{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T18:09:08Z","timestamp":1785434948295,"version":"3.56.0"},"reference-count":58,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T00:00:00Z","timestamp":1779408000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"General Sir John Kotelawala Defence University","award":["KDU\/RG\/2022\/FAHS\/005"],"award-info":[{"award-number":["KDU\/RG\/2022\/FAHS\/005"]}]},{"award":["KDU\/RG\/2022\/FAHS\/005"],"award-info":[{"award-number":["KDU\/RG\/2022\/FAHS\/005"]}],"id":[{"id":"https:\/\/ror.org\/04n37he08","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antibiotics"],"abstract":"<jats:p>Background: The emergence and spread of urinary carbapenem-resistant organisms (CROs) are a major public health concern, particularly in Sri Lanka. Therefore, we aimed to detect and genotypically characterize CROs in urinary tract infections (UTIs) and their clinical outcomes. Methods: Urinary CROs were collected from two hospitals in Sri Lanka from January to December, 2023. Among 7640 urine samples, 100 CROs were identified by disk diffusion method, and 99 were detected by BD PheonixTM automated system. The presence of eight carbapenemase genes; blaKPC, blaNDM, blaVIM, blaIMP, blaOXA-23, blaOXA-48, blaOXA-51, and blaOXA-58, among 97 CROs was detected by a multiplex PCR kit. Results: Out of 99 urinary CROs, K. pneumoniae (33.3%; n = 33\/97) was the most common species. Among the 97 isolates tested by PCR, a single carbapenemase gene was detected in 35.05% (34\/97), while two or more genes co-occurred in 39.18% (38\/97). The most frequently identified gene was blaOXA-51 (47.4%), followed by blaOXA-58 (41.2%). Most patients (95.74%; n = 90\/97) showed clinical improvement within seven days of treatment. Among the 93 patients discharged and followed for three months, 74.20% (n = 69\/93) experienced at least one mild UTI recurrence. A total of 10 patients died during the study period. Of which, four (40%) during hospitalization and six (60%) during follow-up, though none of the deaths were attributed to UTIs. Conclusions:\u00a0K. pneumoniae, showed the highest carbapenemase gene diversity. Recurrent UTIs were observed during the follow-up period. Continuous surveillance and implementation of targeted infection control programs are needed to minimize further emergence and spread of carbapenemase genes.<\/jats:p>","DOI":"10.3390\/antibiotics15060529","type":"journal-article","created":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T12:14:52Z","timestamp":1779452092000},"page":"529","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Multiplex PCR-Based Detection of Eight Carbapenemase Genes and Their Clinical Characteristics in Urinary Tract Infections"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5036-7503","authenticated-orcid":false,"given":"Nishadi","family":"Jayathilaka","sequence":"first","affiliation":[{"name":"Faculty of Graduate Studies, General Sir John Kotelawala Defence University, Colombo 10390, Sri Lanka"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Upeksha","family":"Kulasekara","sequence":"additional","affiliation":[{"name":"Faculty of Graduate Studies, General Sir John Kotelawala Defence University, Colombo 10390, Sri Lanka"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dilini","family":"Nakkawita","sequence":"additional","affiliation":[{"name":"Department of Paraclinical Sciences, Faculty of Medicine, General Sir John Kotelawala Defence University, Colombo 10390, Sri Lanka"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dharshan","family":"De Silva","sequence":"additional","affiliation":[{"name":"Department of Paraclinical Sciences, Faculty of Medicine, General Sir John Kotelawala Defence University, Colombo 10390, Sri Lanka"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samanmalee","family":"Gunasekara","sequence":"additional","affiliation":[{"name":"National Cancer Institute, Maharagama 10280, Sri Lanka"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3767-0975","authenticated-orcid":false,"given":"Thamarasi","family":"Senaratne","sequence":"additional","affiliation":[{"name":"Department of Medical Laboratory Sciences, Faculty of Allied Health Sciences, General Sir John Kotelawala Defence University, Colombo 10390, Sri Lanka"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Mancuso, G., Midiri, A., Gerace, E., Marra, M., Zummo, S., and Biondo, C. (2023). Urinary Tract Infections: The Current Scenario and Future Prospects. Pathogens, 12.","DOI":"10.3390\/pathogens12040623"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"FSO438","DOI":"10.2144\/fsoa-2019-0098","article-title":"A review on bacterial resistance to carbapenems: Epidemiology, detection and treatment options","volume":"6","author":"Elshamy","year":"2020","journal-title":"Future Sci. OA"},{"key":"ref_3","unstructured":"World Health Organization (2013). Global priority list of antibiotic-resistant bacteria to guide research, discovery, and development of new antibiotics. World Health Organ., 43, 348\u2013365."