Genotypic and Phenotypic Landscape of Carbapenem-Resistant Pseudomonas aeruginosa Isolated From Respiratory and Non-Respiratory Samples in a Tertiary Hospital

Genotypic and Phenotypic Landscape of Carbapenem-Resistant Pseudomonas aeruginosa Isolated From Respiratory and Non-Respiratory Samples in a Tertiary Hospital | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Genotypic and Phenotypic Landscape of Carbapenem-Resistant Pseudomonas aeruginosa Isolated From Respiratory and Non-Respiratory Samples in a Tertiary Hospital Hamiyet Büşra GÜNDOĞDU, Erva RAKICI, Nebahat Ejder, Ayşegül Çopur Çiçek, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7690655/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 14 Mar, 2026 Read the published version in BMC Microbiology → Version 1 posted 12 You are reading this latest preprint version Abstract Background The World Health Organization lists carbapenem-resistant Pseudomonas aeruginosa (CRPA) as a critical priority, yet links among resistance, virulence, and clonal spread remain unclear. We aimed to characterise the genotypic and phenotypic landscape of clinical CRPA and test whether specimen source or type III secretion effectors exoT / exoY predict antibiotic resistance. Methods Fifty-eight consecutive CRPA isolates from respiratory and non-respiratory specimens were analysed. Susceptibility to 10 agents was determined with an automated system. Seven carbapenemase genes, six virulence/quorum-sensing genes, and the efflux marker mexY were screened by PCR. Macrorestriction patterns were typed by Spe I PFGE. Associations were assessed using two-tailed Fisher’s exact tests with Benjamini–Hochberg false-discovery-rate correction (α = 0.05). Results Resistance was highest to piperacillin/tazobactam (91%), ceftazidime (81%) and cefepime (81%); 34% of isolates were pan-drug-resistant. Only three strains (5%) carried bla VIM ; no additional carbapenemase genes were detected. Virulence markers were frequent (exoY 66%, exoT 57%, algD 45%; lasR 91%, rhlR 95%). After FDR adjustment, neither exoT , exoY nor specimen origin correlated with β-lactam, aminoglycoside, or fluoroquinolone resistance (lowest q = 0.093); gene prevalence did not differ between respiratory and non-respiratory isolates (lowest q = 0.65). PFGE revealed 41 pulsotypes without a dominant clone, suggesting sporadic horizontal gene transfer rather than clonal expansion. Conclusions This CRPA cohort is genetically diverse, multidrug-resistant, and anatomically non-segregated. exoT / exoY status does not shape resistance phenotypes. Infection-control strategies should prioritise containment of mobile genetic elements and genome-based surveillance rather than focusing on specific clones or body sites. Pseudomonas aeruginosa CRPA carbapenem resistance exoT exoY PFGE Fisher’s exact test FDR BH EUCAST reproducible research Figures Figure 1 Figure 2 Introduction Pseudomonas aeruginosa is the main gram-negative pathogen causing healthcare-associated infections in hospitalised patients. Increased resistance causes hospital infections and serious infections in many areas, including the respiratory and urinary tracts, skin and soft tissues. As a result, healthcare costs rise, leading to increased morbidity and mortality [1]. Carbapenem-resistant P. aeruginosa (CRPA) can be isolated from various parts of the body, but strains isolated from respiratory tract samples typically cause lower respiratory tract infections such as ventilator-associated pneumonia and hospital-acquired pneumonia [2]. These strains are commonly found in patients receiving mechanical ventilation in intensive care units. They typically have a higher antibiotic resistance profile and spread throughout the hospital flora [3]. Many virulence factors contribute to the pathogenicity of P. aeruginosa , including antibiotic resistance, evasion of the immune response, biofilm formation, cytotoxicity, motility and iron binding [4]. The selection of appropriate antibiotics has become difficult in recent years due to the increase in multidrug-resistant (MDR) P. aeruginosa strains [5]. The main cause of carbapenem resistance in P. aeruginosa is chromosomally mediated mechanisms, such as the expression of intrinsic β-lactamases, the loss of outer membrane proteins, and the increased activity of efflux pumps [6]. In addition, plasmid-mediated resistance genes that encode carbapenemases have been demonstrated to be rapidly transferred to other bacteria worldwide [7]. The alarming increase in the virulence and resistance of P. aeruginosa makes it necessary to closely monitor resistant pathogens for the successful treatment of this infection [8]. The production of carbapenemases in P. aeruginosa is particularly important because CRPA spreads rapidly when carbapenemase genes are acquired via mobile genetic elements [9]. Pseudomonas aeruginosa is known to produce carbapenemases from classes A, B and D. The most frequently encountered are class B metallo-β-lactamases, such as New Delhi metallo- β -lactamase (NDM), Verona integron-encoded metallo-β-lactamase (VIM) and imipenemases (IMP) [10]. A major contributor to the intrinsic and acquired bacterial resistance of microbials are multidrug efflux pumps of the resistance-nodulation-cell division (RND) superfamily. One such RND efflux pump, P. aeruginosa MexY, is particularly noteworthy because of its unusual role in mediating resistance to aminoglycoside drugs. MexY is also able to confer resistance to a range of other antimicrobial agents, such as fluoroquinolones, macrolides, tetracyclines, spectinomycin, chloramphenicol, and cefepime [11]. Pseudomonas aeruginosa produces biofilms and numerous virulence factors under the regulation of the quorum sensing (QS) mechanism, a form of cell-to-cell communication. Key virulence genes include exoA (which encodes exotoxin A), exoT and exoY (which are type III secretion system effectors), and algD (which is involved in alginate production and biofilm formation) [12]. In addition, quorum sensing regulator genes lasR and rhlR coordinate the expression of multiple