{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T21:17:57Z","timestamp":1790198277512,"version":"4.1.0"},"reference-count":47,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2023,4,23]],"date-time":"2023-04-23T00:00:00Z","timestamp":1682208000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pathogens"],"abstract":"<jats:p>Global dispersion, hospital outbreaks, and lineage relationships between emerging antibiotic-resistant strains such as Klebsiella pneumoniae are of public health interest. This study aimed to isolate and identify K. pneumoniae clones from third-level healthcare hospitals in Mexico to establish their multidrug-resistant phenotype, phylogeny, and prevalence. Biological and abiotic surface samples were used to isolate K. pneumoniae strains and to test their antibiotic susceptibility to classify them. The housekeeping genes: gapA, InfB, mdh, pgi, phoE, ropB, and tonB were used for multilocus sequence typing (MLST). Phylogenetic networks were constructed with 48 strains. Isolated strains (93) were mainly from urine and blood, 96% were resistant to ampicillin as expected, 60% were extended-spectrum \u03b2-lactamases (ESBL), 98% were susceptible to ertapenem and meropenem and 99% were susceptible to imipenem, 46% were multi-drug resistant (MDR), 17% were extensively-drug resistant (XDR), 1% were pan-drug resistant (PDR), and 36% were not classified. The tonB, mdh, and phoE genes were the most variable, and the InfB gene showed positive selection. The most prevalent sequence types (STs) were ST551 (six clones), ST405 (six clones), ST1088 (four clones), ST25 (four clones), ST392 (three clones), and ST36 (two clones). ST706 was PDR, and ST1088 clones were MDR; neither of these STs has been reported in Mexico. The strains analyzed were from different hospitals and locations; thus, it is important to maintain antibiotic surveillance and avoid clone dissemination to prevent outbreaks, adaptation to antibiotics, and the transmission of antibiotic resistance.<\/jats:p>","DOI":"10.3390\/pathogens12050634","type":"journal-article","created":{"date-parts":[[2023,4,24]],"date-time":"2023-04-24T03:38:07Z","timestamp":1682307487000},"page":"634","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Isolation and Identification of Multidrug-Resistant Klebsiella pneumoniae Clones from the Hospital Environment"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7312-3173","authenticated-orcid":false,"given":"Mar\u00eda Guadalupe","family":"C\u00f3rdova-Espinoza","sequence":"first","affiliation":[{"name":"Escuela Nacional de Ciencias Biol\u00f3gicas, Instituto Polit\u00e9cnico Nacional, Departamento de Microbiolog\u00eda, Prolongaci\u00f3n de Carpio y Plan de Ayala S\/N, Col. Casco de Santo Tomas, Alcald\u00eda Miguel Hidalgo, Mexico City 11340, Mexico"},{"name":"Escuela Militar de Graduados de Sanidad SEDENA, Laboratorio de Inmunologia, Batalla de Celaya 202, Col. Lomas de Sotelo, Alcald\u00eda Miguel Hidalgo, Mexico City 11200, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia","family":"Giono-Cerezo","sequence":"additional","affiliation":[{"name":"Escuela Nacional de Ciencias Biol\u00f3gicas, Instituto Polit\u00e9cnico Nacional, Departamento de Microbiolog\u00eda, Prolongaci\u00f3n de Carpio y Plan de Ayala S\/N, Col. Casco de Santo Tomas, Alcald\u00eda Miguel Hidalgo, Mexico City 11340, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erika Gabriela","family":"Sierra-Atanacio","sequence":"additional","affiliation":[{"name":"Escuela Nacional de Ciencias Biol\u00f3gicas, Instituto Polit\u00e9cnico Nacional, Departamento de Microbiolog\u00eda, Prolongaci\u00f3n de Carpio y Plan de Ayala S\/N, Col. Casco de Santo Tomas, Alcald\u00eda Miguel Hidalgo, Mexico City 11340, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alejandro","family":"Escamilla-Guti\u00e9rrez","sequence":"additional","affiliation":[{"name":"Escuela Nacional de Ciencias Biol\u00f3gicas, Instituto Polit\u00e9cnico Nacional, Departamento de Microbiolog\u00eda, Prolongaci\u00f3n de Carpio y Plan de Ayala S\/N, Col. Casco de Santo Tomas, Alcald\u00eda Miguel Hidalgo, Mexico City 11340, Mexico"},{"name":"Instituto Mexicano del Seguro Social, Hospital General \u201cDr. Gaudencio Gonz\u00e1lez Garza\u201d, Centro Medico Nacional La Raza, Privada de las Jacarandas, S\/N, Col. La Raza, Alcald\u00eda Azcapotzalco, Mexico City 