},{"key":"ref_4","unstructured":"Centers for Diasease Control and Prevention (CDC) (2023, September 25). Carbapenem-resistant Enterobacterals, Available online: https:\/\/www.cdc.gov\/cre\/about\/index.html."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1016\/j.diagmicrobio.2012.11.009","article-title":"Carbapenem-resistant Enterobacteriaceae: A review of treatment and outcomes","volume":"75","author":"Van","year":"2013","journal-title":"Diagn. Microbiol. Infect. Dis."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"S521","DOI":"10.1093\/cid\/ciz824","article-title":"Epidemiology and Diagnostics of Carbapenem Resistance in gram-negative Bacteria","volume":"69","author":"Nordmann","year":"2019","journal-title":"Clin. Infect. Dis."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Radu, V.D., Costache, R.C., Onofrei, P., Miron, A., Bandac, C.-A., Arseni, D., Mironescu, M., Miftode, R.-S., Boiculese, L.V., and Miftode, I.-L. (2024). Urinary Tract Infections with Carbapenem-Resistant Klebsiella pneumoniae in a Urology Clinic\u2014A Case\u2012Control Study. Antibiotics, 13.","DOI":"10.3390\/antibiotics13070583"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1556\/030.66.2019.030","article-title":"Prevalence of carbapenem-hydrolysing OXA-type \u03b2-lactamases among Acinetobacter baumannii in patients with severe urinary tract infection","volume":"67","author":"Girija","year":"2020","journal-title":"Acta Microbiol. Immunol. Hung."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"19","DOI":"10.61186\/mlj.17.6.19","article-title":"Prevalence of carbapenem-resistant Metallo-Beta-Lactamase-producing Escherichia coli","volume":"17","author":"Rashedi","year":"2023","journal-title":"Med. Lab. J."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Mancuso, G., De Gaetano, S., Midiri, A., Zummo, S., and Biondo, C. (2023). The Challenge of Overcoming Antibiotic Resistance in Carbapenem-Resistant Gram-Negative Bacteria: \u201cAttack on Titan\u201d. Microorganisms, 11.","DOI":"10.20944\/preprints202307.0676.v1"},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Caliskan-Aydogan, O., and Alocilja, E.C. (2023). A Review of Carbapenem Resistance in Enterobacterales and Its Detection Techniques. Microorganisms, 11.","DOI":"10.3390\/microorganisms11061491"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1274","DOI":"10.1128\/AAC.01497-10","article-title":"Early dissemination of NDM-1- and OXA-181-producing Enterobacteriaceae in Indian hospitals: Report from the SENTRY Antimicrobial Surveillance Program, 2006-2007","volume":"55","author":"Castanheira","year":"2011","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1087","DOI":"10.1099\/jmm.0.076760-0","article-title":"Molecular mechanisms of \u03b2-lactam resistance in carbapenemase-producing Klebsiella pneumonia from Sri Lanka","volume":"63","author":"Hall","year":"2014","journal-title":"J. Med. Microbiol."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Hammour, K.A., Abu-Farha, R., Itani, R., Karout, S., Allan, A., Manaseer, Q., and Abu Hammour, W. (2023). The prevalence of Carbapenem Resistance Gram negative pathogens in a Tertiary Teaching Hospital in Jordan. BMC Infect. Dis., 23.","DOI":"10.1186\/s12879-023-08610-4"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"240","DOI":"10.1186\/s13643-022-02110-3","article-title":"Prevalence and incidence of carbapenem-resistant K. pneumoniae colonization: Systematic review and meta-analysis","volume":"11","author":"Tesfa","year":"2022","journal-title":"Sys Rev."