{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,28]],"date-time":"2026-02-28T23:11:06Z","timestamp":1772320266729,"version":"3.50.1"},"reference-count":75,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2024,11,13]],"date-time":"2024-11-13T00:00:00Z","timestamp":1731456000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"CONAHCYT","award":["373176"],"award-info":[{"award-number":["373176"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pathogens"],"abstract":"<jats:p>Pseudomonas aeruginosa is a leading cause of healthcare-associated infections, which are related to substantial morbidity and mortality. The incidence of Plasmid-Mediated Quinolone Resistance (PMQR) determinants has been previously reported in this bacterium. However, there is limited information regarding the presence of PMQR and carbapenemase-encoding genes simultaneously. This study aims to analyze the prevalence of these determinants on P. aeruginosa strain isolated from clinical patients in the State of Aguascalientes, Mexico. Fifty-two P. aeruginosa isolates from nosocomial patients were collected from Centenario Hospital Miguel Hidalgo. This is a retrospective observational study conducted at a single center. Antibiotic susceptibility was tested using the Vitek-2 system. Only carbapenem-resistant isolates were included in this study. Carbapenemase-encoding genes and PMQR determinants were screened by polymerase chain reaction (PCR). Resistance rates of 100% were found on tigecycline and ceftriaxone. Of the 52 isolates, 34.6% were positive for the qnr genes, 46.2% for the oqxA gene, and 25% for the aac-(6\u2032)-lb gene. The most frequent carbapenemase genes found in the samples were blaOXA-51 (42.3%), blaOXA-1 (15.4%), and blaVIM (15.4%). blaOXA-51 co-carrying oqxA was detected in 21.1% of the isolates, blaOXA-51 co-carrying aac-(6\u2019)-lb in 11.5%, blaVIM co-carrying aac-(6\u2032)-lb in 3.8%, and blaKPC co-carrying oqxA in 5.8%. Systematic surveillance to detect carbapenemase-encoding genes and PMQR determinants, and rational prescription using the last-line drugs could help in preventing the dissemination of multidrug-resistant determinants.<\/jats:p>","DOI":"10.3390\/pathogens13110992","type":"journal-article","created":{"date-parts":[[2024,11,13]],"date-time":"2024-11-13T08:09:28Z","timestamp":1731485368000},"page":"992","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Occurrence of Plasmid-Mediated Quinolone Resistance and Carbapenemase-Encoding Genes in Pseudomonas aeruginosa Isolates from Nosocomial Patients in Aguascalientes, Mexico"],"prefix":"10.3390","volume":"13","author":[{"given":"Ana S.","family":"Tapia-Cornejo","sequence":"first","affiliation":[{"name":"Departamento de Medicina Interna, Hospital Centenario Miguel Hidalgo, Aguascalientes 20240, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1707-2441","authenticated-orcid":false,"given":"Flor Y.","family":"Ram\u00edrez-Castillo","sequence":"additional","affiliation":[{"name":"Laboratorio de Biolog\u00eda Celular y Tisular, Departamento de Morfolog\u00eda, Centro de Ciencias B\u00e1sicas, Universidad Aut\u00f3noma de Aguascalientes, Aguascalientes 20100, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alma L.","family":"Guerrero-Barrera","sequence":"additional","affiliation":[{"name":"Laboratorio de Biolog\u00eda Celular y Tisular, Departamento de Morfolog\u00eda, Centro de Ciencias B\u00e1sicas, Universidad Aut\u00f3noma de Aguascalientes, Aguascalientes 20100, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-3585-9681","authenticated-orcid":false,"given":"Diana E.","family":"Guillen-Padilla","sequence":"additional","affiliation":[{"name":"Laboratorio de Biolog\u00eda Celular y Tisular, Departamento de Morfolog\u00eda, Centro de Ciencias B\u00e1sicas, Universidad Aut\u00f3noma de Aguascalientes, Aguascalientes 20100, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7430-702X","authenticated-orcid":false,"given":"Jos\u00e9 M.","family":"Arreola-Guerra","sequence":"additional","affiliation":[{"name":"Departamento de Nefrolog\u00eda, Hospital Centenario Miguel Hidalgo, Aguascalientes 20240, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mario","family":"Gonz\u00e1lez-G\u00e1mez","sequence":"additional","affiliation":[{"name":"Departamento de Infectolog\u00eda, Hospital Centenario Miguel Hidalgo, Aguascalientes 