{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T20:27:08Z","timestamp":1791664028285,"version":"4.3.4"},"reference-count":61,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2024,1,4]],"date-time":"2024-01-04T00:00:00Z","timestamp":1704326400000},"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>The interruption of bacteriological surveillance due to the COVID-19 pandemic brought serious consequences, such as the collapse of health systems and the possible increase in antimicrobial resistance. Therefore, it is necessary to know the rate of resistance and its associated mechanisms in bacteria causing hospital infections during the pandemic. The aim of this work was to show the phenotypic and molecular characteristics of antimicrobial resistance in ESKAPE bacteria in a Mexican tertiary care hospital in the second and third years of the pandemic. For this purpose, during 2021 and 2022, two hundred unduplicated strains of the ESKAPE group (Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, and Acinetobacter baumannii) were collected from various clinical sources and categorized by resistance according to the CLSI. An analysis of variance (ANOVA) complemented by the Tukey test was performed to search for changes in antimicrobial susceptibility profiles during the study period. Finally, the mechanisms of resistance involved in carbapenem resistance were analyzed, and the search for efflux pumps and high-risk sequence types in A. baumannii was performed by multilocus analysis (MLST). The results showed no changes in K. pneumoniae resistance during the period analyzed. Decreases in quinolone resistance were identified in E. coli (p = 0.039) and P. aeruginosa (p = 0.03). Interestingly, A. baumannii showed increases in resistance to penicillins (p = 0.004), aminoglycosides (p &lt; 0.001, p = 0.027), carbapenems (p = 0.027), and folate inhibitors (p = 0.001). Several genes involved in carbapenem resistance were identified (blaNDM, blaVIM, blaOXA, blaKPC, blaOXA-40, and blaOXA-48) with a predominance of blaOXA-40 and the adeABCRS efflux pump in A. baumannii. Finally, MLST analysis revealed the presence of globally distributed sequence types (ST369 and ST758) related to hospital outbreaks in other parts of the world. The results presented demonstrate that the ESKAPE group has played an important role during the COVID-19 pandemic as nosocomial antibiotic-resistant pathogens and in particular A. baumannii MDR as a potential reservoir of resistance genes. The implications of the increases in antimicrobial resistance in pathogens of the ESKAPE group and mainly in A. baumannii during the COVID-19 pandemic are analyzed and discussed.<\/jats:p>","DOI":"10.3390\/pathogens13010050","type":"journal-article","created":{"date-parts":[[2024,1,5]],"date-time":"2024-01-05T03:43:00Z","timestamp":1704426180000},"page":"50","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["Gram-Negative ESKAPE Bacteria Surveillance in COVID-19 Pandemic Exposes High-Risk Sequence Types of Acinetobacter baumannii MDR in a Tertiary Care Hospital"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4556-637X","authenticated-orcid":false,"given":"M\u00f3nica Alethia","family":"Cure\u00f1o-D\u00edaz","sequence":"first","affiliation":[{"name":"Hospital Ju\u00e1rez de M\u00e9xico, Mexico City 07760, Mexico"},{"name":"Facultad de Ciencias de la Salud, Doctorado en Ciencias de la Salud, Universidad An\u00e1huac, Naucalpan de Ju\u00e1rez 52786, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Estibeyesbo Said","family":"Plascencia-Nieto","sequence":"additional","affiliation":[{"name":"Secci\u00f3n de Estudios de Posgrado e Investigaci\u00f3n, Escuela Superior de Medicina, Instituto Polit\u00e9cnico Nacional, Mexico City 11340, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5383-8737","authenticated-orcid":false,"given":"Miguel \u00c1ngel","family":"Loyola-Cruz","sequence":"additional","affiliation":[{"name":"Hospital Ju\u00e1rez de M\u00e9xico, Mexico City 07760, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1555-3102","authenticated-orcid":false,"given":"Clemente","family":"Cruz-Cruz","sequence":"additional","affiliation":[{"name":"Hospital Ju\u00e1rez de M\u00e9xico, Mexico City 07760, Mexico"},{"name":"Secci\u00f3n de Estudios de Posgrado e Investigaci\u00f3n, Escuela Superior de Medicina, Instituto Polit\u00e9cnico Nacional, Mexico City 11340, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-7069-8015","authenticated-orcid":false,"given":"Andres Emmanuel","family":"Nolasco-Rojas","sequence":"additional","affiliation":[{"name":"Hospital Ju\u00e1rez de M\u00e9xico, Mexico City 07760, Mexico"},{"name":"Secci\u00f3n de Estudios de Posgrado e Investigaci\u00f3n, Escuela Superior de Medicina, Instituto Polit\u00e9cnico Nacional, Mexico City 11340, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8985-486X","authenticated-orcid":false,"given":"Emilio Mariano","family":"Dur\u00e1n-Manuel","sequence":"additional","affiliation":[{"name":"Hospital Ju\u00e1rez de M\u00e9xico, Mexico City 07760, Mexico"},{"name":"Secci\u00f3n de Estudios de Posgrado e Investigaci\u00f3n, Escuela Superior de Medicina, Instituto Polit\u00e9cnico Nacional, Mexico City 11340, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7969-0942","authenticated-orcid":false,"given":"Gabriela","family":"Ib\u00e1\u00f1ez-Cervantes","sequence":"additional","affiliation":[{"name":"Hospital Ju\u00e1rez de M\u00e9xico, Mexico City 07760, Mexico"},{"name":"Secci\u00f3n de Estudios de Posgrado e Investigaci\u00f3n, Escuela Superior de Medicina, Instituto Polit\u00e9cnico Nacional, Mexico City 11340, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erika","family":"G\u00f3mez-Zamora","sequence":"additional","affiliation":[{"name":"Hospital Ju\u00e1rez de M\u00e9xico, Mexico City 07760, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0201-0184","authenticated-orcid":false,"given":"Mar\u00eda Concepci\u00f3n","family":"Tamayo-Ord\u00f3\u00f1ez","sequence":"additional","affiliation":[{"name":"Laboratorio de Ingenier\u00eda Gen\u00e9tica, Departamento de Biotecnolog\u00eda, Facultad de Ciencias Qu\u00edmicas, Universidad Aut\u00f3noma de Coahuila, Coahuila 25280, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yahaira de Jes\u00fas","family":"Tamayo-Ord\u00f3\u00f1ez","sequence":"additional","affiliation":[{"name":"Laboratorio de Biotecnolog\u00eda Ambiental, Centro de Biotecnolog\u00eda Gen\u00f3mica, Instituto Polit\u00e9cnico Nacional, Reynosa 88710, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5893-8566","authenticated-orcid":false,"given":"Claudia Camelia","family":"Calzada-Mendoza","sequence":"additional","affiliation":[{"name":"Secci\u00f3n de Estudios de Posgrado e Investigaci\u00f3n, Escuela Superior de Medicina, Instituto Polit\u00e9cnico Nacional, Mexico City 11340, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9957-3807","authenticated-orcid":false,"given":"Juan Manuel","family":"Bello-L\u00f3pez","sequence":"additional","affiliation":[{"name":"Hospital Ju\u00e1rez de M\u00e9xico, Mexico City 07760, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,1,4]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1079","DOI":"10.1086\/533452","article-title":"Federal funding for the study of antimicrobial resistance in nosocomial pathogens: No ESKAPE","volume":"197","author":"Rice","year":"2008","journal-title":"J. Infect. Dis."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Loyola-Cruz, M.