{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T13:09:33Z","timestamp":1790255373463,"version":"4.1.0"},"reference-count":52,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,12,3]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n                  <jats:p>\n                    <jats:italic>Klebsiella pneumoniae<\/jats:italic>\n                    carbapenemase (KPC) and metallo-\u03b2-lactamase production are major causes of carbapenem resistance, whereas aminoglycoside resistance is caused by extrinsically acquired 16S-rRNA methyltransferase.\n                    <jats:italic>K. pneumoniae<\/jats:italic>\n                    coharboring resistance genes are serious health care issues that can cause multidrug resistance (MDR). This study aimed to describe the resistance genes (New Delhi metallo-beta-lactamase 1 [\n                    <jats:italic>bla<\/jats:italic>\n                    <jats:sub>NDM-1<\/jats:sub>\n                    ] and\n                    <jats:italic>armA<\/jats:italic>\n                    ) in the plasmids of\n                    <jats:italic>K. pneumoniae<\/jats:italic>\n                    from patients visiting the Paropakar Maternity and Women\u2019s Hospital, Kathmandu, Nepal. All together, 8,017 clinical specimens were processed following standard microbiological procedures to identify\n                    <jats:italic>K. pneumoniae<\/jats:italic>\n                    . Antibiotic susceptibility testing and detection of phenotypic carbapenemase production in\n                    <jats:italic>K. pneumoniae<\/jats:italic>\n                    isolates were performed using the modified Kirby-Bauer disc diffusion method. The resistance genes were detected by conventional polymerase chain reaction. Of 8,017 clinical specimens, 6.8% (\n                    <jats:italic>n<\/jats:italic>\n                    = 545) had bacterial growth, and 70 were\n                    <jats:italic>K. pneumoniae<\/jats:italic>\n                    . Colistin (100%,\n                    <jats:italic>n<\/jats:italic>\n                    = 70) and imipenem (80%,\n                    <jats:italic>n<\/jats:italic>\n                    = 56) were the most effective antibiotics. Thirty percent (\n                    <jats:italic>n<\/jats:italic>\n                    = 21) of the isolates were MDR, whereas 66.7% (\n                    <jats:italic>n<\/jats:italic>\n                    = 14) were carbapenemase producers, among which 38.1% (\n                    <jats:italic>n<\/jats:italic>\n                    = 8) had a minimum inhibitory concentration of 64\n                    <jats:italic>\u00b5<\/jats:italic>\n                    g\/mL to imipenem. Among carbapenemase producers, 23.8% (\n                    <jats:italic>n<\/jats:italic>\n                    = 5) were KPC and 66.7% (\n                    <jats:italic>n<\/jats:italic>\n                    = 14) were metallo-\u03b2-lactamase producers. Out of 21 MDR\n                    <jats:italic>K. pneumoniae<\/jats:italic>\n                    , 19.5% (\n                    <jats:italic>n<\/jats:italic>\n                    = 4) harbored the\n                    <jats:italic>bla<\/jats:italic>\n                    <jats:sub>NDM-1<\/jats:sub>\n                    and\n                    <jats:italic>armA<\/jats:italic>\n                    genes, and 14.3% (\n                    <jats:italic>n<\/jats:italic>\n                    = 2) had both genes. Detection of the coexistence of the resistance genes from\n                    <jats:italic>K. pneumoniae<\/jats:italic>\n                    reveals that there might be increased antibiotic resistance leading to multidrug resistance and an increased resistance to imipenem. In conclusion, advancing antimicrobial-resistance surveillance in maternity wards and minimizing the use of last-line antibiotics are crucial for safeguarding maternal and neonatal health.\n                  <\/jats:p>","DOI":"10.4269\/ajtmh.25-0433","type":"journal-article","created":{"date-parts":[[2025,9,25]],"date-time":"2025-09-25T18:07:13Z","timestamp":1758823633000},"page":"1324-1330","source":"Crossref","is-referenced-by-count":1,"title":["Investigation of the blaNDM-1 and armA Genes in Carbapenem-Resistant Klebsiella pneumoniae Isolated from the Clinical Samples in Kathmandu, Nepal"],"prefix":"10.4269","volume":"113","author":[{"given":"Rohit","family":"Ghimire","sequence":"first","affiliation":[{"name":"Central Department of Microbiology, Tribhuvan University, Kirtipur, Kathmandu, Nepal;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Subash Kumar","family":"Thakur","sequence":"additional","affiliation":[{"name":"Paropakar Maternity and Women\u2019s Hospital, Thapathali, Kathmandu, Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Upendra","family":"Thapa Shrestha","sequence":"additional","affiliation":[{"name":"Central Department of Microbiology, Tribhuvan University, Kirtipur, Kathmandu, Nepal;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Komal Raj","family":"Rijal","sequence":"additional","affiliation":[{"name":"Central Department of Microbiology, Tribhuvan University, Kirtipur, Kathmandu, Nepal;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prakash","family":"Ghimire","sequence":"additional","affiliation":[{"name":"Central Department of Microbiology, Tribhuvan University, Kirtipur, Kathmandu, Nepal;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Megha Raj","family":"Banjara","sequence":"additional","affiliation":[{"name":"Central Department of Microbiology, Tribhuvan University, Kirtipur, Kathmandu, Nepal;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"b1","series-title":"Indian J Pediatr","first-page":"176","article-title":"Nosocomial infections and multidrug-resistant bacterial organisms in the pediatric intensive care unit","volume":"78","author":"McGrath","year":"2011"},{"key":"b2","series-title":"Clin Microbiol Rev","first-page":"589","article-title":"Klebsiella spp. as nosocomial pathogens: Epidemiology, taxonomy, typing methods, and pathogenicity factors","volume":"11","author":"Podschun","year":"1998"},{"key":"b3","series-title":"Antimicrob Agents Chemother","first-page":"4943","article-title":"Carbapenems: Past, present, and future","volume":"55","author":"Papp-Wallace","year":"2011"},{"key":"b4","series-title":"Antimicrob Agents Chemother","first-page":"1697","article-title":"More extended-spectrum \u03b2-lactamases","volume":"35","author":"Jacoby","year":"1991"},{"key":"b5","series-title":"Antimicrob Agents 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