virulence factors. It is crucial to assess the epidemiology and molecular characterisation of carbapenemase genes in order to characterise genetic diversity, confirm the clonal spread of CRPA, and develop infection control strategies [13]. The aim of this study is to evaluate the antibiotic susceptibility of respiratory and non-respiratory clinical CRPA isolates, screen for resistance and virulence genes, investigate the relationship between resistance genes and resistance phenotypes, and analyse clonal relationships between isolates. Materials and Methods Study isolates Between July 2018 and March 2021, we collected 58 non-duplicate, carbapenem-resistant Pseudomonas aeruginosa (CRPA) isolates, defined as resistant to imipenem and/or meropenem according to EUCAST 2021 break-points [14]. Each isolate represented a single patient in one of three clinical settings: intensive-care units (ICU, 29/58 = 50%), general hospital wards (19/58 = 33%), or out-patient clinics (10/58 = 17%). Specimen sources comprised respiratory tract samples—sputum, tracheal aspirate, or broncho-alveolar lavage—(22/58 = 38%) and non-respiratory samples (36/58 = 62%), the latter including tissue or wound swabs (12/58 = 21%), urine (10/58 = 17%), ear discharge (7/58 = 12%), blood or catheter tips (5/58 = 9%), and sterile body fluid obtained by paracentesis (2/58 = 3 %). Species identification and preliminary antimicrobial-susceptibility testing were performed with the VITEK-2 Compact system (bioMérieux, France). Isolate-level epidemiological and molecular characteristics (location, specimen type, phenotypic resistance, virulence and quorum-sensing markers, and PFGE phylotypes) are summarized in Table 1. Antimicrobial susceptibility testing Antimicrobial susceptibility was determined with the VITEK-2 Compact automated system (bioMérieux, France) using the AST-GN13 card ( Pseudomonas panel, REF 413400). The antibiotic panel comprised imipenem, meropenem, amikacin, gentamicin, tobramycin, ceftazidime, cefepime, ciprofloxacin, levofloxacin and piperacillin/tazobactam. Results were interpreted according to EUCAST breakpoint tables, version 11.0 (2021) (EUCAST 2021) [14]. Polymerase chain reaction (PCR) assays Isolates stored in 20 % glycerol at –80 °C were revived on 5 % sheep-blood agar. Genomic DNA of the isolates was extracted by the boiling method [15]. six carbapenemase genes— bla IMP , bla VIM , bla OXA-48 , blaKPC , bla NDM , bla SIM —; the efflux-associated mexY — as well as six virulence or quorum-sensing genes ( exoA , exoT , exoY , algD , lasR and rhlR ) were detected by in-house conventional PCR. Primer sequences are listed in Table 2; cycling parameters and reaction mixtures are provided in the publications [16-24] in the Supplementary Table S1. Amplicons were resolved on 1 % agarose gels (100 V, 60 min) and visualised with a MiniLumi gel documentation system (DNR Bio-Imaging Systems, Israel). Pulsed field gel electrophoresis (PFGE) The PFGE protocol as previously described [25] was modified and then applied. The DNA extracted from the isolates were digested with Spe I enzyme and run for 18 hours at 200 V (6 V/cm), 14 °C temperature, 5 seconds start and 20 seconds end pulse time in CHEF-DR II electrophoresis device (Bio-Rad Laboratories, Nazareth, Belgium) [25]. Pseudomonas aeruginosa ATCC27853 was used as a marker in the evaluation phase. After electrophoresis, the gel was stained with ethidium bromide (Amresco, USA) for 20 minutes, visualised with a UV transilluminator (Vilber Lourmat, Germany) and then was evaluated according to the principles as described prevously [26]. The gel was photographed with a gel imaging system (DNR MiniLumi, Israel). PyElph 1.3 software [27] was used for dendogram analysis. The proximity distance of the gel bands was determined as 2%. Statistical analysis All analyses were performed in Python 3.11 (Anaconda Inc., Austin TX, USA); descriptive cross-checks were carried out in SPSS v25 (IBM, Chicago IL). Categorical variables were compared with two-tailed Fisher’s exact test [28]. An initial significance level of p < 0.05 was applied, and effect size was expressed as an odds ratio (OR) with 95 % confidence intervals (CI) calculated by the Woolf log method. Zero-cell tables were adjusted with the Haldane–Anscombe 0.5 continuity correction. To control for multiple testing, raw p -values were adjusted with the Benjamini–Hochberg step-up procedure (false-discovery rate 0.05) [29]. Adjusted probabilities are reported as q -values, computed with the statsmodels package [30]. Statistical significance was judged after adjustment; hence a comparison was considered significant when q < 0.05, while 0.05 ≤ q < 0.10 was interpreted as a borderline trend. Plots were generated with Matplotlib v3.8, and descriptive percentages combine the “susceptible” and “intermediate” EUCAST categories. All Python code, Conda environment specifications used in these analyses are available in Supplementary Material. Use of AI-assisted tools Parts of manuscript preparation were assisted by an artificial-intelligence tool ( ChatGPT; OpenAI; accessed August 2025 ). The tool was used to: (i) assist with English language editing and formatting; (ii) generate and refactor Python code to reproduce the statistical analyses from our raw count tables (two-tailed Fisher’s exact tests; Benjamini–Hochberg false discovery rate adjustment; figure generation with matplotlib); and (iii) check internal consistency among tables, figures, and file names. All outputs were re-run locally and independently verified against the raw data provided in the Supplementary Materials. No confidential or patient-identifying information was entered. The tool had no role in study design, data collection, or the decision to submit and is not listed as an author . Results Antimicrobial susceptibility testing Composite susceptibility data are shown in Fig 1 . Isolates with an intermediate were pooled with the susceptible category. Resistance was highest to piperacillin–tazobactam, observed in 53 of 58 isolates (91%). Ceftazidime and cefepime shared the