02990, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eduardo","family":"Carrillo-Tapia","sequence":"additional","affiliation":[{"name":"Colegio de Ciencias y Humanidades, Universidad Aut\u00f3noma de la Ciudad de M\u00e9xico, Avenida de la Corona 320, Col. Loma de la Palma, Alcaldia Gustavo a Madero, Mexico City 07160, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura Isabel","family":"Carrillo-V\u00e1zquez","sequence":"additional","affiliation":[{"name":"Posgrado en Ciencia Gen\u00f3micas, Universidad Aut\u00f3noma de la Ciudad de M\u00e9xico, San Lorenzo 290, Col. Del Valle, Alcald\u00eda Benito Ju\u00e1rez, Mexico City 03130, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felipe","family":"Mendoza-P\u00e9rez","sequence":"additional","affiliation":[{"name":"Laboratorio de Biotecnolog\u00eda, Departamento de Sistemas Biol\u00f3gicos, Universidad Aut\u00f3noma Metropolitana Unidad Xochimilco, Calzada del Hueso 1100, Col. Villa Quietud, Alcald\u00eda Coyoac\u00e1n, Mexico City 04960, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4940-6194","authenticated-orcid":false,"given":"Martha","family":"Leyte-Lugo","sequence":"additional","affiliation":[{"name":"Laboratorio de Biotecnolog\u00eda, Departamento de Sistemas Biol\u00f3gicos, CONACYT-Universidad Aut\u00f3noma Metropolitana Unidad Xochimilco, Calzada del Hueso 1100, Col. Villa Quietud, Alcald\u00eda Coyoac\u00e1n, Mexico City 04960, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4400-7506","authenticated-orcid":false,"given":"Raquel","family":"Gonz\u00e1lez-V\u00e1zquez","sequence":"additional","affiliation":[{"name":"Laboratorio de Biotecnolog\u00eda, Departamento de Sistemas Biol\u00f3gicos, CONACYT-Universidad Aut\u00f3noma Metropolitana Unidad Xochimilco, Calzada del Hueso 1100, Col. Villa Quietud, Alcald\u00eda Coyoac\u00e1n, Mexico City 04960, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lino","family":"Mayorga-Reyes","sequence":"additional","affiliation":[{"name":"Laboratorio de Biotecnolog\u00eda, Departamento de Sistemas Biol\u00f3gicos, Universidad Aut\u00f3noma Metropolitana Unidad Xochimilco, Calzada del Hueso 1100, Col. Villa Quietud, Alcald\u00eda Coyoac\u00e1n, Mexico City 04960, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosa","family":"Gonz\u00e1lez-V\u00e1zquez","sequence":"additional","affiliation":[{"name":"Escuela Nacional de Ciencias Biol\u00f3gicas, Instituto Polit\u00e9cnico Nacional, Departamento de Microbiolog\u00eda, Prolongaci\u00f3n de Carpio y Plan de Ayala S\/N, Col. Casco de Santo Tomas, Alcald\u00eda Miguel Hidalgo, Mexico City 11340, Mexico"},{"name":"Instituto Mexicano del Seguro Social, Unidad M\u00e9dica de Alta Especialidad, Hospital de Especialidades \u201cDr. Antonio Fraga Mouret\u201d, Centro Medico Nacional La Raza. Seris y Zaachila S\/N, Col. La Raza, Alcald\u00eda Azcapotzalco, Mexico City 02990, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,4,23]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"42","DOI":"10.21149\/10543","article-title":"Antimicrobial resistance and antibiotic consumption in Mexican hospitals","volume":"62","author":"Hernandez","year":"2019","journal-title":"Salud P\u00fablica de M\u00e9xico"},{"key":"ref_2","first-page":"157","article-title":"K. pneumoniae: \u00bfla nueva \u201csuperbacteria\u201d? Patogenicidad, epidemiolog\u00eda y mecanismos de resistencia","volume":"23","year":"2010","journal-title":"Iatreia"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1812","DOI":"10.3201\/eid2011.140206","article-title":"Genomic Definition of Hypervirulent and Multidrug-Resistant Klebsiella pneumoniae clonal groups","volume":"20","author":"Criscuolo","year":"2014","journal-title":"Emerg. Infect. Dis."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Garza-Gonz\u00e1lez, E., Morf\u00edn-Otero, R., Mendoza-Olazar\u00e1n, S., Bocanegra-Ibarias, P., Flores-Trevi\u00f1o, S., Rodr\u00edguez-Noriega, E., Ponce-De-Le\u00f3n, A., Sanchez-Francia, D., Franco-Cendejas, R., and Arroyo-Escalante, S. (2019). A snapshot of antimicrobial resistance in Mexico. Results from 47 centers from 20 states during a six-month period. PLoS ONE, 14.","DOI":"10.1371\/journal.pone.0209865"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"476","DOI":"10.4067\/S0716-10182017000500476","article-title":"KPC: Klebsiella pneumoniae carbapenemasa, principal carbapenemasa en enterobacterias","volume":"34","author":"Lima","year":"2017","journal-title":"Rev. Chilena Infectol."