{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T18:02:40Z","timestamp":1793642560467,"version":"4.5.1"},"reference-count":72,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2022,10,5]],"date-time":"2022-10-05T00:00:00Z","timestamp":1664928000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"UAE University Start-up Grant Fund","award":["G00003463"],"award-info":[{"award-number":["G00003463"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antibiotics"],"abstract":"<jats:p>Antimicrobial resistance (AMR) is a global problem that also includes countries of the Arabian Peninsula. Of particular concern, is the continuing development of extended-spectrum \u03b2-lactamases (ESBLs) in the countries of this region. Additionally, antibiotic treatment options for ESBL-producing bacteria are becoming limited, primarily due to the continuing development of carbapenem resistance (CR), carbapenems being frequently used to treat such infections. An overview of recent publications (2018\u20132021) indicates the presence of ESBL and\/or CR in patients and hospitals in most countries of the Arabian Peninsula, although the delay between microbial isolation and publication inevitably makes an accurate analysis of the current situation rather difficult. However, there appears to be greater emphasis on CR (including combined ESBL and CR) in recent publications. Furthermore, although publications from Saudi Arabia are the most prevalent, this may simply reflect the increased interest in ESBL and CR within the country. Enhanced ESBL\/CR surveillance is recommended for all countries in the Arabian Peninsula.<\/jats:p>","DOI":"10.3390\/antibiotics11101354","type":"journal-article","created":{"date-parts":[[2022,10,7]],"date-time":"2022-10-07T22:47:27Z","timestamp":1665182847000},"page":"1354","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Extended Spectrum- and Carbapenemase-Based \u03b2-Lactam Resistance in the Arabian Peninsula\u2014A Descriptive Review of Recent Years"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9183-4497","authenticated-orcid":false,"given":"John Philip","family":"Hays","sequence":"first","affiliation":[{"name":"Department of Medical Microbiology and Infectious Diseases, Erasmus University Medical Centre (Erasmus MC), Rotterdam 3015 GD, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8742-4890","authenticated-orcid":false,"given":"Kazi Sarjana","family":"Safain","sequence":"additional","affiliation":[{"name":"Department of Microbiological Sciences, North Dakota State University, Fargo, ND 58108, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8733-1472","authenticated-orcid":false,"given":"Mohammed Suliman","family":"Almogbel","sequence":"additional","affiliation":[{"name":"College of Applied Medical Sciences, University of Hail, Hail 4030, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0938-0607","authenticated-orcid":false,"given":"Ihab","family":"Habib","sequence":"additional","affiliation":[{"name":"Department of Veterinary Medicine, College of Agriculture and Veterinary Medicine, United Arab Emirates University, Al Ain P.O. Box 1555, United Arab Emirates"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2434-1411","authenticated-orcid":false,"given":"Mushtaq Ahmad","family":"Khan","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology and Immunology, College of Medicine and Health Sciences, United Arab Emirates University (UAEU), Al Ain P.O. Box 15551, United Arab Emirates"},{"name":"Zayed Center for Health Sciences, United Arab Emirates University (UAEU), Al Ain P.O. Box 15551, United Arab Emirates"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,10,5]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1093\/jac\/dkaa399","article-title":"The global prevalence and trend of human intestinal carriage of ESBL-producing Escherichia coli in the community","volume":"76","author":"Bezabih","year":"2021","journal-title":"J. Antimicrob. Chemother"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1186\/s40560-020-0429-6","article-title":"Molecular diversity of extended-spectrum beta-lactamases and carbapenemases, and antimicrobial resistance","volume":"8","author":"Sawa","year":"2020","journal-title":"J. Intensive Care"},{"key":"ref_3","first-page":"237","article-title":"Plasmid-mediated extended-spectrum \u03b2-lactamase (CTX-M-3 like) from India and gene association with insertion sequence IS Ecp1","volume":"201","author":"Karim","year":"2001","journal-title":"FEMS Microbiol. Lett."