next-highest rates, each resisted by 47 isolates (81%). Twenty isolates (34%) exhibited a pan-drug-resistant profile, i.e. non-susceptibility to all ten agents tested. Detailed isolate-level metadata are shown in Table 1. PCR findings Quorum-sensing regulators lasR and rhlR were most frequent (53/58; 91% and 55/58; 95%, respectively). The efflux determinant mexY was detected in 28/58 isolates (48%). Distribution of carbapenemase/virulence genes by sample type Prevalence of 11 genes in respiratory (n = 22) versus non-respiratory (n = 36) isolates is summarised in Table 3. Only bla VIM appeared more common in respiratory samples in the unadjusted analysis ( p = 0.046). After Benjamini–Hochberg correction, the lowest q -value was 0.65; no comparison remained significant (Supplementary Fig S1). Sample type therefore did not independently explain gene distribution in this cohort. Relationship between exoT / exoY presence and antibiotic susceptibility Susceptibility to eight antibiotics was compared between exoT / exoY -positive and -negative subgroups (2×2 Fisher’s exact tests, two-tailed; Woolf log OR; BH-FDR across 8 comparisons per gene). For exoT , piperacillin/tazobactam showed a nominal association ( p = 0.012, OR = 17.98, 95% CI 0.94–342.35), but did not remain significant after FDR correction ( q = 0.093). For exoY , gentamicin exhibited a nominal association ( p = 0.044, OR = 0.24, 95% CI 0.06–0.97), which also did not survive FDR ( q = 0.351). No exoT / exoY –antibiotic association remained significant after multiple-testing correction, consistent with Supplementary Fig S2 (BH-adjusted q -values) and Table 4 (counts, OR, 95% CI, p , q ). PFGE results PFGE patterns were interpretable for 55/58 CRPA isolates; three isolates (H4, H20, H36) lacked evaluable banding and were excluded. No dominant outbreak PFGE type was detected. Using Dice similarity (position tolerance 2.0%, optimization 1.0%) and UPGMA clustering with an 85% similarity cut-off, 12 clusters comprising 26/55 (47%) isolates were identified (Fig 2). The largest clusters (PFGE types 30 and 34) each contained three isolates; the remaining clusters (PFGE types 1, 2, 3, 6, 8, 23, 26, 31, 38, and 41) comprised two isolates each. Cluster membership did not segregate by sample origin; identical or highly similar PFGE types occurred in both respiratory and non-respiratory isolates. For example, PFGE type 31 (H23, H24; Surgical ICU) and PFGE type 38 (H53, H55; temporary COVID-19 wards) grouped phenotypically similar isolates but lacked definitive epidemiological linkage. PFGE type 34 (three isolates; Internal-medicine ICU) carried fewer virulence markers and showed broader antibiotic susceptibility, consistent with a less concerning local clone. Overall, the dendrogram supports a polyclonal CRPA population with occasional small clusters rather than a single epidemic lineage. Isolate-level PFGE types and associated metadata are detailed in Table 1. Discussion Carbapenem-resistant Pseudomonas aeruginosa is a serious global health concern. In May 2024, the World Health Organization upgraded CRPA from the 'critical' to the 'high priority' category on its 'List of Bacterial Priority Pathogens', highlighting the ongoing need for investment in research, infection control and treatment due to persistently high resistance rates in certain regions [31]. Respiratory tract isolates are commonly encountered in intensive care units. A study conducted in 2025 revealed that CRPA isolation was an independent predictor of respiratory failure, the requirement for mechanical ventilation, and an extended hospital stay. It was also noted that the production of metallo-β-lactamase (MBL) in respiratory isolates makes treatment and infection control more difficult for these patients [32]. We suggest that the high resistance rate may be due to the fact that half of the samples were collected from the intensive care unit, in which carbapenems are commonly used for in-hospital treatment. Another reason for the high incidence of antibiotic resistance in our study may be the excessive number of hospital admissions, which has led to an increased frequency of antibiotic use. The low resistance to aminoglycosides, particularly amikacin, observed in our study is consistent with findings from the studies [33–35]. It was thought that this may be due to the substrate specificity of the aminoglycoside modifying enzyme responsible for aminoglycoside resistance and its less frequent use. Carbapenemases were first identified in Europe in the 1990s and have since increased at an alarming rate. These enzymes are mostly transported via plasmids, with KPC, VIM, IPM, NDM and OXA-48 species being the most common. Carbapenemase production was primarily detected in the Enterobacterales species, as well as in the Pseudomonas aeruginosa and Acinetobacter baumannii species [36]. In the literature, researchers have carried out phenotypic analyses studies profiling antibiotic resistance profile studies before genotypic screening to detect the presence of carbapenemases [6]. The reason for following such an algorithm may be to detect carbapenem resistance genes at a higher rate, as well as the high cost of genotypic tests compared to other tests, the need for experienced personnel, and the desire to prevent unnecessary work because the working conditions are sensitive. This study evaluated 58 P. aeruginosa isolates with carbapenem resistance and detected the bla VIM gene in three of them (5%). No positivity was observed in any of the other carbapenemase genes, nor was any gene association found. The low prevalence of carbapenemase genes among carbapenem-resistant isolates suggests that Pseudomonas 's resistance profile may be heterogeneous, with mechanisms related to alternative resistance genes, porin loss, or efflux pump activity potentially playing a role [5, 37]. A study showed the similar low carbapenemase gene rates to those in our study [38]. The finding that only the bla VIM gene tested positive is consistent with previous studies [5, 6], indicating the prevalence of the bla VIM and