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Wang, Q., Li, B., Tsang, A.K.L., Yi, Y., Woo, P.C.Y., and Liu, C.H. (2013). Genotypic Analysis of Klebsiella pneumoniae Isolates in a Beijing Hospital Reveals High Genetic Diversity and Clonal Population Structure of Drug-Resistant Isolates. PLoS ONE, 8.","DOI":"10.1371\/journal.pone.0057091"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"S18","DOI":"10.1093\/infdis\/jiw378","article-title":"Clinical Implications of Genomic Adaptation and Evolution of Carbapenem-Resistant Klebsiella pneumoniae","volume":"215","author":"Uhlemann","year":"2017","journal-title":"J. Infect. Dis."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"e00080-20","DOI":"10.1128\/mSphere.00080-20","article-title":"Early OXA-48-Producing Enterobacterales Isolates Recovered in a Spanish Hospital Reveal a Complex Introduction Dominated by Sequence Type 11 (ST11) and ST405 Klebsiella pneumoniae Clones","volume":"5","author":"Tedim","year":"2020","journal-title":"Msphere"},{"key":"ref_9","unstructured":"Koneman, E.W., Allen, S., Janda, W.M., Schereckenberger, P.C., and Win Jr, W.C. (2008). Microbiological diagnosis: Text and Color Atlas, Editorial M\u00e9dica Panamericana. [6th ed.]."},{"key":"ref_10","unstructured":"Cerezo, S.G., Gutierrez, A.E., and Gomez, J.L.V. (1994). Secretaria de Salud."},{"key":"ref_11","unstructured":"(2014). Performance Standards for Antimicrobial Susceptibility Testing; Twenty-Fourth Informational Supplement. CLSI Document M100-S24., 34."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1186\/s13742-016-0137-2","article-title":"Streaming algorithms for identification of pathogens and antibiotic resistance potential from real-time MinIONTM sequencing","volume":"5","author":"Cao","year":"2016","journal-title":"Gigascience"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"4178","DOI":"10.1128\/JCM.43.8.4178-4182.2005","article-title":"Multilocus sequence typing of Klebsiella pneumoniae nosocomial isolates","volume":"43","author":"Diancourt","year":"2005","journal-title":"J. Clin. Microbiol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1518","DOI":"10.1128\/JB.186.5.1518-1530.2004","article-title":"eBURST: Inferring patterns of evolutionary descent among clusters of related bacterial genotypes from multilocus sequence typing data","volume":"186","author":"Feil","year":"2004","journal-title":"J. Bacteriol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1230","DOI":"10.1093\/bioinformatics\/17.12.1230","article-title":"Sequence type analysis and recombinational tests (START)","volume":"17","author":"Jolley","year":"2001","journal-title":"Bioinformatics"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1451","DOI":"10.1093\/bioinformatics\/btp187","article-title":"DnaSP v5: A software for comprehensive analysis of DNA polymorphism data","volume":"25","author":"Librado","year":"2009","journal-title":"Bioinformatics"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"983","DOI":"10.1111\/j.1467-8659.2009.01450.x","article-title":"Force-directed edge bundling for graph visualization","volume":"28","author":"Holten","year":"2009","journal-title":"Comput. Graph. Forum"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"W260","DOI":"10.1093\/nar\/gkz303","article-title":"NGPhylogeny.fr: New generation phylogenetic services for non-specialists","volume":"47","author":"Lemoine","year":"2019","journal-title":"Nucleic Acids Res."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"3059","DOI":"10.1093\/nar\/gkf436","article-title":"MAFFT: A novel method for rapid multiple sequence alignment based on fast Fourier transform","volume":"30","author":"Kazutaka","year":"2002","journal-title":"Nucleic Acids Res."