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Palmeira, J.D., Cunha, M.V., Carvalho, J., Ferreira, H., Fonseca, C., and Torres, R.T. (2021). Emergence and Spread of Cephalosporinases in Wildlife: A Review. Animals, 11.","DOI":"10.3390\/ani11061765"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"dlab092","DOI":"10.1093\/jacamr\/dlab092","article-title":"Extended-spectrum beta-lactamases: An update on their characteristics, epidemiology and detection","volume":"3","author":"Castanheira","year":"2021","journal-title":"JAC\u2014Antimicrob. Resist."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"4038","DOI":"10.1128\/AAC.46.12.4038-4040.2002","article-title":"Chromosome-encoded Ambler class A \u03b2-lactamase of Kluyvera georgiana, a probable progenitor of a subgroup of CTX-M extended-spectrum \u03b2-lactamases","volume":"46","author":"Poirel","year":"2002","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1455","DOI":"10.1080\/14656566.2021.1904891","article-title":"Escalating antimicrobial resistance among Enterobacteriaceae: Focus on carbapenemases","volume":"22","author":"Lynch","year":"2021","journal-title":"Expert Opin. Pharmacother."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"720","DOI":"10.1111\/tmi.13584","article-title":"Genotypic and phenotypic profiles of antibiotic-resistant bacteria isolated from hospitalised patients in Bangladesh","volume":"26","author":"Safain","year":"2021","journal-title":"Trop. Med. Int. Health"},{"key":"ref_9","first-page":"15","article-title":"Carbapenem resistance: Overview of the problem and future perspectives","volume":"3","author":"Meletis","year":"2016","journal-title":"Ther. Adv. Infect. Dis."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1016\/j.jhin.2015.01.008","article-title":"Multidrug-resistant Gram-negative bacteria: A product of globalization","volume":"89","author":"Hawkey","year":"2015","journal-title":"J. Hosp. Infect."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"37","DOI":"10.4236\/aim.2021.111004","article-title":"An Overview of Extended Spectrum Beta Lactamases and Metallo Beta Lactamases","volume":"11","author":"Nagshetty","year":"2021","journal-title":"Adv. Microbiol."},{"key":"ref_12","unstructured":"(2021, November 29). Arabian Peninsula. Available online: https:\/\/en.wikipedia.org\/wiki\/Arabian_Peninsula."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1016\/j.jiph.2018.07.011","article-title":"Extended-spectrum \u03b2-lactamase producing E. coli in urinary tract infections: A two-center, cross-sectional study of prevalence, genotypes and risk factors in Amman, Jordan","volume":"12","author":"Albsoul","year":"2019","journal-title":"J. Infect. Public Health"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1089\/mdr.2018.0036","article-title":"PME and Other ESBL-Positive Multiresistant Pseudomonas aeruginosa Isolated from Hospitalized Patients in the Region of Kurdistan, Iraq","volume":"25","author":"Maghdid","year":"2019","journal-title":"Microb. Drug Resist."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"e2019041","DOI":"10.4084\/mjhid.2019.041","article-title":"Prevalence of blaTEM, blaSHV, and blaCTX-M Genes among ESBL-Producing Klebsiella pneumoniae and Escherichia coli Isolated from Thalassemia Patients in Erbil, Iraq","volume":"11","author":"Pishtiwan","year":"2019","journal-title":"Mediterr. J. Hematol. Infect. Dis."