20240, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francisco J.","family":"Avelar-Gonz\u00e1lez","sequence":"additional","affiliation":[{"name":"Laboratorio de Estudios Ambientales, Departamento de Fisiolog\u00eda y Farmacolog\u00eda, Centro de Ciencias B\u00e1sicas, Universidad Aut\u00f3noma de Aguascalientes, Aguascalientes 20100, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3163-1847","authenticated-orcid":false,"given":"Abraham","family":"Loera-Muro","sequence":"additional","affiliation":[{"name":"CONAHCYT, Centro de Investigaciones Biol\u00f3gicas del Noreste (CIBNOR), La Paz 23205, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5996-9313","authenticated-orcid":false,"given":"Eduardo","family":"Hern\u00e1ndez-Cuellar","sequence":"additional","affiliation":[{"name":"Laboratorio de Biolog\u00eda Celular y Tisular, Departamento de Morfolog\u00eda, Centro de Ciencias B\u00e1sicas, Universidad Aut\u00f3noma de Aguascalientes, Aguascalientes 20100, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carmen L.","family":"Ramos-Medell\u00edn","sequence":"additional","affiliation":[{"name":"Laboratorio Cl\u00ednico, Hospital Centenario Miguel Hidalgo, Aguascalientes 20240, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cesar","family":"Adame-\u00c1lvarez","sequence":"additional","affiliation":[{"name":"Laboratorio Cl\u00ednico, Hospital Centenario Miguel Hidalgo, Aguascalientes 20240, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ricardo","family":"Garc\u00eda-Romo","sequence":"additional","affiliation":[{"name":"Laboratorio Cl\u00ednico, Hospital Centenario Miguel Hidalgo, Aguascalientes 20240, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3504-0398","authenticated-orcid":false,"given":"Fabiola","family":"Galindo-Guerrero","sequence":"additional","affiliation":[{"name":"Laboratorio de Biolog\u00eda Celular y Tisular, Departamento de Morfolog\u00eda, Centro de Ciencias B\u00e1sicas, Universidad Aut\u00f3noma de Aguascalientes, Aguascalientes 20100, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adriana C.","family":"Moreno-Flores","sequence":"additional","affiliation":[{"name":"Laboratorio de Biolog\u00eda Celular y Tisular, Departamento de Morfolog\u00eda, Centro de Ciencias B\u00e1sicas, Universidad Aut\u00f3noma de Aguascalientes, Aguascalientes 20100, Mexico"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,11,13]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2117","DOI":"10.1007\/s40265-021-01635-6","article-title":"The Epidemiology and Pathogenesis and Treatment of Pseudomonas aeruginosa Infections: An Update","volume":"81","author":"Reynolds","year":"2021","journal-title":"Drugs"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"S49","DOI":"10.1086\/504477","article-title":"Mechanisms of multidrug resistance in Acinetobacter species and Pseudomonas aeruginosa","volume":"43","author":"Bonomo","year":"2006","journal-title":"Clin. Infect. Dis."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"596","DOI":"10.1038\/s41393-019-0393-y","article-title":"Multidrug-resistant Gram-negative organisms and association with 1-year mortality, readmission, and length of stay in Veterans with spinal cord injuries and disorders","volume":"58","author":"Ramanathan","year":"2020","journal-title":"Spinal Cord"},{"key":"ref_4","unstructured":"Antimicrobial Resistance Collaborators (2022). Global burden of bacterial antimicrobial resistance in 2019: A systematic analysis. Lancet, 399, 629\u2013655."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Avakh, A., Grant, G.D., Cheesman, M.J., Kalkundri, T., and Hall, S. (2023). The Art of War with Pseudomonas aeruginosa: Targeting Mex Efflux Pumps Directly to Strategically Enhance Antipseudomonal Drug Efficacy. Antibiotics, 12.","DOI":"10.3390\/antibiotics12081304"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1016\/S1473-3099(15)00424-7","article-title":"Emergence of plasmid-mediated colistin resistance mechanism MCR-1 in animals and human beings in China: A microbiological and molecular biological study","volume":"16","author":"Liu","year":"2016","journal-title":"Lancet Infct. Dis."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"643","DOI":"10.1016\/j.ajic.2017.12.014","article-title":"Nosocomial outbreaks caused by Acinetobacter baumannii and Pseudomonas aeruginosa: Results of a systematic review","volume":"46","author":"Wieland","year":"2018","journal-title":"Am. J. Infect. Control."