bla IMP genes in Pseudomonas . In the literature, there are studies that overlap with the findings of this study, as well as publications reporting higher gene detection rates. The studies carried out in our country are the most parallel to the results of this study. It has been predicted that genetic diversity can be revealed more comprehensively if the sample size increases [39]. Analysis of the relationship between resistance genes and sample source revealed that all three bla VIM -positive isolates were obtained from respiratory tract samples. However, the small sample size makes statistical interpretation difficult. In this study, 28 (48%) of the isolates were found to be mexY -positive. Similar rates of mexY positivity were also found in other studies [40]. Only one isolate showed bla VIM and mexY positivity together. Although this isolate was a respiratory tract sample, no statistically significant relationship was found between mexY positivity and sample source (Table 3 ). exoA , exoS , exoT , exoY and exoU , biofilm formation are common virulence factors of Pseudomonas aeruginosa . Quorum Sensing (QS) is the system that regulates virulence factors; it is regulated by las and rhl genes [13]. In this study, the QS genes rhlR and lasR were frequent ( rhlR 95%; lasR 91%), while the virulence genes exoY , exoT , and algD were found to be highly positive. This shows that these bacteria have high pathogenic potential and are capable of attacking in a coordinated manner by detecting environmental signals. The Las system is effective at the early stage of biofilm formation, whereas the Rhl system is effective at the later stage [13]. Some studies have found that strains containing a deficient lasR gene are less virulent, and that there is a relationship between a mutation in the lasR gene and decreased biofilm formation [41]. The high detection rate of QS gene, virulence genes and high resistance profile in our study may be related to the fact that half of the isolates were collected from the intensive care unit. Many studies indicate that exoT and exoY , two genes belonging to the T3SS family, are detected with a frequency above 90% [12]. As in our study, other studies [12, 42] have found that exoA is detected at a lower rate than exoT and exoY . In addition to studies in which the algD gene was detected in all isolates, or at high rates of up to 98% and 87%, there are also studies that detected it at a rate closer to that of our study, at around 58%. In this study, the T3SS effector genes exoT and exoY do not co-segregate with β-lactam, aminoglycoside, or fluoroquinolone resistance in this small cohort. The mechanisms mediating drug escape (efflux, porin loss, carbapenemase) appear to evolve independently of these effectors. There are studies showing that the detection rate of many P. aeruginosa virulence factors and genes, including algD , is higher in respiratory tract samples compared to other sample types [12]. In this study, no statistically significant relationship was found between virulence gene prevalence and respiratory tract and other sample types (Table 3 ). After false-discovery-rate adjustment no exoT or exoY association with antibiotic resistance remained significant (lowest q = 0.093 for exoT –TZP) (Table 4 ). Tang et al. [43] reported significant differences in TZP, levofloxacin and amikacin resistance across virulence-level groups (n = 45); exoT was found in 100% of strains and correlated with higher resistance rates. Ullah et al. [44] (burn patients) detected exoT in 100%, exoY ≈ 88%; although they did not apply FDR, they noted lower resistance to imipenem/TZP in exoY -positive isolates. Together, Table 3 and Table 4 show a sample-type-independent, polyclonal gene pool and a virulence-gene-independent resistance profile in our CRPA isolates, supporting horizontal gene transfer—rather than clonal expansion—as the primary driver of resistance dissemination. Many clustered isolates originate from intensive care units (ICUs), yet clusters cut across different ICUs and even outpatient units, suggesting sporadic introductions rather than sustained ward-specific outbreaks. Pan-drug-resistant profiles appear on multiple, genetically distant branches, supporting the idea that horizontal gene transfer (e.g., integrons, plasmids) rather than clonal spread explains the uniform resistance burden. Similar epidemiological results were presented in a study conducted in Poland with isolates collected from 11 different hospitals [45]. This finding differs from other studies reporting similar cross-contamination in intensive care units. In some studies conducted in Kosovo [46] and Europe [47], cross-contamination and clonal clusters were found more frequently in intensive care units. In a study [48] conducted in our country, genomic diversity was observed similar to this study, but no correlation was found between genotypic and phenotypic characteristics. In another study, the clustering rate of P. aeruginosa was 53%, which is in parallel with this study. There are studies suggesting that the relatively high recombination frequency of P. aeruginosa strains plays an important role in the multi-clone population structure [49]. Infection control should focus on broad horizontal-gene-transfer barriers (hand hygiene, environmental decontamination, antibiotic stewardship) rather than chasing a single clone. Surveillance schemes would benefit from whole-genome sequencing to disentangle the relative contributions of plasmid-borne resistance versus clonal spread. Our integrative re-analysis—backed by stringent BH-FDR control—aligns with the majority of recent genomic epidemiology reports (Pan et al. 2024)[50] portraying CRPA as a recombinant, gene-flux community. Outlier studies [35, 44] that tie T3SS genes to resistance likely reflect clone-specific contexts or uncorrected statistical noise [43, 44]. Consequently, it should be underscored the need to blend high-resolution genomics with disciplined statistics to disentangle true resistance-virulence synergies from epidemiological coincidences. Abbreviations