\u00c1., Gonzalez-Avila, L.U., Mart\u00ednez-Trejo, A., Salda\u00f1a-Padilla, A., Hern\u00e1ndez-Cortez, C., Bello-L\u00f3pez, J.M., and Castro-Escarpulli, G. (2023). ESKAPE and Beyond: The Burden of Coinfections in the COVID-19 Pandemic. Pathogens, 12.","DOI":"10.3390\/pathogens12050743"},{"key":"ref_3","first-page":"2200672","article-title":"Clinical epidemiology and case fatality due to antimicrobial resistance in Germany: A systematic review and meta-analysis, 1 January 2010 to 31 December 2021","volume":"28","author":"Ayobami","year":"2023","journal-title":"Euro Surveill."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1186\/s13756-023-01250-y","article-title":"Epidemiology of community origin of major multidrug-resistant ESKAPE uropathogens in a paediatric population in South-East Gabon","volume":"12","author":"Onanga","year":"2023","journal-title":"Antimicrob. Resist. Infect. Control"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"58","DOI":"10.3855\/jidc.13545","article-title":"Clonal dispersion of Acinetobacter baumannii in an intensive care unit designed to patients COVID-19","volume":"15","year":"2021","journal-title":"J. Infect. Dev. Ctries"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"e15007","DOI":"10.7717\/peerj.15007","article-title":"Gram-negative ESKAPE bacteria bloodstream infections in patients during the COVID-19 pandemic","volume":"11","year":"2023","journal-title":"PeerJ."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"729","DOI":"10.1016\/j.ajic.2022.08.012","article-title":"ESKAPE bacteria characterization reveals the presence of Acinetobacter baumannii and Pseudomonas aeruginosa outbreaks in COVID-19\/VAP patients","volume":"51","year":"2023","journal-title":"Am. J. Infect. Control"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1186\/s13613-020-00775-4","article-title":"Ventilator-associated pneumonia in patients with SARS-CoV-2-associated acute respiratory distress syndrome requiring ECMO: A retrospective cohort study","volume":"10","author":"Luyt","year":"2020","journal-title":"Ann. Intensive Care"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"110139","DOI":"10.1016\/j.mehy.2020.110139","article-title":"Ventilator-associated pneumonia (VAP) caused by carbapenem-resistant Acinetobacter baumannii in patients with COVID-19: Two problems, one solution?","volume":"144","author":"Lima","year":"2020","journal-title":"Med. Hypotheses"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"417","DOI":"10.1007\/s40121-020-00306-5","article-title":"COVID-19: An Alert to Ventilator-Associated Bacterial Pneumonia","volume":"9","author":"Chianca","year":"2020","journal-title":"Infect. Dis. Ther."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Masoud, S.S., Kovacevich, A., Gangji, R., Nyawale, H., Nyange, M., and Ntukula, A. (2022). Extent and Resistance Patterns of ESKAPE Pathogens Isolated in Pus Swabs from Hospitalized Patients. Can. J. Infect. Dis. Med. Microbiol., 2022.","DOI":"10.1155\/2022\/3511306"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1093\/ofid\/ofz503","article-title":"ESKAPE Pathogens in Bloodstream Infections Are Associated With Higher Cost and Mortality but Can Be Predicted Using Diagnoses Upon Admission","volume":"6","author":"Marturano","year":"2019","journal-title":"Open Forum Infect. Dis."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1186\/s13756-019-0590-7","article-title":"Economic burden of antibiotic resistance in ESKAPE organisms: A systematic review","volume":"8","author":"Zhen","year":"2019","journal-title":"Antimicrob. Resist. Infect. Control"},{"key":"ref_14","first-page":"e21","article-title":"Incidence and costs of ventilator-associated pneumonia in the adult intensive care unit of a tertiary referral hospital in Mexico","volume":"9","year":"2019","journal-title":"Am. J. Infect. Control"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"e314","DOI":"10.1017\/S0950268819001900","article-title":"Impact of mechanical ventilation on the daily costs of ICU care: A systematic review and meta regression","volume":"147","author":"Kaier","year":"2019","journal-title":"Epidemiol Infect."