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"581711","DOI":"10.3389\/fmicb.2020.581711","article-title":"Molecular Characterization of Extended-Spectrum beta-Lactamase-Producing Escherichia coli and Klebsiella pneumoniae Among the Pediatric Population in Qatar","volume":"11","author":"Sundararaju","year":"2020","journal-title":"Front. Microbiol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"e00429-20","DOI":"10.1128\/MRA.00429-20","article-title":"Draft Genome Sequence of an Extended-Spectrum beta-Lactamase-Producing Klebsiella oxytoca Strain Bearing mcr-9 from Qatar","volume":"9","author":"Tsui","year":"2020","journal-title":"Microbiol. Resour. Announc"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"662","DOI":"10.1016\/j.jgar.2020.06.029","article-title":"Plasmid-mediated colistin resistance encoded by mcr-1 gene in Escherichia coli co-carrying blaCTX-M-15 and blaNDM-1 genes in pediatric patients in Qatar","volume":"22","author":"Tsui","year":"2020","journal-title":"J. Glob. Antimicrob. Resist."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"2843","DOI":"10.2147\/IDR.S317079","article-title":"CTX-M-15 Positive Escherichia coli and Klebsiella pneumoniae Outbreak in the Neonatal Intensive Care Unit of a Maternity Hospital in Ha\u2019il, Saudi Arabia","volume":"14","author":"Almogbel","year":"2021","journal-title":"Infect. Drug Resist."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"759","DOI":"10.1016\/j.jiph.2019.12.001","article-title":"ESBL expression and antibiotic resistance patterns in a hospital in Saudi Arabia: Do healthcare staff have the whole picture?","volume":"13","author":"Aldrazi","year":"2020","journal-title":"J. Infect. Public Health"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"14847","DOI":"10.1038\/s41598-018-33093-8","article-title":"Molecular characterization, antimicrobial resistance and clinico-bioinformatics approaches to address the problem of extended-spectrum \u03b2-lactamase-producing Escherichia coli in western Saudi Arabia","volume":"8","author":"Yasir","year":"2018","journal-title":"Sci. Rep."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1186","DOI":"10.15537\/smj.2018.12.23273","article-title":"Risk factors and molecular features of extended-spectrum beta-lactamase producing bacteria at southwest of Saudi Arabia","volume":"39","author":"Ghonaim","year":"2018","journal-title":"Saudi Med. J."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"3026851","DOI":"10.1155\/2018\/3026851","article-title":"Prevalence of Multidrug Resistance and Extended-Spectrum beta-Lactamase Carriage of Clinical Uropathogenic Escherichia coli Isolates in Riyadh, Saudi Arabia","volume":"2018","author":"Alqasim","year":"2018","journal-title":"Int. J. Microbiol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"6054694","DOI":"10.1155\/2019\/6054694","article-title":"Phenotypic Characterization and Antibiotic Resistance Patterns of Extended-Spectrum beta-Lactamase- and AmpC beta-Lactamase-Producing Gram-Negative Bacteria in a Referral Hospital, Saudi Arabia","volume":"2019","author":"Ibrahim","year":"2019","journal-title":"Can. J. Infect. Dis. Med. Microbiol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1450","DOI":"10.3892\/etm.2021.10885","article-title":"Emergence of bla TEM, bla CTX-M, bla SHV and bla OXA genes in multidrug-resistant Enterobacteriaceae and Acinetobacter baumannii in Saudi Arabia","volume":"22","author":"Ibrahim","year":"2021","journal-title":"Exp. Ther. Med."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"5408","DOI":"10.1016\/j.sjbs.2021.05.067","article-title":"Occurrence of bla CTX-MGp1 and bla CTX-MGp26 in third generation cephalosporin-resistant and carbapenem- resistant bacterial isolates from southwest region of Saudi Arabia-a preliminary study","volume":"28","author":"Sobia","year":"2021","journal-title":"Saudi J. Biol. Sci."