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Huang, W., Wei, X., Xu, G., Zhang, X., and Wang, X. (2023). Carbapenem-resistant Pseudomonas aeruginosa infections in critically ill children: Prevalence, risk factors, and impact on outcome in a large tertiary pediatric hospital of China. Front. Public Heal., 11.","DOI":"10.3389\/fpubh.2023.1088262"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"480","DOI":"10.1128\/AAC.45.2.480-484.2001","article-title":"Carbapenem resistance mechanisms in Pseudomonas aeruginosa clinical isolates","volume":"45","author":"Pai","year":"2001","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"381","DOI":"10.1016\/S1473-3099(11)70056-1","article-title":"Metallo-\u03b2-lactamases: A last frontier for \u03b2-lactams?","volume":"11","author":"Cornaglia","year":"2011","journal-title":"Lancet Infect. Dis."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1089\/mdr.2022.0226","article-title":"Carbapenemase-Encoding Genes and Colistin Resistance in Gram-Negative Bacteria During the COVID-19 Pandemic in Mexico: Results from the Invifar Network","volume":"29","year":"2023","journal-title":"Microb. Drug. Resist."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"2943","DOI":"10.1128\/AAC.00679-07","article-title":"Metallo-beta-lactamase gene bla (IMP-15) in a class 1 integron, In95, from Pseudomonas aeruginosa clinical isolates from a hospital in Mexico","volume":"52","author":"Sader","year":"2008","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Nieto-Saucedo, J.R., L\u00f3pez-Jacome, L.E., Franco-Cendejas, R., Col\u00edn-Castro, C.A., Hern\u00e1ndez-Duran, M., Rivera-Garay, L.R., Zamarripa-Martinez, K.S., and Mosqueda-G\u00f3mez, J.L. (2023). Carbapenem-Resistant Gram-Negative Bacilli Characterization in a Tertiary Care Center from El Bajio, Mexico. Antibiotics, 12.","DOI":"10.3390\/antibiotics12081295"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1016\/j.drup.2016.09.001","article-title":"Plasmid-mediated quinolone resistance: Two decades on","volume":"29","author":"Machuca","year":"2016","journal-title":"Drug Resist. Updates"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"2296","DOI":"10.1038\/s41598-022-06128-4","article-title":"Occurrence of plasmid-mediated quinolone resistance genes in Pseudomonas aeruginosa strains isolated from clinical specimens in southwest Iran: A multicentral study","volume":"12","author":"Saki","year":"2022","journal-title":"Sci Rep."},{"key":"ref_16","first-page":"853","article-title":"Presence of qnr gene in environmental and clinical Pseudomonas aeruginosa isolates in Baghdad","volume":"3","year":"2014","journal-title":"Int. J. Curr. Microbiol. Appl. Sci."},{"key":"ref_17","first-page":"1386","article-title":"Prevalence and fluoroquinolone resistance of Pseudomonas aeruginosa in a hospital of South China","volume":"8","author":"Yang","year":"2015","journal-title":"Int. J. Clin. Exp. Med."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1016\/j.micpath.2018.07.026","article-title":"Comparative genomic analyses of two novel qnrVC6 carrying multidrug-resistant Pseudomonas","volume":"123","author":"Liu","year":"2018","journal-title":"spp strains, Microb. Pathog."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1055\/s-0042-1742636","article-title":"Plasmid-Mediated Fluoroquinolone Resistance in Pseudomonas aeruginosa and Acinetobacter baumannii","volume":"14","author":"Venkataramana","year":"2022","journal-title":"J. Lab. Physicians"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1532","DOI":"10.1007\/s00284-020-01974-9","article-title":"Prevalence of qnrVC Genes in Pseudomonas aeruginosa Clinical Isolates from Guangdong, China","volume":"77","author":"Lin","year":"2020","journal-title":"Curr. Microbiol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s43042-019-0026-1","article-title":"Characterization of plasmid-mediated qnrA and qnrB genes among Enterobacteriaceae strains: Quinolone resistance and ESBL production in Ismailia, Egypt","volume":"20","author":"Taha","year":"2019","journal-title":"Egypt. J. Med. Hum. Genet."},{"key":"ref_22","first-page":"298","article-title":"Full characterization of an IncR plasmid harboring qnrS1 recovered from a VIM-11-producing Pseudomonas aeruginosa","volume":"52","author":"Elena","year":"2020","journal-title":"Rev. Argent. Microbiol."