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1177\/1751143717740804","article-title":"Cost of treating ventilator-associated pneumonia post cardiac surgery in the National Health Service: Results from a propensity-matched cohort study","volume":"19","author":"Luckraz","year":"2018","journal-title":"J. Intensive Care Soc."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"928","DOI":"10.1016\/j.ajic.2020.11.027","article-title":"A systematic scoping review of the cost-impact of ventilator-associated pneumonia (VAP) intervention bundles in intensive care","volume":"7","author":"Ladbrook","year":"2021","journal-title":"Am. J. Infect. Control"},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Venkateswaran, P., Vasudevan, S., David, H., Shaktivel, A., Shanmugam, K., Neelakantan, P., and Solomon, A.P. (2023). Revisiting ESKAPE Pathogens: Virulence, resistance, and combating strategies focusing on quorum sensing. Front. Cell. Infect. Microbiol., 13.","DOI":"10.3389\/fcimb.2023.1159798"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"992","DOI":"10.1086\/605539","article-title":"Bad bugs, no drugs: No ESCAPE revisited","volume":"6","author":"Peterson","year":"2009","journal-title":"Clin. Infect. Dis."},{"key":"ref_20","first-page":"1037","article-title":"Mortality attributable to nosocomial Clostridium difficile-associated disease during an epidemic caused by a hypervirulent strain in Quebec","volume":"9","author":"Valiquette","year":"2005","journal-title":"CMAJ."},{"key":"ref_21","first-page":"E508","article-title":"Implementation of control measures against an outbreak due to Clostridioides difficile producing toxin B in a tertiary hospital in Mexico","volume":"2","year":"2021","journal-title":"J. Prev. Med. Hyg."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Gajd\u00e1cs, M., and Albericio, F. (2019). Antibiotic Resistance: From the Bench to Patients. Antibiotics, 3.","DOI":"10.3390\/antibiotics8030129"},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Cruz-C\u00f3rdova, A., Mancilla-Rojano, J., Luna-Pineda, V.M., Escalona-Venegas, G., C\u00e1zares-Dom\u00ednguez, V., Ormsby, C., Franco-Hern\u00e1ndez, I., Zavala-Vega, S., Hern\u00e1ndez, M.A., and Medina-Pelcastre, M. (2020). Molecular Epidemiology, Antibiotic Resistance, and Virulence Traits of Stenotrophomonas maltophilia Strains Associated with an Outbreak in a Mexican Tertiary Care Hospital. Front. Cell. Infect. Microbiol., 10.","DOI":"10.3389\/fcimb.2020.00050"},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Benk\u0151, R., Gajd\u00e1cs, M., Matuz, M., Bod\u00f3, G., L\u00e1z\u00e1r, A., Hajd\u00fa, E., Papfalvi, E., Hannauer, P., Erd\u00e9lyi, P., and Pet\u0151, Z. (2020). Prevalence and Antibiotic Resistance of ESKAPE Pathogens Isolated in the Emergency Department of a Tertiary Care Teaching Hospital in Hungary: A 5-Year Retrospective Survey. Antibiotics, 9.","DOI":"10.3390\/antibiotics9090624"},{"key":"ref_25","first-page":"657","article-title":"Klebsiella pneumoniae blaNDM-1 carrying a class 1 integron causing a hospital outbreak in a Mexican attention center","volume":"1","year":"2021","journal-title":"J. Infect. Dev. Ctries"},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Dur\u00e1n-Manuel, E.M., Loyola-Cruz, M.\u00c1., Cruz-Cruz, C., Ib\u00e1\u00f1ez-Cervantes, G., Gayt\u00e1n-Cervantes, J., Gonz\u00e1lez-Torres, C., Quiroga-Vargas, E., Calzada-Mendoza, C.C., Cure\u00f1o-D\u00edaz, M.A., and Fern\u00e1ndez-S\u00e1nchez, V. (2022). Massive sequencing of the V3-V4 hypervariable region of bronchoalveolar lavage from patients with COVID-19 and VAP reveals the collapse of the pulmonary microbiota. J. Med. Microbiol., 71.","DOI":"10.1099\/jmm.0.001634"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1474","DOI":"10.1016\/j.ajic.2021.09.012","article-title":"Impact of the modification of a cleaning and disinfection method of mechanical ventilators of COVID-19 