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Zhu, C., Liyanapathirana, V., Li, C., Pinto, V., Hui, M., Lo, N., Wong, K.T., Dissanayake, N., and Ip, M. (2018). Characterizing mobilized virulence factors and multidrug resistance genes in carbapenemase-producing Klebsiella pneumoniae in a Sri Lankan hospital. Front. Microbiol., 9.","DOI":"10.3389\/fmicb.2018.02044"},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Tissera, K., Liyanapathirana, V., Dissanayake, N., Pinto, V., Ekanayake, A., Tennakoon, M., Adasooriya, D., and Nanayakkara, D. (2017). Spread of resistant gram negatives in a Sri Lankan intensive care unit. BMC Infect. Dis., 17.","DOI":"10.1186\/s12879-017-2590-7"},{"key":"ref_18","first-page":"E56:1-7","article-title":"Detection of carbapenemase producing enterobacterales using the Modified Hodge Test from clinical isolates in Colombo South Teaching Hospital and Sri Jayewardenepura General Hospital, Sri Lanka in 2017","volume":"14","author":"Jayathilaka","year":"2024","journal-title":"Sri Lankan J. Infect. Dis."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Fernando, M.M.P.S.C., Luke, W.A.N.V., Miththinda, J.K.N.D., Wickramasinghe, R.D.S.S., Sebastiampillai, B.S., Gunathilake, M.P.M.L., Silva, F.H.D.S., and Premaratna, R. (2017). Extended spectrum beta lactamase producing organisms causing urinary tract infections in Sri Lanka and their antibiotic susceptibility pattern\u2013A hospital based cross sectional study. BMC Infect. Dis., 17.","DOI":"10.1186\/s12879-017-2250-y"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1330","DOI":"10.1016\/j.jiph.2020.04.010","article-title":"Epidemiology of multidrug-resistant Enterobacteriaceae in Sri Lanka: First evidence of blaKPC harboring Klebsiella pneumoniae","volume":"13","author":"Kumudunie","year":"2020","journal-title":"J. Infect. Public Health"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"dlac004.030","DOI":"10.1093\/jacamr\/dlac004.030","article-title":"Gut colonization of carbapenem-resistant Enterobacteriaceae among patients with haematological malignancies in National Cancer Institute, Sri Lanka","volume":"4","author":"Suranadee","year":"2022","journal-title":"JAC-Antimicrob. Resist."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1093\/jacamr\/dlac004.031","article-title":"Occurrence of blaKPC, blaNDM and bla OXA-48 genes among carbapenemase-producing Enterobacteriaceae (CRE) in National Cancer Institute, Sri Lanka","volume":"4","author":"Suranadee","year":"2022","journal-title":"JAC-Antimicrob. Resist."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"126","DOI":"10.33393\/dti.2023.2660","article-title":"Management of urinary tract infections in the era of antimicrobial resistance","volume":"17","author":"Pothoven","year":"2023","journal-title":"Drug Target Insights"},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Thirapanmethee, K., Srisiri-A-nun, T., Houngsaitong, J., Montakantikul, P., Khuntayaporn, P., and Chomnawang, M.T. (2020). Prevalence of OXA-type \u03b2-lactamase genes among carbapenem-resistant Acinetobacter baumannii clinical isolates in Thailand. Antibiotics, 9.","DOI":"10.3390\/antibiotics9120864"},{"key":"ref_25","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_26","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1016\/j.jgar.2024.03.020","article-title":"Global trends in carbapenem- and difficult-to-treat-resistance among World Health Organization priority bacterial pathogens: ATLAS surveillance program 2018\u20132022","volume":"37","author":"Wise","year":"2024","journal-title":"J. Glob. Antimicrob. Resist."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Elbadawi, H.S., Elhag, K.M., Mahgoub, E., Altayb, H.N., Ntoumi, F., Elton, L., McHugh, T.D., Tembo, J., Ippolito, G., and Osman, A.Y. (2021). Detection and characterization of carbapenem resistant Gram-negative bacilli isolates recovered from hospitalized patients at Soba University Hospital, Sudan. BMC Microbiol., 21.","DOI":"10.1186\/s12866-021-02133-1"},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Chen, Y.C., Tsai, I.T., Lai, C.H., Lin, K.H., and Hsu, Y.C. (2024). Risk Factors and Outcomes of Community-Acquired Carbapenem-Resistant Klebsiella pneumoniae Infection in Elderly Patients. Antibiotics, 13.","DOI":"10.3390\/antibiotics13030282"},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Codjoe, F., and Donkor, E. (2017). Carbapenem Resistance: A Review. Med. Sci., 6.","DOI":"10.3390\/medsci6010001"},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Beig, M., Parvizi, E., Navidifar, T., Bostanghadiri, N., Mofid, M., Golab, N., and Sholeh, M. (2024). Geographical mapping and temporal trends of Acinetobacter baumannii carbapenem resistance: A comprehensive meta-analysis. PLoS ONE, 19.","DOI":"10.1371\/journal.pone.0311124"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1186\/s13756-022-01061-7","article-title":"Phenotype-genotype correlations among carbapenem-resistant Enterobacterales recovered from four Egyptian hospitals with the report of SPM