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Araujo, B.F., Ferreira, M.L., Campos, P.A., Royer, S., Batist\u00e3o, D.W., Dantas, R.C., Gon\u00e7alves, I.R., Faria, A.L., Brito, C.S., and Yokosawa, J. (2016). Clinical and Molecular Epidemiology of Multidrug-Resistant P. aeruginosa Carrying aac (6\u2032)-Ib-cr, qnrS1 and blaSPM Genes in Brazil. PLoS ONE, 11.","DOI":"10.1371\/journal.pone.0155914"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"336","DOI":"10.1099\/jmm.0.000927","article-title":"Acquired qnrVC1 and blaNDM-1 resistance markers in an international high-risk Pseudomonas aeruginosa ST773 clone","volume":"68","author":"Kocsis","year":"2019","journal-title":"J. Med. Microbiol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1556\/030.63.2016.002","article-title":"Plasmid-mediated quinolone resistance among extended spectrum beta lactase producing Enterobacteriaceae from bloodstream infections","volume":"63","author":"Domokos","year":"2016","journal-title":"Acta Microbiol. Immunol. Hung."},{"key":"ref_26","first-page":"469","article-title":"Pseudomonas aeruginosa antimicrobial susceptibility profiles, resistance mechanisms and international clonal lineages: Update from ESGARS-ESCMID\/ISARPAE Group","volume":"30","author":"Oliver","year":"2023","journal-title":"Clin. Microbiol. Infect. Off. Publ. Eur. Soc. Clin. Microbiol. Infect. Dis."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"e00007\u201319","DOI":"10.1128\/CMR.00007-19","article-title":"Transferable mechanisms of Quinolone Resistance from 1998 onward","volume":"32","author":"Ruiz","year":"2019","journal-title":"Clin. Microbiol. Rev."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"2907","DOI":"10.1093\/jac\/dkt295","article-title":"Risk factors and clinical characteristics of patients with qnr-positive Klebsiella pneumoniae bacteraemia","volume":"68","author":"Liao","year":"2013","journal-title":"J. Antimicrob. Chemother."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"e37534","DOI":"10.1016\/j.heliyon.2024.e37534","article-title":"Prevalence of plasmid-mediated quinolone resistance genes in extended-spectrum beta-lactamase producing Klebsiella pneumoniae isolates in northern Iran","volume":"10","author":"Hoseinzadeh","year":"2024","journal-title":"Heliyon"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"4943","DOI":"10.2147\/IDR.S419064","article-title":"Clinical characteristics and prognosis of bloodstream infection with carbapenem-resistant pseudomonas aeruginosa in patients with hematologic malignancies","volume":"16","author":"Yuan","year":"2023","journal-title":"Infect. Drug Resist."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Aslan, A.T., and Akova, M. (2024). Recent updates in treating carbapenem-resistant infections in patients with hematological malignancies. Expert Rev. Anti Infect. Ther., 1\u201317.","DOI":"10.1080\/14787210.2024.2408746"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1523","DOI":"10.2147\/IDR.S173455","article-title":"Characterization of antimicrobial resistance mechanisms in carbapenem-resistant Pseudomonas aeruginosa carrying IMP variants recovered form a Mexican Hospital","volume":"11","author":"Torres","year":"2018","journal-title":"Infect. Drug. Resist."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"2074","DOI":"10.1128\/JCM.42.5.2074-2079.2004","article-title":"PCR-based assay for differentiation of Pseudomonas aeruginosa from other Pseudomonas species recovered from cystic fibrosis patients","volume":"42","author":"Spilker","year":"2004","journal-title":"J Clin Microbiol."},{"key":"ref_34","unstructured":"CLSI (2020). Clinical Laboratory Standard Institute. Performance Standards for Antimicrobial Susceptibility Testing, Clinical and Laboratory Standards Institute. [30th ed.]. CLSI document M100-ED30."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1111\/j.1469-0691.2011.03570.x","article-title":"Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: An international expert proposal for interim standard definitions for acquired resistance","volume":"18","author":"Magiorakos","year":"2012","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_36","unstructured":"Sambrook, J., and Russell, D.W. (2001). Molecular Cloning, A Laboratory Manual, Cold Spring Harbor Laboratory. [3rd ed.]."