},{"key":"ref_27","first-page":"6736897","article-title":"Cooccurrence of NDM-1, ESBL, RmtC, AAC(6\u2019)-Ib, and QnrB in Clonally Related Klebsiella pneumoniae Isolates Together with Coexistence of CMY-4 and AAC(6\u2019)-Ib in Enterobacter cloacae Isolates from Saudi Arabia","volume":"2019","author":"Radwan","year":"2019","journal-title":"Biomed. Res. Int."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"650","DOI":"10.3390\/clinpract11030080","article-title":"Antimicrobial Resistance Patterns and ESBL of Uropathogens Isolated from Adult Females in Najran Region of Saudi Arabia","volume":"11","author":"Alasmary","year":"2021","journal-title":"Clin. Pract."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1016\/j.tmaid.2018.01.007","article-title":"Community-acquired urinary tract infections due to extended-spectrum beta-lactamase-producing organisms in United Arab Emirates","volume":"22","author":"Dash","year":"2018","journal-title":"Travel Med. Infect. Dis."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1304793","DOI":"10.1155\/2018\/1304793","article-title":"First Report of blaCTX-M-28 in Enterobacteriaceae Isolates in the United Arab Emirates","volume":"2018","author":"Alfaresi","year":"2018","journal-title":"J. Pathog."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1537","DOI":"10.1089\/mdr.2018.0024","article-title":"Prevalence of ST131 Clone Producing Both ESBL CTX-M-15 and AAC (6\u2032) Ib-cr Among Ciprofloxacin-Resistant Escherichia coli Isolates from Yemen","volume":"24","author":"Alsharapy","year":"2018","journal-title":"Microb. Drug Resist."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"953","DOI":"10.3855\/jidc.10560","article-title":"Epidemiology of extended-spectrum beta-lactamase producing Escherichia coli from hospital settings in Yemen","volume":"12","author":"Nasher","year":"2018","journal-title":"J. Infect. Dev. Ctries."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1556\/030.65.2018.005","article-title":"Genetic support of carbapenemases in double carbapenemase producer Klebsiella pneumoniae isolated in the Arabian Peninsula","volume":"65","author":"Pal","year":"2018","journal-title":"Acta Microbiol. Et Immunol. Hung."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"138","DOI":"10.4103\/JLP.JLP_118_18","article-title":"Detection of VIM and NDM-1 metallo-beta-lactamase genes in carbapenem-resistant Pseudomonas aeruginosa clinical strains in Bahrain","volume":"11","author":"Joji","year":"2019","journal-title":"J. Lab. Physicians"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"111","DOI":"10.4103\/JLP.JLP_101_18","article-title":"Epidemiology of carbapenem-resistant Enterobacteriaceae in a Tertiary Care Center in the Kingdom of Bahrain","volume":"11","author":"Saeed","year":"2019","journal-title":"J. Lab. Physicians"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1016\/j.jgar.2021.08.005","article-title":"Phenotypic and genotypic characterisation of cephalosporin-, carbapenem- and colistin-resistant Gram-negative bacterial pathogens in Lebanon, Jordan and Iraq","volume":"27","author":"Moghnieh","year":"2021","journal-title":"J. Glob. Antimicrob. Resist."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1121","DOI":"10.1089\/mdr.2017.0238","article-title":"Characterization of Carbapenemase-Producing Enterobacteriaceae from Patients in Amman, Jordan","volume":"24","author":"Aqel","year":"2018","journal-title":"Microb. Drug Resist."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"e14998","DOI":"10.1111\/ijcp.14998","article-title":"Molecular epidemiology of carbapenem-resistant Acinetobacter baumannii isolated from three major hospitals in Jordan","volume":"75","author":"Ababneh","year":"2021","journal-title":"Int. J. Clin. Pract"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"524","DOI":"10.1093\/jac\/dkaa463","article-title":"Identification of thresholds in relationships between specific antibiotic use and carbapenem-resistant Acinetobacter baumannii (CRAb) incidence rates in hospitalized patients in Jordan","volume":"76","author":"Hayajneh","year":"2021","journal-title":"J. Antimicrob. Chemother"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"516","DOI":"10.1093\/jac\/dkaa464","article-title":"Impact of an antimicrobial stewardship programme on reducing broad-spectrum antibiotic use and its effect on carbapenem-resistant Acinetobacter baumannii (CRAb) in hospitals in Jordan","volume":"76","author":"Yusef","year":"2021","journal-title":"J. Antimicrob. Chemother."