AK : Amikacin BH : Benjamini–Hochberg CAZ : Ceftazidime CIP : Ciprofloxacin CI : Confidence interval CN : Gentamicin CRPA : Carbapenem-resistant Pseudomonas aeruginosa EUCAST : European Committee on Antimicrobial Susceptibility Testing FDR : False discovery rate FEP : Cefepime HGT : Horizontal gene transfer ICU : Intensive care unit I : Intermediate (EUCAST category) KPC : Klebsiella pneumoniae carbapenemase LEV : Levofloxacin MDR : Multidrug-resistant NDM : New Delhi metallo-β-lactamase OR : Odds ratio OXA-48 : OXA-48-like class D carbapenemase PCR : Polymerase chain reaction PFGE : Pulsed-field gel electrophoresis PDR : Pan-drug-resistant q-value : FDR-adjusted p -value R : Resistant (EUCAST category) SIM : Seoul imipenemase S: Susceptible (EUCAST category) SpeI : Type II restriction endonuclease SpeI T3SS : Type III secretion system TOB : Tobramycin TZP : Piperacillin/tazobactam VIM : Verona integron-encoded metallo-β-lactamase ENT : Ear, nose and throat TA : Tracheal aspirate Declarations Ethics approval and consent to participate This study was reviewed by the Recep Tayyip Erdoğan University Non-Interventional Clinical Research Ethics Committee (Recep Tayyip Erdoğan Üniversitesi Girişimsel Olmayan Klinik Araştırmalar Etik Kurulu) (decision No. 2020/181, date 20 August 2020). The Committee waived the requirement for informed consent to participate, as the research used fully de-identified residual bacterial isolates and routine laboratory data with no patient contact and no access to identifiable personal information. This waiver was granted in accordance with applicable national regulations for non-interventional research on anonymized data and institutional policy. The study was conducted in accordance with the Declaration of Helsinki and relevant institutional/national guidelines and regulations. Consent for publication Not applicable. No individual person’s data are included. Clinical trial number: not applicable. Competing interests The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. Funding This work was financially supported by the Recep Tayyip Erdogan University Scientific Research Projects Coordination Unit (Project Number TTU-2020-1191). The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Authors’ contributions HBG and OBÖ conceived and designed the study. HBG, ER, NE, and AÇÇ carried out the laboratory investigations and sample processing. OBÖ performed the formal statistical analyses and generated the figures; HBG cross-checked descriptive statistics. AÇÇ and NE provided resources and laboratory support. HBG drafted the initial version of the manuscript. OBÖ coordinated the revisions and, together with all authors, critically reviewed and edited the manuscript. OBÖ acquired funding and supervised the study. All authors read and approved the final manuscript. 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Infect Drug Resist. 2019;12:675-685. doi: 10.2147/IDR.S183151. Kidd TJ, Ritchie SR, Ramsay KA, Grimwood K, Bell SC, Rainey PB. Pseudomonas aeru ginosa exhibits frequent recombination, but only a limited association between genotype and ecological setting. PLoS One. 2012;7(9):e44199. doi: 10.1371/journal.pone.0044199. Pan Y, Zhao M, Liu W, Jia W, Li G. Study on molecular epidemiology of carbapenem resistant Pseudomonas aeruginosa and related genes of quorum sensing signal system. Microb Pathog. 2024;196:106899. doi: 10.1016/j.micpath.2024.106899. Tables Table 1 Epidemiological and molecular characteristics of the 58 CRPA isolates analysed in this study. Rows are ordered first by specimen group (top panel, respiratory; bottom panel, non-respiratory) and then by isolate code (H1–H58). For each isolate we report the hospital location, specimen source, phenotypic resistance pattern. Pseudomonas aeruginosa isolate Hospital Unit Source Antibiotic Resistance Pattern Resistance Gene(s) Virulence Gene(s) Quorum Sensing Gene(s) PFGE Phylotype Respiratory tract sample (n= 22) H4 Anaesthesia ICU TA IPM, MEM, CAZ, FEP, TZP mexY - lasR, rhlR ND H5 Surgical ICU Sputum PDR mexY exoT lasR, rhlR 1 H7 Surgical ICU TA IPM, MEM, CAZ, FEP, CIP, LEV, TZP mexY - lasR, rhlR 23 H12 Surgical ICU TA IPM, MEM, CIP, LEV, TZP mexY exoT, exoY lasR, rhlR 14 H14 Chest diseases service Lavage PDR mexY exoT lasR, rhlR 3b H17 Surgical ICU TA PDR - rhlR rhlR 32 H24 Surgical ICU TA PDR - exoY lasR 31a H26 Internal medicine ICU TA IPM, MEM, CAZ, FEP, TZP - exoT, exoY lasR, rhlR 36 H27 Surgical ICU TA IPM, MEM, CAZ, FEP, CIP, LEV, TZP - exoT, exoY lasR, rhlR 40 H28 Internal medicine ICU TA PDR bla VIM exoT, exoY lasR, rhlR 22 H31 Internal medicine ICU TA PDR - exoT, algD, exoY lasR, rhlR 2 H34 Chest diseases service TA IPM, MEM, TZP - exoT, algD, exoY lasR, rhlR 27 H36 Surgical ICU TA PDR - exoY rhlR ND H41 Internal medicine ICU TA IPM, MEM, CN, TOB, CAZ, FEP, CIP, LEV, TZP bla VIM , mexY exoT, exoY, exoA lasR, rhlR 12 H42 2nd line ICU Sputum IPM, MEM, CAZ, FEP, CIP, LEV, TZP mexY exoT, algD, exoY lasR, rhlR 16 H43 Internal medicine ICU TA IPM, MEM, CAZ, FEP, CIP, LEV, TZP - exoT, algD, exoY lasR, rhlR 17 H44 Chest diseases service TA IPM, MEM, TZP mexY exoT, exoY lasR, rhlR 37 H45 Internal medicine ICU TA IPM, MEM, CAZ, FEP, LEV, TZP mexY algD, exoY lasR, rhlR 19 H47 Chest diseases service Sputum IPM, CAZ, FEP, TZP mexY exoT, algD, exoY lasR, rhlR 24 H48 Anaesthesia ICU TA PDR bla VIM exoT, algD, exoY, exoA lasR, rhlR 13 H50 Surgical ICU TA IPM, MEM - algD, exoY, exoA lasR, rhlR 25 H55 Covid service-9 (brain surgery) TA IPM, MEM, CN, CAZ, FEP, CIP, LEV, TZP - exoT, algD, exoY, exoA lasR, rhlR 38b Non-Respiratory tract sample (n=36) H1 Orthopaedic service Tissue IPM, MEM, CN, CAZ, FEP, CIP, LEV, TZP mexY exoT lasR, rhlR 8 H2 Anaesthesia ICU Blood/Catheter PDR - algD lasR, rhlR 4 H3 Internal medicine service Wound swab PDR mexY - lasR, rhlR 1 H6 Internal medicine ICU Blood PDR mexY - lasR, rhlR 5 H8 ENT Outpatient polyclinic Ear discharge IPM, MEM, AK, CN, TOB, CAZ, CIP, LEV, TZP mexY - lasR, rhlR 23b H9 Anaesthesia ICU Urine PDR mexY - lasR, rhlR 3 H10 ENT outpatient polyclinic Ear discharge PDR