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"3214","DOI":"10.1128\/AAC.47.10.3214-3221.2003","article-title":"Antimicrobial resistance genes in enterotoxigenic Escherichia coli O149:K91 isolates obtained over a 23-year period from pigs","volume":"47","author":"Maynard","year":"2003","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"3214","DOI":"10.1099\/jmm.0.001310","article-title":"Novel multiplex PCRs for detection of the most prevalent carbapenemase genes in Gram-negative bacteria within Germany","volume":"70","author":"Cerezales","year":"2021","journal-title":"J. Med. Microbiol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"2872","DOI":"10.1128\/AAC.01647-05","article-title":"qnr prevalence in ceftazidime-resistant Enterobacteriaceae isolates from the United States","volume":"50","author":"Robicsek","year":"2006","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1892","DOI":"10.1128\/AAC.01400-08","article-title":"New plasmid-mediated quinolone resistance gene, qnrC, found in a clinical isolates of Proteus mirabilis","volume":"53","author":"Wang","year":"2009","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"603","DOI":"10.1128\/AAC.00997-08","article-title":"qnrD, a novel gene conferring transferable quinolone resistance in Salmonella enterica serovar Kentucky and Bovismorbificans strains of human origin","volume":"53","author":"Cavaco","year":"2009","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"3953","DOI":"10.1128\/AAC.00915-06","article-title":"Prevalence in the United States of aac (6\u2032)-Ib-cr encoding a ciprofloxacin-modifying enzyme","volume":"50","author":"Park","year":"2006","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"3423","DOI":"10.1128\/AAC.06191-11","article-title":"Prevalence of qnr, aac (6\u2032)-Ib-cr, qepA, and oqxAB in Escherichia coli Isolates from Humans, Animals, and the Environment","volume":"56","author":"Chen","year":"2012","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"ofx176","DOI":"10.1093\/ofid\/ofx176","article-title":"Prevalence of Carbapenem-Resistant Gram-Negative Infections in the United States Predominated by Acinetobacter baumannii and Pseudomonas aeruginosa","volume":"4","author":"Cai","year":"2017","journal-title":"Open Forum Infect. Dis."},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Palavutitotai, N., Jitmuang, A., Tongsai, S., Kiratisin, P., and Angkasekwinai, N. (2018). Epidemiology and risk factors of extensively drug-resistant Pseudomonas aeruginosa infections. PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0193431"},{"key":"ref_46","doi-asserted-by":"crossref","unstructured":"Kim, Y.J., Jun, Y.H., Kim, Y.R., Park, K.G., Park, Y.J., Kang, J.Y., and Kim, S.I. (2014). Risk factors for mortality in patients with Pseudomonas aeruginosa bacteremia; retrospective study of impact of combination antimicrobial therapy. BMC Infect. Dis., 14.","DOI":"10.1186\/1471-2334-14-161"},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Frem, J.A., Doumat, G., Kazma, J., Gharamti, A., Kanj, S.S., Fayad, A.G.A., Matar, G.M., and Kanafani, Z.A. (2013). Clinical predictors of mortality in patients with Pseudomonas aeruginosa infection. PLoS ONE, 18.","DOI":"10.1371\/journal.pone.0282276"},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Mart\u00ednez-Zavaleta, M.G., Fern\u00e1ndez-Rodr\u00edguez, D., Hern\u00e1ndez-Dur\u00e1n, M., Col\u00edn-Castro, C.A., Garc\u00eda-Hern\u00e1ndez, M.d.L., Becerra-Lobato, N., Franco-Cendejas, R., and L\u00f3pez-J\u00e1come, L.E. (2023). Acquired blaVIM and blaGES Carbapenemase-Encoding Genes in Pseudomonas aeruginosa: A Seven-Year Survey Highlighting an Increasing Epidemiological Threat. Pathogens, 12.","DOI":"10.3390\/pathogens12101256"},{"key":"ref_49","doi-asserted-by":"crossref","unstructured":"Kawa, D.E., Tickler, I.A., Tenover, F.C., and Shettima, S.A. (2023). Characterization of Beta-Lactamase and Fluoroquinolone Resistance Determinants in Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa Isolates from a Tertiary Hospital in Yola, Nigeria. Trop. Med. Infect. Dis., 8.","DOI":"10.3390\/tropicalmed8110500"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"e0166923","DOI":"10.1128\/aac.01669-23","article-title":"Nationwide genome surveillance of carbapenem-resistant Pseudomonas aeruginosa in Japan","volume":"68","author":"Yano","year":"2024","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_51","doi-asserted-by":"crossref","unstructured":"Galindo-M\u00e9ndez, M., Navarrete-Salazar, H., Pacheco-V\u00e1squez, R., Quintas-de