},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Al Fadhli, A.H., Jamal, W.Y., and Rotimi, V.O. (2020). Prevalence of carbapenem-resistant Enterobacteriaceae and emergence of high rectal colonization rates of blaOXA-181-positive isolates in patients admitted to two major hospital intensive care units in Kuwait. PLoS ONE, 15.","DOI":"10.1371\/journal.pone.0241971"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"370","DOI":"10.1016\/j.jgar.2021.04.009","article-title":"Monitoring antibiotic resistance profiles of faecal isolates of Enterobacteriaceae and the prevalence of carbapenem-resistant isolates among food handlers in Kuwait","volume":"25","author":"Moghnia","year":"2021","journal-title":"J. Glob. Antimicrob. Resist."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"737828","DOI":"10.3389\/fmicb.2021.737828","article-title":"Preponderance of bla KPC-Carrying Carbapenem-Resistant Enterobacterales Among Fecal Isolates from Community Food Handlers in Kuwait","volume":"12","author":"Moghnia","year":"2021","journal-title":"Front. Microbiol."},{"key":"ref_44","first-page":"001409","article-title":"Molecular characterization of rectal isolates of carbapenemase-negative carbapenem-resistant enterobacterales obtained from ICU patients in Kuwait by whole-genome sequencing","volume":"70","author":"Jamal","year":"2021","journal-title":"J. Med. Microbiol."},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Al-Farsi, H.M., Camporeale, A., Ininbergs, K., Al-Azri, S., Al-Muharrmi, Z., Al-Jardani, A., and Giske, C.G. (2020). Clinical and molecular characteristics of carbapenem non-susceptible Escherichia coli: A nationwide survey from Oman. PLoS ONE, 15.","DOI":"10.1371\/journal.pone.0239924"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"472","DOI":"10.1016\/j.jgar.2020.09.001","article-title":"Corrigendum to \u201cPlasmid-mediated colistin resistance encoded by mcr-1 gene in Escherichia coli co-carrying blaCTX-M-15 and blaNDM-1 genes in pediatric patients in Qatar\u201d","volume":"23","author":"Tsui","year":"2020","journal-title":"J. Glob. Antimicrob. Resist."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"e0112221","DOI":"10.1128\/Spectrum.01122-21","article-title":"Fecal Carriage and Molecular Characterization of Carbapenemase-Producing Enterobacterales in the Pediatric Population in Qatar","volume":"9","author":"Sundararaju","year":"2021","journal-title":"Microbiol. Spectr."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"1779","DOI":"10.1007\/s10096-021-04185-7","article-title":"Molecular characterization of clinical carbapenem-resistant Enterobacterales from Qatar","volume":"40","author":"Abid","year":"2021","journal-title":"Eur. J. Clin. Microbiol. Infect. Dis."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"465","DOI":"10.1016\/j.jiph.2019.03.024","article-title":"Carbapenem-Resistant Enterobacteriaceae: An update narrative review from Saudi Arabia","volume":"12","author":"Alotaibi","year":"2019","journal-title":"J. Infect. Public Health"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"1492","DOI":"10.1016\/j.jsps.2020.09.015","article-title":"Evaluating the appropriateness of carbapenem and piperacillin-tazobactam prescribing in a tertiary care hospital in Saudi Arabia","volume":"28","author":"Alsaleh","year":"2020","journal-title":"Saudi Pharm. J."