{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T19:11:47Z","timestamp":1792523507635,"version":"4.5.0"},"reference-count":59,"publisher":"King Faisal Specialist Hospital and Research Centre","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Ann Saudi Med"],"published-print":{"date-parts":[[2026,1]]},"abstract":"\n BACKGROUND:<\/jats:title>\n \n The increase in carbapenem-resistant\n K. pneumoniae<\/jats:italic>\n (CR-Kp) in intensive care units (ICUs) causes treatment difficulties and increases risk in mortality.\n <\/jats:p>\n <\/jats:sec>\n \n OBJECTIVES:<\/jats:title>\n The aim of this study was to investigate the susceptibility rates of CR-Kp isolates obtained from ICUs to ceftazidime-avibactam (CAZ-AVI) and colistin, carbapenem resistance genes, clonal relationships and clinical characteristics of the patients.<\/jats:p>\n <\/jats:sec>\n \n DESIGN:<\/jats:title>\n Retrospective cohort<\/jats:p>\n <\/jats:sec>\n \n SETTING:<\/jats:title>\n Single-center, University of Health Sciences, \u00dcmraniye Training and Research Hospital<\/jats:p>\n <\/jats:sec>\n \n MATERIALS AND METHODS:<\/jats:title>\n This study was conducted between June 2023 and December 2024. Isolates were identified using VITEK MS v.3.2, and antibiotic susceptibility testing was performed using the VITEK 2 Compact system. CAZ-AVI susceptibility was determined using disk diffusion, and colistin susceptibility was determined using broth microdilution to determine minimum inhibitory concentration (MIC) values. Carbapenem resistance genes were determined using multiplex real-time polymerase chain reaction (RT-PCR) and clonal relationship arbitrarily primed-polymerase chain reaction (AP-PCR).<\/jats:p>\n <\/jats:sec>\n \n MAIN OUTCOME MEASURES:<\/jats:title>\n Resistance genes of CR-Kp isolates, clonal relationships, CAZ-AVI and colistin resistance, and clinical characteristics of patients<\/jats:p>\n <\/jats:sec>\n \n SAMPLE SIZE:<\/jats:title>\n Ninety-seven isolates from 76 patients<\/jats:p>\n <\/jats:sec>\n \n RESULTS:<\/jats:title>\n Among patients with CR-Kp isolates, central venous catheter use was detected in 59 cases (78%), ventilator-associated pneumonia in 44 cases (58%), and bacteremia in 39 cases (51%), respectively. It was determined that 53 of the patients (70%) died. Using the AP-PCR method, 60 different genotypes were identified among 97 isolates, and clustering was determined in 42 of the isolates (46%). It was determined that 36 (37%) of the isolates were resistant to colistin and 42 (45%) were resistant to CAZ-AVI. NDM+OXA-48, OXA-48, KPC, KPC+NDM, and NDM genes were detected in 40 (43%), 32 (35%), 10 (11%), 2 (2%), and 3 (3%) isolates, respectively. It was determined that 30 (75%) of the isolates with NDM+OXA-48 and only 4 (12%) of the isolates with OXA-48 were resistant to CAZ-AVI.<\/jats:p>\n <\/jats:sec>\n \n CONCLUSION:<\/jats:title>\n In addition to OXA-48, an increase in the frequency of CR-Kp isolates containing the NDM, NDM+OXA-48, KPC+NDM, and OXA-48+KPC genes were also detected. It was also determined that resistance to colistin and CAZ-AVI is increasing. The AP-PCR method can also be used to investigate infections.<\/jats:p>\n <\/jats:sec>\n \n LIMITATIONS:<\/jats:title>\n Single center, Pulsed Field Gel Electrophoresis (PFGE) could not be performed together with AP-PCR<\/jats:p>\n <\/jats:sec>","DOI":"10.5144\/0256-4947.2026.9","type":"journal-article","created":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T10:17:09Z","timestamp":1768990629000},"page":"9-19","source":"Crossref","is-referenced-by-count":3,"title":["Investigation of the susceptibility rates to ceftazidime-avibactam and colistin, clonal relationships, and clinical data of patients with carbapenem-resistant\n Klebsiella pneumoniae<\/i>\n isolates detected in the ICUs of a hospital in \u0130stanbul"],"prefix":"10.5144","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1297-944X","authenticated-orcid":true,"given":"Y\u00fcksel","family":"Akkaya","sequence":"first","affiliation":[{"name":"From the Department of Microbiology, Faculty of Medicine, University of Health Sciences Hamidiye, \u00dcsk\u00fcdar, Istanbul, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u0130rfan","family":"Ayd\u0131n","sequence":"additional","affiliation":[{"name":"From the Pharmacy Services Department, Fenerbah\u00e7e University, Istanbul, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebile","family":"Harmankaya","sequence":"additional","affiliation":[{"name":"From the Medical Microbiology Laboratory, \u00dcmraniye Training and Research Hospital, Istanbul, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mehmet","family":"Karaku\u015f","sequence":"additional","affiliation":[{"name":"From the Department of Microbiology, Faculty of Medicine, University of Health Sciences Hamidiye, \u00dcsk\u00fcdar, Istanbul, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mehtap","family":"Aydin","sequence":"additional","affiliation":[{"name":"From the Department of Infectious Diseases and Clinical Microbiology, \u00dcmraniye Training and Research Hospital, Istanbul, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beg\u00fcm Nal\u00e7a","family":"Erdin","sequence":"additional","affiliation":[{"name":"From the Medical Microbiology Laboratory, \u00dcmraniye Training and Research Hospital, Istanbul, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmet M\u00fcnir","family":"Y\u0131lmaz","sequence":"additional","affiliation":[{"name":"From the Department of Emergency Medicine, Abdulkadir Yuksel State Hospital, Ministry of Health, Gaziantep, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emine H\u00fcdanur","family":"B\u00fcy\u00fckavc\u0131","sequence":"additional","affiliation":[{"name":"From the Medical Microbiology Laboratory, \u00dcmraniye Training and Research Hospital, Istanbul, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Z\u00fclal A\u0219\u00e7\u0131","family":"Toraman","sequence":"additional","affiliation":[{"name":"From the Department of Medical Microbiology, Faculty of Medicine, Firat University, Elazig, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u0130brahim Halil","family":"K\u0131l\u0131\u00e7","sequence":"additional","affiliation":[{"name":"From the Molecular Biology Department, Faculty of Arts and Sciences, Gaziantep University, Gaziantep, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"3134","reference":[{"issue":"2","key":"e_1_3_2_2_2","doi-asserted-by":"crossref","first-page":"234","DOI":"10.3390\/antibiotics12020234","article-title":"Carbapenem-resistant Klebsiella pneumoniae: virulence factors, molecular epidemiology and latest updates in treatment options","volume":"12","author":"Karampatakis T","year":"2023","unstructured":"Karampatakis T, Tsergouli K, Behzadi P. 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