{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T17:16:23Z","timestamp":1778260583180,"version":"3.51.4"},"reference-count":79,"publisher":"PeerJ","license":[{"start":{"date-parts":[[2025,12,18]],"date-time":"2025-12-18T00:00:00Z","timestamp":1766016000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Fundamental Research Grant Scheme from the Ministry of Higher Education Malaysia","award":["FRGS\/1\/2022\/SKK06\/USM\/02\/7"],"award-info":[{"award-number":["FRGS\/1\/2022\/SKK06\/USM\/02\/7"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Antibiotic resistance in multidrug-resistant\n                      <jats:italic>Klebsiella pneumoniae<\/jats:italic>\n                      (MDR-KP), particularly against carbapenems and colistin, is a critical concern, increasing morbidity and mortality among hospitalized patients. This systematic review aims to identify methylase genes in\n                      <jats:italic>K. pneumoniae<\/jats:italic>\n                      and examine their co-existence with \u03b2-lactamase and carbapenemase genes contributing to antibiotic resistance.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A literature search was conducted across three electronic databases from inception until 6 December 2023. The quality assessment followed Critical Appraisal Skills Programme (CASP) criteria. Studies focusing on methylase genes and antibiotic resistance in\n                      <jats:italic>K. pneumoniae<\/jats:italic>\n                      were included. Two authors independently screened titles, abstracts, and full texts, with a third resolving disagreements.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Thirty-four studies met the inclusion criteria. Methylase genes in\n                      <jats:italic>K. pneumoniae<\/jats:italic>\n                      isolates were predominantly reported in Europe and Asia, particularly in Iran, China, Japan, and India (8.8%,\n                      <jats:italic>N<\/jats:italic>\n                      \u00a0=\u00a03). The most prevalent 16S rRNA methyltransferase genes identified were\n                      <jats:italic>armA<\/jats:italic>\n                      (76.5%,\n                      <jats:italic>N<\/jats:italic>\n                      \u00a0=\u00a026),\n                      <jats:italic>rmtB<\/jats:italic>\n                      (61.8%,\n                      <jats:italic>N<\/jats:italic>\n                      \u00a0=\u00a021), and\n                      <jats:italic>rmtC<\/jats:italic>\n                      (29.4%,\n                      <jats:italic>N<\/jats:italic>\n                      \u00a0=\u00a010). Common extended-spectrum \u03b2-lactamase (ESBL) genes included\n                      <jats:italic>\n                        bla\n                        <jats:sub>CTXM<\/jats:sub>\n                      <\/jats:italic>\n                      (64.7%,\n                      <jats:italic>N<\/jats:italic>\n                      \u00a0=\u00a022) and\n                      <jats:italic>\n                        bla\n                        <jats:sub>SHV<\/jats:sub>\n                      <\/jats:italic>\n                      (47%,\n                      <jats:italic>N<\/jats:italic>\n                      \u00a0=\u00a016), while\n                      <jats:italic>\n                        bla\n                        <jats:sub>KPC<\/jats:sub>\n                      <\/jats:italic>\n                      (26.5%,\n                      <jats:italic>N<\/jats:italic>\n                      \u00a0=\u00a09) and\n                      <jats:italic>\n                        bla\n                        <jats:sub>NDM<\/jats:sub>\n                      <\/jats:italic>\n                      (23.5%,\n                      <jats:italic>N<\/jats:italic>\n                      \u00a0=\u00a08) were the predominant carbapenemase genes. The coexistence of methylase genes with ESBL and carbapenemase genes conferred significant resistance to aminoglycosides (gentamicin, kanamycin, tobramycin, amikacin, arbekacin), cephalosporins (cefazolin, cefoxitin, cefotaxime), and carbapenems (imipenem, meropenem).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      The widespread distribution of resistance mechanisms in\n                      <jats:italic>K. pneumoniae<\/jats:italic>\n                      highlights a global challenge, emphasizing the need for strategic antimicrobial use to reduce resistance rates.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.7717\/peerj.20428","type":"journal-article","created":{"date-parts":[[2025,12,18]],"date-time":"2025-12-18T08:14:12Z","timestamp":1766045652000},"page":"e20428","source":"Crossref","is-referenced-by-count":1,"title":["A systematic review of the role of methylase genes in antibiotic resistance: co-existence with extended spectrum \u03b2-lactamase and carbapenemase genes in\n                    <i>Klebsiella pneumoniae<\/i>"],"prefix":"10.7717","volume":"13","author":[{"given":"Nur Husna","family":"Shahimi","sequence":"first","affiliation":[{"name":"Institute for Research in Molecular Medicine (INFORMM), Health Campus, Universiti Sains Malaysia,  Kubang Kerian, Kelantan, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nabiha","family":"Bouafia","sequence":"additional","affiliation":[{"name":"Infection Prevention and Control Centre of Excellence, Prince Sultan Medical Military City, Riyadh,  Saudi Arabia"},{"name":"Preventive and Community 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