findings\u00a0 emphasize the need to strengthen hospital infection control and implement effective therapeutic\u00a0 interventions.<\/jats:p>","DOI":"10.17843\/rpmesp.2025.422.14293","type":"journal-article","created":{"date-parts":[[2025,7,4]],"date-time":"2025-07-04T21:37:57Z","timestamp":1751665077000},"page":"138-46","source":"Crossref","is-referenced-by-count":1,"title":["Double-carbapenemase-producing &lt;i&gt;Enterobacteriaceae&lt;\/i&gt;: complete genome sequencing of isolates from hospitals in Paraguay, 2021","&lt;i&gt;Enterobacteriaceae&lt;\/i&gt; productoras de doble carbapenemasa: secuenciaci\u00f3n del genoma completo de aislamientos en hospitales de Paraguay, 2021"],"prefix":"10.17843","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3746-7662","authenticated-orcid":false,"given":"Nancy","family":"Melgarejo 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