la Paz, D., Baltazar-Jim\u00e9nez, I., Santiago-Luna, J.D., and Guadarrama-Monroy, L. (2023). Detection of Plasmid-Mediated Resistance against Colistin in Multi-Drug-Resistant Gram-Negative Bacilli Isolated from a Tertiary Hospital. Microorganisms, 11.","DOI":"10.20944\/preprints202307.0036.v1"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"2483","DOI":"10.3892\/mmr.2016.5538","article-title":"Resistant mechanisms and molecular epidemiology of imipenem-resistant Acinetobacter baumannii","volume":"14","author":"Xiao","year":"2016","journal-title":"Mol. Med. Rep."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1186\/s13756-017-0262-4","article-title":"Clonal diversity and detection of carbapenem resistance encoding genes among multidrug-resistant Acinetobacter baumannii isolates recovered from patients and environment in two intensive care units in a Moroccan hospital","volume":"6","author":"Uwingabiye","year":"2017","journal-title":"Antimicrob. Resist. Infect. Control."},{"key":"ref_54","doi-asserted-by":"crossref","unstructured":"Nitz, F., de Melo, B.O., da Silva, L.C.N., de Souza Monteiro, A., Marques, S.G., Monteiro-Neto, V., de Jesus Gomes Turri, R., Junior, A.D.S., Concei\u00e7\u00e3o, P.C.R., and Magalh\u00e3es, H.J.C. (2021). Molecular Detection of Drug-Resistance Genes of blaOXA-23-blaOXA-51 and mcr-1 in Clinical Isolates of Pseudomonas aeruginosa. Microorganisms, 9.","DOI":"10.3390\/microorganisms9040786"},{"key":"ref_55","doi-asserted-by":"crossref","unstructured":"Gondal, A.J., Choudhry, N., Niaz, A., and Yasmin, N. (2024). Molecular Analysis of Carbapenem and Aminoglycoside Resistance Genes in Carbapenem-Resistant Pseudomonas aeruginosa Clinical Strains: A Challenge for Tertiary Care Hospitals. Antibiotics, 13.","DOI":"10.3390\/antibiotics13020191"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"100686","DOI":"10.1016\/j.nmni.2020.100686","article-title":"Evaluating the antimicrobial resistance patterns and molecular frequency of blaOXA-48 and blaGES-2 genes in Pseudomonas aeruginosa and Acinetobacter baumannii strains isolated from burn wound infection in Tehran, Iran","volume":"37","author":"Tarafdar","year":"2020","journal-title":"New Microbes New Infect."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1111\/j.1574-6968.2004.tb09639.x","article-title":"Insertional inactivation of oprD in clinical isolates of Pseudomonas aeruginosa leading to carbapenem resistance","volume":"236","author":"Wolter","year":"2004","journal-title":"FEMS Microbiol. Lett."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"835","DOI":"10.1007\/s15010-020-01520-6","article-title":"Treatment options for K. pneumoniae, P. aeruginosa and A. baumannii co-resistant to carbapenems, aminoglycosides, polymyxins and tigecycline: An approach based on the mechanisms of resistance to carbapenems","volume":"48","author":"Karakonstantis","year":"2020","journal-title":"Infection"},{"key":"ref_59","first-page":"2164","article-title":"In vitro activity of ceftolozane\/tazobactam alone and in combination with amikacin against MDR\/XDR Pseudomonas aeruginosa isolates from Greece","volume":"75","author":"Galani","year":"2020","journal-title":"J. Antimicrob. Chemother."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1080\/1040841X.2018.1492902","article-title":"The rise and spread of mcr plasmid-mediated polymyxin resistance","volume":"45","author":"Nang","year":"2019","journal-title":"Crit. Rev. Microbiol."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"323","DOI":"10.2147\/IDR.S238811","article-title":"Prevalence and Some Possible Mechanisms of Colistin Resistance among Multidrug-Resistant and Extensively Drug-Resistant Pseudomonas aeruginosa","volume":"13","author":"Masoud","year":"2020","journal-title":"Infect. Drug Resist."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"e00679-e18","DOI":"10.1128\/AAC.00679-18","article-title":"Chromosomally Encoded mcr-5 in Colistin-Nonsusceptible Pseudomonas aeruginosa","volume":"62","author":"Snesrud","year":"2018","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_63","doi-asserted-by":"crossref","unstructured":"Abdelrahim, S.S., Hassuna, N.A., Waly, N.G.F.M., Kotb, D.N., Abdelhamid, H., and Zaki, S. (2024). Coexistence of plasmid-mediated quinolone resistance (PMQR) and extended-spectrum beta-lactamase (ESBL) genes among clinical Pseudomonas aeruginosa isolates in Egypt. BMC Microbiol., 24.","DOI":"10.1186\/s12866-024-03319-z"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"925","DOI":"10.1016\/j.bjm.2016.07.016","article-title":"The role of gyrA and parC mutations in fluoroquinolones-resistant Pseudomonas aeruginosa isolates from Iran","volume":"47","author":"Nouri","year":"2016","journal-title":"Braz. J. Microbiol."