patients and ventilator-associated pneumonia: One year of experience","volume":"49","year":"2021","journal-title":"Am. J. Infect. Control"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1016\/j.ajic.2022.03.037","article-title":"Disinfection efficacy of ozone on ESKAPE bacteria biofilms: Potential use in difficult-to-access medical devices","volume":"51","year":"2023","journal-title":"Am. J. Infect. Control"},{"key":"ref_29","first-page":"338","article-title":"Increment Antimicrobial Resistance During the COVID-19 Pandemic: Results from the Invifar Network","volume":"28","year":"2022","journal-title":"Microb. Drug. Resist."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"302","DOI":"10.1016\/j.cmi.2022.12.006","article-title":"Antibiotic resistance associated with the COVID-19 pandemic: A systematic review and meta-analysis","volume":"29","author":"Langford","year":"2023","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_31","unstructured":"CLSI (2022). Performance Standards for Antimicrobial Susceptibility Testing, Clinical and Laboratory Standards Institute. [32nd ed.]. CLSI Suppl. M100."},{"key":"ref_32","first-page":"e65","article-title":"Consenso latinoamericano para definir, categorizar y notificar pat\u00f3genos multirresistentes, con resistencia extendida o panresistentes [Latin American consensus to define, categorize, and report multidrug-resistant, extensively drug-resistant, or pandrug-resistant pathogensConsenso latino-americano para defini\u00e7\u00e3o, categoriza\u00e7\u00e3o e notifica\u00e7\u00e3o de pat\u00f3genos multirresistentes, com resist\u00eancia ampliada ou panresistentes]","volume":"43","author":"Galas","year":"2019","journal-title":"Rev. Panam. Salud. Publica."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1229","DOI":"10.1093\/bioinformatics\/btx763","article-title":"shinyCircos: An R\/Shiny application for interactive creation of Circos plot","volume":"34","author":"Yu","year":"2018","journal-title":"Bioinformatics"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"2321","DOI":"10.1128\/JCM.00193-17","article-title":"Modified carbapenem inactivation method for phenotypic detection of carbapenemase production among Enterobacteriaceae","volume":"55","author":"Pierce","year":"2017","journal-title":"J. Clin. Microbiol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"490","DOI":"10.1093\/jac\/dkp498","article-title":"Development of a set of multiplex PCR assays for the detection of genes encoding important \u03b2-lactamases in Enterobacteriaceae","volume":"65","author":"Dallenne","year":"2010","journal-title":"J. Antimicrob. Chemother."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"718","DOI":"10.1128\/JCM.01773-10","article-title":"How to detect NDM-1 producers","volume":"49","author":"Nordmann","year":"2011","journal-title":"J. Clin. Microbiol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"4114","DOI":"10.1128\/AAC.00778-06","article-title":"Analysis of antibiotic resistance genes in multidrug-resistant Acinetobacter sp. isolates from military and civilian patients treated at the Walter Reed Army Medical Center","volume":"50","author":"Hujer","year":"2006","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Alc\u00e1ntar-Curiel, M.D., Rosales-Reyes, R., Jarillo-Quijada, M.D., Gayosso-V\u00e1zquez, C., Fern\u00e1ndez-V\u00e1zquez, J.L., Toledano-Tableros, J.E., Giono-Cerezo, S., Garza-Villafuerte, P., L\u00f3pez-Huerta, A., and Vences-Vences, D. (2019). Carbapenem-Resistant Acinetobacter baumannii in Three Tertiary Care Hospitals in Mexico: Virulence Profiles, Innate Immune Response and Clonal Dissemination. Front. Microbiol., 10.","DOI":"10.3389\/fmicb.2019.02116"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"4382","DOI":"10.1128\/JCM.43.9.4382-4390.2005","article-title":"Development of a multilocus sequence typing scheme for characterization of clinical isolates of Acinetobacter baumannii","volume":"43","author":"Bartual","year":"2005","journal-title":"J. Clin. Microbiol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"188","DOI":"10.1007\/s00134-020-06323-9","article-title":"Relationship between SARS-CoV-2 infection and the incidence of ventilator-associated lower respiratory tract infections: A European multicenter cohort study","volume":"47","author":"Povoa","year":"2021","journal-title":"Intensive Care Med."