mexY exoT lasR, rhlR 18 H11 Plastic surgery polyclinic Tissue PDR mexY exoT lasR, rhlR 6 H13 Surgical ICU Wound swab PDR mexY exoT, algD lasR, rhlR 6b H15 ENT outpatient polyclinic Ear discharge IPM, MEM, AK, CN, TOB, FEP, CIP, LEV, TZP mexY algD lasR, rhlR 30 H16 Internal medicine service Urine IPM, MEM, CAZ, FEP, CIP, LEV, TZP mexY exoT, algD - 30 H18 Internal medicine ICU Tissue IPM, MEM, CN - - - 34 H19 Internal medicine ICU Wound swab IPM, MEM, CN, - exoY - 30 H20 Home health services Urine IPM, MEM, CAZ, FEP, CIP, LEV, TZP - exoT, exoY lasR, rhlR ND H21 Internal medicine ICU Blood IPM, MEM, CN, CAZ, FEP, LEV, TZP - lasR, rhlR lasR, rhlR 34 H22 Internal medicine ICU Tissue IPM, MEM, CN, CAZ, FEP, LEV, TZP - lasR, rhlR lasR, rhlR 34b H23 Surgical ICU Blood PDR - exoY, lasR, rhlR lasR, rhlR 31 H25 ENT outpatient polyclinic Ear discharge PDR - exoT, algD, exoY lasR, rhlR 33 H29 Orthopaedic service Tissue IPM, MEM, CN, CAZ, FEP, TZP - exoT, exoY, exoA rhlR 20 H30 Infectious diseases service Tissue PDR mexY exoT, algD, exoY lasR, rhlR 2 H32 Internal medicine Service Urine IPM, MEM, TOB, CAZ, FEP, TZP mexY exoT, exoY lasR, rhlR 41 H33 Palliative care unit Ascites IPM, MEM mexY exoY lasR, rhlR 41a H35 Internal medicine service Wound swab IPM, MEM - algD, exoY lasR, rhlR 39 H37 Internal medicine ICU Urine IPM, MEM, CN, TOB, CAZ, FEP, CIP, LEV, TZP - exoT, exoY lasR, rhlR 35 H38 Internal medicine polyclinic Urine IPM, MEM, CAZ, FEP, LEV, TZP - algD, exoY lasR, rhlR 9 H39 Internal medicine service Urine IPM, MEM, CAZ, CIP, LEV, TZP - exoY lasR, rhlR 10 H40 ENT outpatient polyclinic Ear discharge IPM, MEM, AK, CN, TOB, FEP, CIP, LEV, TZP mexY exoT, algD, exoY lasR, rhlR 15 H46 ENT outpatient polyclinic Ear discharge IPM, MEM, AK, CN, TOB, FEP, CIP, LEV, TZP mexY exoT, algD, exoY lasR, rhlR 21 H49 Surgical ICU Tissue IPM, MEM, CN, TOB, CAZ, FEP, CIP, LEV, TZP - algD, exoY, exoA lasR, rhlR 8b H51 Internal medicine service Catheter IPM, MEM, CN, TOB, CAZ, FEP, CIP, LEV, TZP - exoT, algD lasR, rhlR 26 H52 Internal medicine service Paracentesis PDR mexY exoT, algD, exoY lasR, rhlR 26a H53 Covid service-9 (brain surgery) Wound swab IPM, MEM, CN, CAZ, FEP, CIP, LEV, TZP mexY exoT, exoY, exoA lasR, rhlR 38 H54 Anaesthesia ICU Urine IPM, MEM, CN, CAZ, FEP, TZP - exoT, algD, exoY lasR, rhlR 11 H56 ENT outpatient polyclinic Ear discharge PDR mexY algD, exoY, exoA lasR, rhlR 7 H57 Chest diseases service Urine IPM, MEM, CN, CAZ, FEP, TZP - exoT, algD, exoY lasR, rhlR 28 H58 Emergency polyclinic Urine IPM, MEM, CN, CAZ, LEV, TZP - algD, exoY, exoA lasR, rhlR 29 IMI = imipenem, MEM = meropenem, AK = amikacin, CN = gentamicin, TOB = tobramycin, CAZ = ceftazidime, FEP = cefepime, CIP = ciprofloxacin, LEV = levofloxacin, TZP = piperacillin/tazobactam; PDR = pan-drug resistance, the carbapenemase and efflux genes detected (e.g. bla VIM , mexY ), virulence genes (e.g. exoT , algD ), quorum-sensing regulators ( lasR , rhlR ), and the corresponding PFGE phylotype (PT 1–41; ND , band pattern not obtained for isolates H4, H20, and H36) Table 2 PCR primer sequences, expected amplicon sizes, and references used in this study. Group Primer Target Gene Primer Sequence (5´→ 3´) Amplicon size (bp) References Carbapenemase genes bla IMP F: CATGGTTTGGTGGTTCTTGT R: ATAATTTGGCGGACTTTGGC 488 [16] bla VIM F: ATTGGTCTATTTGACCGCGTC R: TGCTACTCAACGACTGAGCG 780 [16] bla OXA-48 F: GCGTGGTTAAGGATGAACAC R: CATCAAGTTCAACCCAACCG 442 [17] bla KPC F: ATGTCACTGTATCGCCGTCT R: TTTTCAGAGCCTTACTGCCC 893 [18] bla NDM F: GAGATTGCCGAGCGACTTG R: CGAATGTCTGGCAGCACACTT 497 [19] bla SIM F: TACAAGGGATTCGGCATCG R: TAATGGCCTGTTCCCATGTG 570 [20] Virulence Factor Genes exoA F: AACCAGCTCAGCCACATGTC R: CGCTGGCCCATTCGCTCCAGCGCT 396 [21] exoT F: AATCGCCGTCCAACTGCATGCG R: TGTTCGCCGAGGTACTGCTC 152 [21] exoY F: CGGATTCTATGGCAGGGAGG R: GCCCTTGATGCACTCGACCA 289 [21] algD F: ATGCGAATCAGCATCTTTGGT R: CTACCAGCAGATGCCCTCGGC 1311 [22] Quorum Sensing Genes lasR F:AAGTGGAAAATTGGAGTGGAG R: GTAGTTGCCGACGACGATGAAG 130 [23] rhlR F: TGCATTTTATCGATCAGGGC R: CACTTCCTTTTCCAGGACG 133 [23] Efflux/Resistance marker mexY F: CGCCGCAACTGACCCGCTACA R: GGACCACGCCGAAACCGAACG 236 [24] Table 3 Prevalence of resistance- and virulence-associated genes in respiratory versus non-respiratory CRPA isolates Gene Respiratory n(%) Non-respiratory n(%) OR 95% CI p q bla OXA-48 0 (0%) 0 (0%) 1.622 0.03–84.68 1.000 1.000 bla SIM 0 (0%) 0 (0%) 1.622 0.03–84.68 1.000 1.000 bla VIM 3 (14%) 0 (0%) 13.103 0.64–266.83 0.050 0.649 bla IMP 0 (0%) 0 (0%) 1.622 0.03–84.68 1.000 1.000 bla KPC 0 (0%) 0 (0%) 1.622 0.03–84.68 1.000 1.000 bla NDM 0 (0%) 0 (0%) 1.622 0.03–84.68 1.000 1.000 exoA 4 (18%) 5 (14%) 1.393 0.35–5.49 0.718 1.000 exoY 17 (77%) 21 (58%) 2.294 0.72–7.31 0.166 1.000 exoT 15 (68%) 18 (50%) 2.067 0.70–6.11 0.274 1.000 algD 9 (41%) 17 (47%) 0.784 0.27–2.24 0.787 1.000 mexY 10 (45%) 18 (50%) 0.840 0.30–2.38 0.791 1.000 lasR 20 (91%) 33 (92%) 0.857 0.15–4.75 1.000 1.000 rhlR 21 (95%) 34 (94%) 1.039 0.13–8.44 1.000 1.000 Counts (n) and within-group proportions (%) are shown for each gene among respiratory (n = 22) and non-respiratory (n = 36) isolates. Odds ratios (OR) and 95% confidence intervals (CI) were calculated with a Haldane–Anscombe 0.5 correction to accommodate zero cells. Two-tailed Fisher’s exact test p -values were adjusted for multiple comparisons with the Benjamini–Hochberg procedure (FDR = 0.05); adjusted values are reported as q -values. No gene remained significant after FDR correction (lowest q = 0.65). Table 4 Association between type III-secretion effector genes ( exoT , exoY ) and antibiotic resistance. Antibiotic exoT Resistant Gene+ n(%) exoT Susceptible Gene+ n(%) exoT Resistant Gene– n(%) exoT Susceptible Gene– n(%) exoT OR exoT 95% CI exoT p exoT q exoY Resistant Gene+ n(%) exoY Susceptible Gene+ n(%) exoY Resistant Gene– n(%) exoY Susceptible Gene– n(%) exoY OR exoY 95% CI exoY p exoY q Amikacin 16 (48%) 17 (52%) 13 (52%) 12 (48%) 0.869 0.31–2.46 1.000 1.000 16 (42%) 22 (58%) 13 (65%) 7 (35%) 0.392 0.13–1.20 0.167 0.373 Gentamicin 22 (67%) 11 (33%) 17 (68%) 8 (32%) 0.941 0.31–2.85 