carbapenemase","volume":"11","author":"Abdelaziz","year":"2022","journal-title":"Antimicrob. Resist. Infect. Control"},{"key":"ref_32","first-page":"e72387","article-title":"An Investigation Into Carbapenem Resistance in Enterobacteriaceae Among Outpatients With Urinary Tract Infection in Southwestern Uganda Study profile","volume":"6","author":"Tuhamize","year":"2024","journal-title":"Cureus"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"597","DOI":"10.1016\/S1473-3099(10)70143-2","article-title":"Emergence of a new antibiotic resistance mechanism in India, Pakistan, and the UK: A molecular, biological, and epidemiological study","volume":"10","author":"Kumarasamy","year":"2010","journal-title":"Lancet Infect. Dis."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"407","DOI":"10.3389\/fmicb.2018.00407","article-title":"Occurrence of blaNDM variants among enterobacteriaceae from a neonatal intensive care unit in a Northern India hospital","volume":"9","author":"Ahmad","year":"2018","journal-title":"Front Microbiol."},{"key":"ref_35","first-page":"e75032","article-title":"Genotypic Characterisation of Carbapenem- Resistant Enterobacteriaceae in a Tertiary Care Hospital in South India","volume":"16","author":"Anbazhagan","year":"2024","journal-title":"Cureus"},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Zhang, X., Chen, D., Xu, G., Huang, W., and Wang, X. (2018). Molecular epidemiology and drug-resistant mechanism in carbapenem-resistant Klebsiella pneumoniae isolated from paediatric patients in Shanghai, China. PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0194000"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"14418","DOI":"10.1038\/s41598-024-65106-0","article-title":"Distribution and molecular characterization of carbapenemase-producing gram-negative bacteria in Henan, China","volume":"14","author":"Li","year":"2024","journal-title":"Sci. Rep."},{"key":"ref_38","first-page":"823","article-title":"Phenotyping and Genotyping Evaaluation of E. coli Produces Carbapenemase Isolated from Cancer Patients in Al-Basrah, Iraq","volume":"78","year":"2023","journal-title":"Arch. Razi Inst."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1007\/s11274-023-03565-9","article-title":"High prevalence of extensively drug resistant and extended spectrum beta lactamases (ESBLs) producing uropathogenic Escherichia coli isolated from Faisalabad, Pakistan","volume":"39","author":"Ehsan","year":"2023","journal-title":"World J. Microbiol. Biotechnol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"e30","DOI":"10.26633\/RPSP.2020.30","article-title":"Socioeconomic factors associated with antimicrobial resistance of Pseudomonas aeruginosa, Staphylococcus aureus, and Escherichia coli in Chilean hospitals (2008\u20132017)","volume":"44","author":"Allel","year":"2020","journal-title":"Rev. Panam. Salud P\u00fablica"},{"key":"ref_41","first-page":"13859","article-title":"Drug-resistant gene of blaOXA-23, blaOXA-24, blaOXA-51 and blaOXA-58 in Acinetobacter baumannii","volume":"8","author":"Hou","year":"2015","journal-title":"Int. J. Clin. Exp. Med."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"2576","DOI":"10.47391\/JPMA.01537","article-title":"Molecular detection of blaOXA-23gene and blaOXA-51 gene in carbapenem resistant strains of Acinetobacter baumannii in patients with ventilator associated pneumonia at tertiary care hospital","volume":"71","author":"Ishtiaq","year":"2021","journal-title":"J. Pak. Med. Assoc."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"57","DOI":"10.4103\/ksj.ksj_48_24","article-title":"Awareness Regarding the Disease and Its Prevention amongst Women with Recurrent Urinary Tract Infection: A Cohort Study","volume":"30","author":"Thulasi","year":"2024","journal-title":"Kerala Surg. J."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"dlad062","DOI":"10.1093\/jacamr\/dlad062","article-title":"Drivers of inappropriate antibiotic use in low- and middle-income countries","volume":"5","author":"Otaigbe","year":"2023","journal-title":"JAC-Antimicrob. Resist."