},{"key":"ref_51","doi-asserted-by":"crossref","unstructured":"Zaman, T.U., Alrodayyan, M., Albladi, M., Aldrees, M., Siddique, M.I., Aljohani, S., and Balkhy, H.H. (2018). Clonal diversity and genetic profiling of antibiotic resistance among multidrug\/carbapenem-resistant Klebsiella pneumoniae isolates from a tertiary care hospital in Saudi Arabia. BMC Infect. Dis., 18.","DOI":"10.1186\/s12879-018-3114-9"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"23","DOI":"10.15537\/smj.2018.1.21094","article-title":"The emergence of carbapenem-resistant Klebsiella pneumoniae isolates producing OXA-48 and NDM in the Southern (Asir) province, Saudi Arabia","volume":"39","author":"Alsiri","year":"2018","journal-title":"Saudi Med. J."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"63","DOI":"10.5144\/0256-4947.2021.63","article-title":"Molecular characterization of carbapenem-resistant Enterobacterales in thirteen tertiary care hospitals in Saudi Arabia","volume":"41","author":"AlHababi","year":"2021","journal-title":"Ann. Saudi Med."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"3113","DOI":"10.2147\/IDR.S206691","article-title":"Characterization of phenotypic and genotypic traits of carbapenem-resistant Acinetobacter baumannii clinical isolates recovered from a tertiary care hospital in Taif, Saudi Arabia","volume":"12","author":"Abdelwahab","year":"2019","journal-title":"Infect. Drug Resist."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"334","DOI":"10.3855\/jidc.11056","article-title":"Enterobacterial infection in Saudi Arabia: First record of Klebsiella pneumoniae with triple carbapenemase genes resistance","volume":"13","author":"Khan","year":"2019","journal-title":"J. Infect. Dev. Ctries."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1093\/trstmh\/trab055","article-title":"Genotypes and prevalence of carbapenemase-producing Enterobacteriaceae and Pseudomonas aeruginosa in a hospital in Saudi Arabia","volume":"116","author":"Rabaan","year":"2022","journal-title":"Trans. R. Soc. Trop. Med. Hyg."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"632","DOI":"10.1016\/j.jiph.2019.08.013","article-title":"Molecular characterization of clinical and environmental carbapenem resistant Acinetobacter baumannii isolates in a hospital of the Eastern Region of Saudi Arabia","volume":"13","author":"Pal","year":"2020","journal-title":"J. Infect. Public Health"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12941-018-0301-x","article-title":"Prevalence of Acinetobacter baumannii in Saudi Arabia: Risk factors, antimicrobial resistance patterns and mechanisms of carbapenem resistance","volume":"18","author":"Ibrahim","year":"2019","journal-title":"Ann. Clin. Microbiol. Antimicrob."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1016\/j.nmni.2018.09.007","article-title":"First report of carbapenem-resistant Providencia stuartii in Saudi Arabia","volume":"26","author":"Abdallah","year":"2018","journal-title":"N. Microbes. N. Infect."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"2006","DOI":"10.1093\/jac\/dkaa077","article-title":"OXA-48 carbapenemase-producing Salmonella enterica serovar Kentucky ST198 isolated from Saudi Arabia","volume":"75","author":"Alghoribi","year":"2020","journal-title":"J. Antimicrob. Chemother."},{"key":"ref_61","doi-asserted-by":"crossref","unstructured":"Basode, V.K., Abdulhaq, A., Alamoudi, M.U.A., Tohari, H.M., Quhal, W.A., Madkhali, A.M., Hobani, Y.H., and Hershan, A.A. (2018). Prevalence of a carbapenem-resistance gene (KPC), vancomycin-resistance genes (van A\/B) and a methicillin-resistance gene (mecA) in hospital and municipal sewage in a southwestern province of Saudi Arabia. BMC Res. Notes, 11.","DOI":"10.1186\/s13104-018-3167-2"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"1105","DOI":"10.15537\/smj.2019.11.24586","article-title":"A matched case-control study to assess the carbapenem-resistant Enterobacteriaceae infections among hospitalized children at King Fahad Medical City, Riyadh, Saudi Arabia","volume":"40","author":"Alzomor","year":"2019","journal-title":"Saudi Med. J."