1.000 1.000 22 (58%) 16 (42%) 17 (85%) 3 (15%) 0.243 0.06–0.97 0.044 0.351 Tobramycin 17 (52%) 16 (48%) 11 (44%) 14 (56%) 1.352 0.48–3.84 0.606 0.969 15 (39%) 23 (61%) 13 (65%) 7 (35%) 0.351 0.11–1.08 0.097 0.373 Ceftazidime 28 (85%) 5 (15%) 19 (76%) 6 (24%) 1.768 0.47–6.63 0.504 0.969 29 (76%) 9 (24%) 18 (90%) 2 (10%) 0.358 0.07–1.85 0.299 0.478 Cefepime 30 (91%) 3 (9%) 18 (72%) 7 (28%) 3.889 0.89–16.97 0.083 0.221 30 (79%) 8 (21%) 18 (90%) 2 (10%) 0.417 0.08–2.18 0.468 0.614 Ciprofloxacin 27 (82%) 6 (18%) 15 (60%) 10 (40%) 3.000 0.91–9.89 0.081 0.221 26 (68%) 12 (32%) 16 (80%) 4 (20%) 0.542 0.15–1.97 0.538 0.614 Levofloxacin 27 (82%) 6 (18%) 19 (76%) 6 (24%) 1.421 0.40–5.08 0.745 0.994 28 (74%) 10 (26%) 18 (90%) 2 (10%) 0.311 0.06–1.59 0.187 0.373 Piperacillin/tazobactam 33 (100%) 0 (0%) 20 (80%) 5 (20%) 17.976 0.94–342.35 0.012 0.093 34 (89%) 4 (11%) 19 (95%) 1 (5%) 0.447 0.05–4.30 0.650 0.650 For each antibiotic, resistant and susceptible isolate counts plus proportions (%) are provided for gene-positive and gene-negative subgroups ( exoT or exoY ). Odds ratios (OR) and 95% CIs use the Woolf log method; zero cells were handled with a Haldane–Anscombe 0.5 continuity correction. Two-tailed Fisher’s exact test p -values were adjusted for eight comparisons per gene using Benjamini–Hochberg FDR (α = 0.05); q -values are reported. After adjustment, no exoT or exoY association reached significance (lowest q corresponds to exoT vs piperacillin/tazobactam). Supplementary Information Additional files 1-3 are not available with this version. Additional Declarations No competing interests reported. Supplementary Files Additionalfile4CodeandData.zip Additional file 4 (ZIP): Code & data package → Additional_file_4_Code_and_Data.zip Cite Share Download PDF Status: Published Journal Publication published 14 Mar, 2026 Read the published version in BMC Microbiology → Version 1 posted Editorial decision: Revision requested 26 Nov, 2025 Reviews received at journal 20 Nov, 2025 Reviews received at journal 20 Nov, 2025 Reviewers agreed at journal 23 Oct, 2025 Reviewers agreed at journal 23 Oct, 2025 Reviewers agreed at journal 21 Oct, 2025 Reviewers agreed at journal 21 Oct, 2025 Reviewers invited by journal 21 Oct, 2025 Editor invited by journal 30 Sep, 2025 Editor assigned by journal 25 Sep, 2025 Submission checks completed at journal 25 Sep, 2025 First submitted to journal 23 Sep, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Medicine","correspondingAuthor":false,"prefix":"","firstName":"Erva","middleName":"","lastName":"RAKICI","suffix":""},{"id":520623388,"identity":"87565ae1-c97e-4a75-b0f2-c0aea2358c6c","order_by":2,"name":"Nebahat Ejder","email":"","orcid":"","institution":"Recep Tayyip Erdogan University Faculty of Medicine","correspondingAuthor":false,"prefix":"","firstName":"Nebahat","middleName":"","lastName":"Ejder","suffix":""},{"id":520623389,"identity":"b26109b7-21c0-4b6a-bc3a-70e3f6fa6d11","order_by":3,"name":"Ayşegül Çopur Çiçek","email":"","orcid":"","institution":"Istanbul Medipol University Faculty of Medicine","correspondingAuthor":false,"prefix":"","firstName":"Ayşegül","middleName":"Çopur","lastName":"Çiçek","suffix":""},{"id":520623390,"identity":"9b1685ed-d2b3-45f4-b7c4-cd3e9f8364e8","order_by":4,"name":"Osman Birol Özgümüş","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAABBUlEQVRIiWNgGAWjYFADCeYDDAxsUA4PcVrYElC0SBChhceAOC38/MevSd1sq2Pgl+75+LiizMauf3YD44O3bQx15g3YtUg2nCmTzm07zCA55+xmwzPn0pJn3DnAbDi3jUFC5gB2LQYHe9KAWg4wGNzI3SbZ2HY4meFGAps0L1ALLpcZHOYBaakDasl5/hOkRf5GAvtvvFqOsR8DamEGaWFjBGqxMwDawoxPi2QPD7N1zrnDPJJzjhlLNpxLSzC8kdgsOeechOQM3CH28HZOWZ0cv3Tzw48NZTb2cjeSD354U2bDjztiQNGBFN2JDQyMDQz4Y5L9AQrXHo/SUTAKRsEoGKEAAOOuVQgG6nrxAAAAAElFTkSuQmCC","orcid":"","institution":"Recep Tayyip Erdogan University Faculty of Medicine","correspondingAuthor":true,"prefix":"","firstName":"Osman","middleName":"Birol","lastName":"Özgümüş","suffix":""}],"badges":[],"createdAt":"2025-09-23 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15:29:06","extension":"html","order_by":19,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":267873,"visible":true,"origin":"","legend":"","description":"","filename":"earlyproof.html","url":"https://assets-eu.researchsquare.com/files/rs-7690655/v1/d3fa51c63743dcd128e1bc14.html"},{"id":92426520,"identity":"3340568e-c674-4164-a4d2-b1ccc392fd08","added_by":"auto","created_at":"2025-09-29 15:21:06","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":139218,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eAntimicrobial profile of 58 carbapenem-resistant \u003c/strong\u003e\u003cem\u003e\u003cstrong\u003ePseudomonas aeruginosa\u003c/strong\u003e\u003c/em\u003e\u003cstrong\u003e (CRPA) isolates.\u003c/strong\u003eStacked bars show the proportions of \u003cstrong\u003eresistant (R)\u003c/strong\u003e and \u003cstrong\u003esusceptible + intermediate (S)\u003c/strong\u003e isolates for each antibiotic. Abbreviations: AK, amikacin; CN, gentamicin; TOB, tobramycin; CAZ, ceftazidime; FEP, cefepime; CIP, ciprofloxacin; LEV, levofloxacin; TZP, piperacillin/tazobactam. Exact percentages are annotated on the bars.\u003c/p\u003e","description":"","filename":"FIGURE1.png","url":"https://assets-eu.researchsquare.com/files/rs-7690655/v1/48020f7da2293dcb31139c02.png"},{"id":92427761,"identity":"d6327118-30a3-4526-9c2c-32f3cdb361a2","added_by":"auto","created_at":"2025-09-29 15:29:06","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":375725,"visible":true,"origin":"","legend":"\u003cp\u003ePulsed-field gel electrophoresis (PFGE) dendrogram and metadata for 58 CRPA isolates. Left, UPGMA dendrogram generated from SpeI macro-restriction patterns (Dice coefficient, 2 % position tolerance); the scale bar indicates percent similarity. The horizontal dashed line marks the 85 % similarity threshold used to define pulsotypes (PTs). Centre, the corresponding banding patterns; identical patterns share a colour-coded genotype number (PT 1–41). Right, isolate metadata: hospital location, specimen type (TA = tracheal aspirate), and phenotypic resistance profile (IPM = imipenem, MEM = meropenem, CAZ = ceftazidime, FEP = cefepime, CIP = ciprofloxacin, LEV = levofloxacin, TZP = piperacillin/tazobactam, AK = amikacin, CN = gentamicin, TOB = tobramycin). Clustering shows high clonal heterogeneity (41 PTs); only 12 micro-clusters (≥ 2 isolates, 26/58; 47 %) are observed, with pan-drug-resistant (PDR) phenotypes scattered across multiple unrelated PTs. TA: tracheal aspirate, ENT: otolaryngology, ICU: intensive care unit.