},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Neidh\u00f6fer, C., Buechler, C., Neidh\u00f6fer, G., Bierbaum, G., Hannet, I., Hoerauf, A., and Par\u010dina, M. (2021). Global Distribution Patterns of Carbapenemase-Encoding Bacteria in a New Light: Clues on a Role for Ethnicity. Front. Cell. Infect. Microbiol., 11.","DOI":"10.3389\/fcimb.2021.659753"},{"key":"ref_46","doi-asserted-by":"crossref","unstructured":"Theodorakis, N., Feretzakis, G., Hitas, C., Kreouzi, M., Kalantzi, S., Spyridaki, A., Boufeas, I.Z., Sakagianni, A., Paxinou, E., and Verykios, V.S. (2024). Antibiotic Resistance in the Elderly: Mechanisms, Risk Factors, and Solutions. Microorganisms, 12.","DOI":"10.3390\/microorganisms12101978"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1186\/s13756-020-0686-0","article-title":"Risk factors for carbapenem-resistant Klebsiella pneumoniae infection relative to two types of control patients: A systematic review and meta-analysis","volume":"9","author":"Zhu","year":"2020","journal-title":"Antimicrob. Resist. Infect. Control"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"100306","DOI":"10.1016\/j.lansea.2023.100306","article-title":"Response to antimicrobial resistance in South\u2012East Asia Region","volume":"18","author":"Sihombing","year":"2023","journal-title":"Lancet Reg. Health-Southeast Asia"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"224","DOI":"10.1017\/ice.2018.321","article-title":"Point-prevalence study of antimicrobial use in public hospitals in southern Sri Lanka identifies opportunities for improving prescribing practices","volume":"40","author":"Sheng","year":"2019","journal-title":"Infect. Control. Hosp. Epidemiol."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"e01140-18","DOI":"10.1128\/JCM.01140-18","article-title":"Phenotypic detection of carbapenemase-producing organisms from clinical isolates","volume":"56","author":"Tamma","year":"2018","journal-title":"J. Clin. Microbiol."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"495","DOI":"10.4103\/0255-0857.195367","article-title":"Does the presence of Klebsiella pneumoniae carbapenemase and New Delhi metallo-\u03b2-lactamase-1 genes in pathogens lead to fatal outcome ?","volume":"34","author":"Mathur","year":"2016","journal-title":"Indian J. Med. Microbiol."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"3025","DOI":"10.2147\/IDR.S363588","article-title":"Association Between Types of Carbapenemase and Clinical Outcomes of Infection Due to Carbapenem Resistance Enterobacterales","volume":"15","author":"Pudpong","year":"2022","journal-title":"Infect. Drug Resist."},{"key":"ref_53","first-page":"2012","article-title":"Emergence of Escherichia coli, CO-producing NDM-1 and OXA-48 carbapenemases, in urinary isolates, at a tertiary care center at central India","volume":"8","author":"Khajuria","year":"2014","journal-title":"J. Clin. Diagn. Res."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"1393","DOI":"10.2147\/IDR.S298530","article-title":"Risk Factors for and Clinical Outcomes of Nosocomial Infections: A Retrospective Study in a Tertiary Hospital in Beijing, China","volume":"14","author":"Chai","year":"2021","journal-title":"Infect. Drug Resist."},{"key":"ref_55","doi-asserted-by":"crossref","unstructured":"Rule, R., Paruk, F., Becker, P., Neuhoff, M., Chausse, J., and Said, M. (2021). Clinical utility of the BioFire FilmArray Blood Culture Identification panel in the adjustment of empiric antimicrobial therapy in the critically ill septic patient. PLoS ONE, 16.","DOI":"10.1371\/journal.pone.0254389"},{"key":"ref_56","doi-asserted-by":"crossref","unstructured":"Kakizaki, N., Asai, K., Kuroda, M., Watanabe, R., Kujiraoka, M., Sekizuka, T., Katagiri, M., Moriyama, H., Watanabe, M., and Saida, Y. (2023). Rapid identification of bacteria using a multiplex polymerase chain reaction system for acute abdominal infections. Front. Microbiol., 14.","DOI":"10.3389\/fmicb.2023.1220651"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1055\/s-0035-1544208","article-title":"Carbapenemase-producing Enterobacteriaceae","volume":"36","author":"Doi","year":"2015","journal-title":"Semin. Respir. Crit. Care Med."},{"key":"ref_58","unstructured":"CLSI (2023). M100 for Antimicrobial Susceptibility Testing, Clinical and Laboratory Standards Institue. [33rd ed.]. CLSI supplement M100."}],"container-title":["Antibiotics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2079-6382\/15\/6\/529\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,31]],"date-time":"2026-05-31T04:12:17Z","timestamp":1780200737000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2079-6382\/15\/6\/529"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,22]]},"references-count":58,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2026,6]]}},"alternative-id":["antibiotics15060529"],"URL":"https:\/\/doi.org\/10.3390\/antibiotics15060529","relation":{},"ISSN":["2079-6382"],"issn-type":[{"value":"2079-6382","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,22]]}}}