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"2467","DOI":"10.1128\/AAC.01615-12","article-title":"Differential distribution of plasmid-mediated quinolone resistance genes in clinical enterobacteria with unusual phenotypes of quinolone susceptibility from Argentina","volume":"57","author":"Andres","year":"2013","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2015\/518167","article-title":"Prevalence of plasmid-mediated quinolone resistance determinants and oqxab efflux pumps among extended-spectrum \u03b2-lactamase producing Klebsiella pneumoniae isolated from patients with nosocomial urinary tract infection in Tehran, Iran","volume":"2015","author":"Goudarzi","year":"2015","journal-title":"Scientifica"},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1016\/j.ijid.2019.05.025","article-title":"Genomic characterization of multidrug-resistant ESBL-producing Klebsiella pneumoniae isolated from a Ghanaian teaching hospital","volume":"85","author":"Agyepong","year":"2019","journal-title":"Int. J. Infect. Dis."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1186\/s13756-019-0489-3","article-title":"The nature and epidemiology of OqxAB, a multidrug efflux pump","volume":"8","author":"Li","year":"2019","journal-title":"Antimicrob. Resist. Infect. Control."},{"key":"ref_69","first-page":"93","article-title":"Relationship of OqxAB efflux pump to antibiotic resistance, mainly fluoroquinolones in Klebsiella pneumoniae, isolated from hospitalized patients","volume":"26","author":"Amereh","year":"2023","journal-title":"Iran. J. Basic Med. Sci."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"310","DOI":"10.7883\/yoken.JJID.2008.310","article-title":"Investigation of plasmid-mediated quinolone resistance among isolates obtained in a Turkish intensive care unit","volume":"61","author":"Nazik","year":"2008","journal-title":"Jpn. J. Infect. Dis."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"463","DOI":"10.1093\/jac\/dki245","article-title":"Emergence of plasmid-mediated resistance to quinolones in Enterobacteriaceae","volume":"56","author":"Nordmann","year":"2005","journal-title":"J. Antimicrob. Chemother."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"381","DOI":"10.1016\/j.diagmicrobio.2014.03.025","article-title":"Emergence of plasmid-mediated quinolone resistance genes in clinical isolates of Acinetobacter baumannii and Pseudomonas aeruginosa in Henan, China","volume":"79","author":"Jiang","year":"2014","journal-title":"Diagn. Micr. Infec. Dis."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"2237","DOI":"10.1093\/jac\/dkv103","article-title":"Description of an original integron encompassing blaVIM-2, qnrVC1 and genes encoding bacterial group II intron proteins in Pseudomonas aeruginosa","volume":"70","author":"Belotti","year":"2015","journal-title":"J. Antimicrob. Chemother."},{"key":"ref_74","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":"Bhuyan","year":"2021","journal-title":"Trop. Med. Int. Health"},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1016\/j.gendis.2019.04.001","article-title":"Emergence of antibiotic resistance Pseudomonas aeruginosa in intensive care unit; a critical review","volume":"6","author":"Pachori","year":"2019","journal-title":"Genes Dis."}],"container-title":["Pathogens"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-0817\/13\/11\/992\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T16:31:28Z","timestamp":1760113888000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-0817\/13\/11\/992"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,11,13]]},"references-count":75,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2024,11]]}},"alternative-id":["pathogens13110992"],"URL":"https:\/\/doi.org\/10.3390\/pathogens13110992","relation":{},"ISSN":["2076-0817"],"issn-type":[{"value":"2076-0817","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,11,13]]}}}