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1186\/s13054-021-03588-4","article-title":"Relationship between ventilator-associated pneumonia and mortality in COVID-19 patients: A planned ancillary analysis of the coVAPid cohort","volume":"25","author":"Nseir","year":"2021","journal-title":"Crit. Care"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1375","DOI":"10.1016\/j.jiph.2021.08.003","article-title":"Bacterial and fungal ventilator associated pneumonia in critically ill COVID-19 patients during the second wave","volume":"14","author":"Meawed","year":"2021","journal-title":"J. Infect. Public Health"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"372","DOI":"10.18683\/germs.2022.1341","article-title":"Antimicrobial resistance pattern in clinical Escherichia coli and Pseudomonas aeruginosa isolates obtained from a secondary-care hospital prior to and during the COVID-19 pandemic in Kuwait","volume":"12","author":"Alali","year":"2022","journal-title":"Germs"},{"key":"ref_44","first-page":"156","article-title":"Antibiotics susceptibility of Escherichia coli isolates from clinical specimens before and during COVID-19 pandemic","volume":"2","author":"Wardoyo","year":"2021","journal-title":"Iran J. Microbiol."},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Chatterjee, N., Nirwan, P.K., Srivastava, S., Rati, R., Sharma, L., Sharma, P., Dwivedi, P., and Jaggi, N. (2023). Trends in carbapenem resistance in Pre-COVID and COVID times in a tertiary care hospital in North India. Ann. Clin. Microbiol. Antimicrob., 22.","DOI":"10.1186\/s12941-022-00549-9"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"350","DOI":"10.1016\/j.bjid.2015.03.009","article-title":"Spread of multidrug-resistant Acinetobacter baumannii and Pseudomonas aeruginosa clones in patients with ventilator-associated pneumonia in an adult intensive care unit at a university hospital","volume":"4","author":"Royer","year":"2015","journal-title":"Braz. J. Infect. Dis."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1007\/s42399-021-01114-9","article-title":"Evaluation of Bacterial Coinfection and Antibiotic Resistance in Patients with COVID-19 Under Mechanical Ventilation","volume":"4","author":"Jamnani","year":"2022","journal-title":"SN Compr. Clin. Med."},{"key":"ref_48","first-page":"115","article-title":"Microbiological profile of bacteria causing ventilator-associated pneumonia in the intensive care unit of a high-complexity hospital","volume":"40","year":"2023","journal-title":"Rev. Peru. Med. Exp. Salud Publica"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"769","DOI":"10.2147\/IDR.S394777","article-title":"Pathogen Burden Among ICU Patients in a Tertiary Care Hospital in Hail Saudi Arabia with Particular Reference to \u03b2-Lactamases Profile","volume":"16","author":"Saleem","year":"2023","journal-title":"Infect. Drug Resist."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"102628","DOI":"10.1016\/j.plasmid.2022.102628","article-title":"Evolution of Acinetobacter baumannii plasmids carrying the oxa58 carbapenemase resistance gene via plasmid fusion, IS26-mediated events and dif module shuffling","volume":"121","author":"Jones","year":"2022","journal-title":"Plasmid"},{"key":"ref_51","first-page":"625","article-title":"A conjugative plasmid carrying the carbapenem resistance gene blaOXA-23 in AbaR4 in an extensively resistant GC1 Acinetobacter baumannii isolate","volume":"10","author":"Hamidian","year":"2014","journal-title":"J. Antimicrob. Chemother."