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1186\/1471-2148-10-210","article-title":"BMGE (Block Mapping and Gathering with Entropy): A new software for selection of phylogenetic informative regions from multiple sequence alignments","volume":"10","author":"Criscuolo","year":"2010","journal-title":"BMC Evol. Biol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"2798","DOI":"10.1093\/molbev\/msv150","article-title":"FastME 2.0: A Comprehensive, accurate, and fast distance-based phylogeny inference program","volume":"32","author":"Lefort","year":"2015","journal-title":"Mol. Biol. Evol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"609840","DOI":"10.3389\/fmicb.2021.609840","article-title":"Colistin resistance among multiple sequence types of Klebsiella pneumoniae is associated with diverse resistance mechanisms: A report from India","volume":"12","author":"Azam","year":"2021","journal-title":"Front. Microbiol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"e00148-22","DOI":"10.1128\/spectrum.00148-22","article-title":"Extensively drug-resistant Klebsiella pneumoniae counteracts fitness and virulence costs that accompanied ceftazidime-avibactam resistance acquisition","volume":"10","author":"Eger","year":"2022","journal-title":"Microbiol. Spectr."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"4445","DOI":"10.1128\/iai.65.11.4445-4451.1997","article-title":"N-glycosylated proteins are involved in efficient internalization of Klebsiella pneumoniae by cultured human epithelial cells","volume":"65","author":"Fumagalli","year":"1997","journal-title":"Infect. Immun."},{"key":"ref_25","unstructured":"Secretaria de Salud, G.d.M. (2022, June 15). Bolet\u00edn Infecciones Asociadas a la Atenci\u00f3n de la Salud (IAAS) Red Hospitalaria de Vigilancia Epidemiol\u00f3gica (RHOVE). Available online: https:\/\/www.gob.mx\/cms\/uploads\/attachment\/file\/773554\/BOLET_N_RHOVE_SEPTIEMBRE_2022_Final_31102022.pdf."},{"key":"ref_26","unstructured":"Salud, S.d. (2022, June 15). Bolet\u00edn Infecciones Asociadas a la Atenci\u00f3n de la Salud (IAAS) Red Hospitalaria de Vigilancia Epidemiol\u00f3gica (RHOVE). Available online: https:\/\/epidemiologia.salud.gob.mx\/gobmx\/salud\/documentos\/manuales\/28_Manual_RHoVE.pdf."},{"key":"ref_27","first-page":"17","article-title":"Frecuencia de infecciones asociadas a la atenci\u00f3n de la salud en los principales sistemas de informaci\u00f3n de M\u00e9xico","volume":"3","year":"2018","journal-title":"Bolet\u00edn CONAMED-OPS"},{"key":"ref_28","first-page":"181","article-title":"Bacterial drug resistance of priority pathogens isolated in Chilpancingo, Guerrero, Mexico","volume":"68","year":"2022","journal-title":"Revista Mexicana de Patolog\u00eda Cl\u00ednica y Medicina de Laboratorio"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"106535","DOI":"10.1016\/j.ijantimicag.2022.106535","article-title":"Prevalence of ESBL non-CRE Escherichia coli and Klebsiella pneumoniae among clinical isolates collected by the SMART global surveillance programme from 2015 to 2019","volume":"59","author":"Karlowsky","year":"2022","journal-title":"Int. J. Antimicrob. Agents"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"483","DOI":"10.1016\/j.diagmicrobio.2014.05.010","article-title":"Characteristics of KPC-2\u2013producing Klebsiella pneumoniae (ST258) clinical isolates from outbreaks in 2 Mexican medical centers","volume":"79","author":"Barrios","year":"2014","journal-title":"Diagn. Microbiol. Infect. Dis."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"4086","DOI":"10.1128\/AAC.02530-12","article-title":"First outbreak of KPC-3-producing Klebsiella pneumoniae (ST258) clinical isolates in a Mexican Medical Center","volume":"57","author":"Barrios","year":"2013","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1186\/s12866-018-1166-z","article-title":"Carbapenemase-producing Enterobacteriaceae in Mexico: Report of seven non-clonal cases in a pediatric hospital","volume":"18","author":"Ranero","year":"2018","journal-title":"BMC Microbiol."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Torres-Gonzalez, P., Cervera-Hernandez, M., Niembro-Ortega, M.D., Leal-Vega, F., Cruz-Hervert, L.P., Garc\u00eda-Garc\u00eda, L., Galindo-Fraga, A., Martinez-Gamboa, A., Valle, M.B.-D., and Sifuentes-Osornio, J. (2015). Factors associated to prevalence and incidence of carbapenem-resistant enterobacteriaceae fecal carriage: A cohort study in a mexican tertiary care hospital. PLoS One, 10.","DOI":"10.1371\/journal.pone.0139883"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1089\/fpd.2020.2847","article-title":"Klebsiella pneumoniae: Prevalence, reservoirs, antimicrobial resistance, pathogenicity, and infection: A hitherto unrecognized zoonotic bacterium","volume":"18","author":"Hu","year":"2021","journal-title":"Foodborne Pathog. Dis."