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"1729","DOI":"10.2147\/IDR.S210554","article-title":"Epidemic IncX3 plasmids spreading carbapenemase genes in the United Arab Emirates and worldwide","volume":"12","author":"Mouftah","year":"2019","journal-title":"Infect. Drug Resist."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1016\/j.jgar.2019.07.021","article-title":"Assessment of the performance of CHROMagar KPC and Xpert Carba-R assay for the detection of carbapenem-resistant bacteria in rectal swabs: First comparative study from Abu Dhabi, United Arab Emirates","volume":"20","author":"Moubareck","year":"2020","journal-title":"J. Glob. Antimicrob. Resist."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1089\/mdr.2018.0443","article-title":"Characterization of Carbapenem-Resistant Enterobacteriaceae Clinical Isolates in Al Thawra University Hospital, Sana\u2019a, Yemen","volume":"26","author":"Alsharapy","year":"2020","journal-title":"Microb. Drug. Resist."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1016\/j.ijid.2020.07.050","article-title":"In vitro efficacy of ceftazidime-avibactam, aztreonam-avibactam and other rescue antibiotics against carbapenem-resistant Enterobacterales from the Arabian Peninsula","volume":"99","author":"Sonnevend","year":"2020","journal-title":"Int. J. Infect. Dis."},{"key":"ref_67","doi-asserted-by":"crossref","unstructured":"Mouftah, S.F., Pal, T., Higgins, P.G., Ghazawi, A., Idaghdour, Y., Alqahtani, M., Omrani, A.S., Rizvi, T.A., and Sonnevend, A. (2021). Diversity of carbapenem-resistant Klebsiella pneumoniae ST14 and emergence of a subgroup with KL64 capsular locus in the Arabian Peninsula. Eur. J. Clin. Microbiol. Infect. Dis.","DOI":"10.1007\/s10096-021-04384-2"},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"404","DOI":"10.1016\/j.jhin.2020.09.004","article-title":"Mapping hospital antimicrobial stewardship programmes in the Gulf Cooperation Council states against international standards: A systematic review","volume":"106","author":"Hashad","year":"2020","journal-title":"J. Hosp. Infect."},{"key":"ref_69","doi-asserted-by":"crossref","unstructured":"Nassar, H., Abu-Farha, R., Barakat, M., and Alefishat, E. (2022). Antimicrobial Stewardship from Health Professionals\u2019 Perspective: Awareness, Barriers, and Level of Implementation of the Program. Antibiotics, 11.","DOI":"10.3390\/antibiotics11010099"},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1186\/s12941-019-0325-x","article-title":"Health care providers\u2019 perceptions regarding antimicrobial stewardship programs (AMS) implementation-facilitators and challenges: A cross-sectional study in the Eastern province of Saudi Arabia","volume":"18","author":"Baraka","year":"2019","journal-title":"Ann. Clin. Microbiol. Antimicrob."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"784","DOI":"10.1016\/j.jiph.2018.08.001","article-title":"The role of whole genome sequencing in monitoring antimicrobial resistance: A biosafety and public health priority in the Arabian Peninsula","volume":"11","author":"Alghoribi","year":"2018","journal-title":"J. Infect. Public Health"},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"FSO420","DOI":"10.2144\/fsoa-2019-0054","article-title":"Practices of patients consuming antibiotics and knowledge about antibiotic resistance in Hail region\u2014Saudi Arabia","volume":"5","author":"Benmerzouga","year":"2019","journal-title":"Future Sci."}],"container-title":["Antibiotics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2079-6382\/11\/10\/1354\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T00:46:38Z","timestamp":1760143598000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2079-6382\/11\/10\/1354"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,10,5]]},"references-count":72,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2022,10]]}},"alternative-id":["antibiotics11101354"],"URL":"https:\/\/doi.org\/10.3390\/antibiotics11101354","relation":{},"ISSN":["2079-6382"],"issn-type":[{"value":"2079-6382","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,10,5]]}}}