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"1045","DOI":"10.1111\/eva.13441","article-title":"Co-evolutionary adaptations of Acinetobacter baumannii and a clinical carbapenemase-encoding plasmid during carbapenem exposure","volume":"7","author":"Zhang","year":"2022","journal-title":"Evol. Appl."},{"key":"ref_53","first-page":"119","article-title":"Emergence and spread of carbapenem-resistant Acinetobacter baumannii international clones II and III in Lima, Peru","volume":"7","author":"Roca","year":"2018","journal-title":"Emerg. Microbes Infect."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"2684","DOI":"10.1128\/AAC.44.10.2684-2688.2000","article-title":"Molecular characterization of integrons in Acinetobacter baumannii: Description of a hybrid class 2 integron","volume":"44","author":"Ploy","year":"2000","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_55","first-page":"303","article-title":"Mechanisms responsible for the emergence of carbapenem resistance in Pseudomonas aeruginosa","volume":"6","author":"Meletis","year":"2012","journal-title":"Hippokratia"},{"key":"ref_56","doi-asserted-by":"crossref","unstructured":"S\u0142oczy\u0144ska, A., Wand, M.E., Bock, L.J., Tyski, S., and Laudy, A.E. (2023). Efflux-Related Carbapenem Resistance in Acinetobacter baumannii Is Associated with Two-Component Regulatory Efflux Systems\u2019 Alteration and Insertion of \u0394AbaR25-Type Island Fragment. Int. J. Mol. Sci., 24.","DOI":"10.3390\/ijms24119525"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"7957","DOI":"10.4103\/jfmpc.jfmpc_1117_22","article-title":"Rapid spread and high mortality due to community-acquired pneumonia caused by Acinetobacter baumannii (CAP-AB) in a COVID-19 intensive care unit","volume":"12","author":"Shafigh","year":"2022","journal-title":"J. Family Med. Prim. Care"},{"key":"ref_58","doi-asserted-by":"crossref","unstructured":"Hwang, S.M., Cho, H.W., Kim, T.Y., Park, J.S., Jung, J., Song, K.H., Lee, H., Kim, E.S., Kim, H.B., and Park, K.U. (2021). Whole-Genome Sequencing for Investigating a Health Care-Associated Outbreak of Carbapenem-Resistant Acinetobacter baumannii. Diagnostics, 11.","DOI":"10.3390\/diagnostics11020201"},{"key":"ref_59","first-page":"522","article-title":"Carbapenem-resistant Acinetobacter baumannii causing osteomyelitis and infections of skin and soft tissues in hospitals of Medell\u00edn, Colombia","volume":"35","author":"Vanegas","year":"2015","journal-title":"Biomedica"},{"key":"ref_60","doi-asserted-by":"crossref","unstructured":"Mancilla-Rojano, J., Castro-Jaimes, S., Ochoa, S.A., Bobadilla Del Valle, M., Luna-Pineda, V.M., Bustos, P., Laris-Gonz\u00e1lez, A., Arellano-Galindo, J., Parra-Ortega, I., and Hern\u00e1ndez-Castro, R. (2019). Whole-Genome Sequences of Five Acinetobacter baumannii strains from a child with leukemia M2. Front. Microbiol., 10.","DOI":"10.3389\/fmicb.2019.00132"},{"key":"ref_61","unstructured":"(2023, November 21). Public Databases for Molecular Typing and Microbial Genome Diversity (PubMLST). Available online: https:\/\/pubmlst.org\/bigsdb?page=profileInfo&db=pubmlst_abaumannii_seqdef&scheme_id=1&profile_id=1679."}],"container-title":["Pathogens"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-0817\/13\/1\/50\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T13:40:13Z","timestamp":1760103613000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-0817\/13\/1\/50"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1,4]]},"references-count":61,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,1]]}},"alternative-id":["pathogens13010050"],"URL":"https:\/\/doi.org\/10.3390\/pathogens13010050","relation":{},"ISSN":["2076-0817"],"issn-type":[{"value":"2076-0817","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,1,4]]}}}