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"422","DOI":"10.1089\/mdr.2017.0073","article-title":"Nosocomial, multidrug-resistant Klebsiella pneumoniae strains isolated from mexico city produce robust biofilms on abiotic surfaces but not on human lung cells","volume":"24","author":"Sakai","year":"2018","journal-title":"Microb. Drug Resist."},{"key":"ref_36","first-page":"fux053","article-title":"Environmental factors influencing the development and spread of antibiotic resistance","volume":"42","author":"Kristiansson","year":"2017","journal-title":"FEMS Microbiol. Rev."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"404","DOI":"10.3855\/jidc.13573","article-title":"An unequivocal superbug: PDR Klebsiella pneumoniae with an arsenal of resistance and virulence factor genes","volume":"15","author":"Sleiman","year":"2021","journal-title":"J. Infect. Dev. Ctries."},{"key":"ref_38","first-page":"62","article-title":"An\u00e1lisis de las bacteremias por Klebsiella pneumoniae en pacientes del Hospital M\u00e9xico","volume":"58","year":"2016","journal-title":"Acta Med. Costarric."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1476","DOI":"10.1099\/jmm.0.000577","article-title":"Fluoroquinolone resistance in extended-spectrum \u03b2-lactamase-producing Klebsiella pneumoniae in a Japanese tertiary hospital: Silent shifting to CTX-M-15-producing K. pneumoniae","volume":"66","author":"Higashino","year":"2017","journal-title":"J. Med. Microbiol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"e0179651","DOI":"10.1371\/journal.pone.0179651","article-title":"Molecular and microbiological report of a hospital outbreak of NDM-1-carrying Enterobacteriaceae in Mexico","volume":"12","author":"Barrios","year":"2017","journal-title":"PLoS ONE"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"739","DOI":"10.3201\/eid2504.181482","article-title":"Klebsiella pneumoniae ST307 with blaOXA-181, South Africa, 2014\u20132016","volume":"25","author":"Lowe","year":"2019","journal-title":"Emerg. Infect. Dis."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1016\/j.jgar.2018.06.008","article-title":"Population structure of OXA-48-producing Klebsiella pneumoniae ST405 isolates during a hospital outbreak characterised by genomic typing","volume":"15","author":"Wesselink","year":"2018","journal-title":"J. Glob. Antimicrob. Resist."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"260","DOI":"10.1186\/s12866-015-0597-z","article-title":"Molecular epidemiology of carbapenem resistant Enterobacteriaceae in Valle d\u2019Aosta region, Italy, shows the emergence of KPC-2 producing Klebsiella pneumoniae clonal complex 101 (ST101 and ST1789)","volume":"15","author":"Paone","year":"2015","journal-title":"BMC Microbiol."},{"key":"ref_44","first-page":"e000110","article-title":"Diversity, virulence, and antimicrobial resistance of the KPC-producing Klebsiella pneumoniae ST307 clone","volume":"3","author":"Villa","year":"2017","journal-title":"Microb. Genom."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"118","DOI":"10.1016\/j.scitotenv.2019.06.076","article-title":"What antibiotics for what pathogens? The sensitivity spectrum of isolated strains in an intensive care unit","volume":"687","author":"Zaha","year":"2019","journal-title":"Sci. Total Environ."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"475","DOI":"10.1159\/000346352","article-title":"One-Year Surveillance of ESKAPE Pathogens in an Intensive Care Unit of Monterrey, Mexico","volume":"58","author":"Flores","year":"2012","journal-title":"Chemotherapy"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"208","DOI":"10.1186\/s40168-022-01407-8","article-title":"Human microbiota drives hospital-associated antimicrobial resistance dissemination in the urban environment and mirrors patient case rates","volume":"10","author":"Salazar","year":"2022","journal-title":"Microbiome"}],"container-title":["Pathogens"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-0817\/12\/5\/634\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T19:21:34Z","timestamp":1760124094000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-0817\/12\/5\/634"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,4,23]]},"references-count":47,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2023,5]]}},"alternative-id":["pathogens12050634"],"URL":"https:\/\/doi.org\/10.3390\/pathogens12050634","relation":{},"ISSN":["2076-0817"],"issn-type":[{"value":"2076-0817","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,4,23]]}}}