\u003c/p\u003e","description":"","filename":"FIGURE2.png","url":"https://assets-eu.researchsquare.com/files/rs-7690655/v1/6cd401e96441b4174a1324a1.png"},{"id":104739542,"identity":"a6228366-0d46-4707-8e88-6b77636f3003","added_by":"auto","created_at":"2026-03-16 16:08:58","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":2400261,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7690655/v1/8ab3c0d3-be0c-42d0-9d4b-87472bb53cde.pdf"},{"id":92429334,"identity":"438f465d-c568-49c3-8b77-7f9577264ac8","added_by":"auto","created_at":"2025-09-29 15:45:06","extension":"zip","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":532603,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eAdditional file 4 (ZIP):\u003c/strong\u003e Code \u0026amp; data package → Additional_file_4_Code_and_Data.zip\u003c/p\u003e","description":"","filename":"Additionalfile4CodeandData.zip","url":"https://assets-eu.researchsquare.com/files/rs-7690655/v1/dd1bf6a9daabde744320260e.zip"}],"financialInterests":"No competing interests reported.","formattedTitle":"Genotypic and Phenotypic Landscape of Carbapenem-Resistant Pseudomonas aeruginosa Isolated From Respiratory and Non-Respiratory Samples in a Tertiary Hospital","fulltext":[{"header":"Introduction","content":"\u003cp\u003e\u003cem\u003ePseudomonas aeruginosa\u003c/em\u003e is the main gram-negative pathogen causing healthcare-associated infections in hospitalised patients. Increased resistance causes hospital infections and serious infections in many areas, including the respiratory and urinary tracts, skin and soft tissues. As a result, healthcare costs rise, leading to increased morbidity and mortality [1].\u003c/p\u003e\u003cp\u003eCarbapenem-resistant \u003cem\u003eP. aeruginosa\u003c/em\u003e (CRPA) can be isolated from various parts of the body, but strains isolated from respiratory tract samples typically cause lower respiratory tract infections such as ventilator-associated pneumonia and hospital-acquired pneumonia [2]. These strains are commonly found in patients receiving mechanical ventilation in intensive care units. They typically have a higher antibiotic resistance profile and spread throughout the hospital flora [3]. Many virulence factors contribute to the pathogenicity of \u003cem\u003eP. aeruginosa\u003c/em\u003e, including antibiotic resistance, evasion of the immune response, biofilm formation, cytotoxicity, motility and iron binding [4].\u003c/p\u003e\u003cp\u003eThe selection of appropriate antibiotics has become difficult in recent years due to the increase in multidrug-resistant (MDR) \u003cem\u003eP. aeruginosa\u003c/em\u003e strains [5]. The main cause of carbapenem resistance in \u003cem\u003eP. aeruginosa\u003c/em\u003e is chromosomally mediated mechanisms, such as the expression of intrinsic β-lactamases, the loss of outer membrane proteins, and the increased activity of efflux pumps [6].\u003c/p\u003e\u003cp\u003eIn addition, plasmid-mediated resistance genes that encode carbapenemases have been demonstrated to be rapidly transferred to other bacteria worldwide [7]. The alarming increase in the virulence and resistance of \u003cem\u003eP. aeruginosa\u003c/em\u003e makes it necessary to closely monitor resistant pathogens for the successful treatment of this infection [8].\u003c/p\u003e\u003cp\u003eThe production of carbapenemases in \u003cem\u003eP. aeruginosa\u003c/em\u003e is particularly important because CRPA spreads rapidly when carbapenemase genes are acquired via mobile genetic elements [9]. \u003cem\u003ePseudomonas aeruginosa\u003c/em\u003e is known to produce carbapenemases from classes A, B and D. The most frequently encountered are class B metallo-β-lactamases, such as New Delhi metallo-\u003cem\u003eβ\u003c/em\u003e-lactamase (NDM), Verona integron-encoded metallo-β-lactamase (VIM) and imipenemases (IMP) [10].\u003c/p\u003e\u003cp\u003eA major contributor to the intrinsic and acquired bacterial resistance of microbials are multidrug efflux pumps of the resistance-nodulation-cell division (RND) superfamily. One such RND efflux pump, \u003cem\u003eP. aeruginosa\u003c/em\u003e MexY, is particularly noteworthy because of its unusual role in mediating resistance to aminoglycoside drugs. MexY is also able to confer resistance to a range of other antimicrobial agents, such as fluoroquinolones, macrolides, tetracyclines, spectinomycin, chloramphenicol, and cefepime [11].\u003c/p\u003e\u003cp\u003e\u003cem\u003ePseudomonas aeruginosa\u003c/em\u003e produces biofilms and numerous virulence factors under the regulation of the quorum sensing (QS) mechanism, a form of cell-to-cell communication. Key virulence genes include \u003cem\u003eexoA\u003c/em\u003e (which encodes exotoxin A), \u003cem\u003eexoT\u003c/em\u003e and \u003cem\u003eexoY\u003c/em\u003e (which are type III secretion system effectors), and \u003cem\u003ealgD\u003c/em\u003e (which is involved in alginate production and biofilm formation) [12]. In addition, quorum sensing regulator genes \u003cem\u003elasR\u003c/em\u003e and \u003cem\u003erhlR\u003c/em\u003e coordinate the expression of multiple virulence factors. It is crucial to assess the epidemiology and molecular characterisation of carbapenemase genes in order to characterise genetic diversity, confirm the clonal spread of CRPA, and develop infection control strategies [13].\u003c/p\u003e\u003cp\u003eThe aim of this study is to evaluate the antibiotic susceptibility of respiratory and non-respiratory clinical CRPA isolates, screen for resistance and virulence genes, investigate the relationship between resistance genes and resistance phenotypes, and analyse clonal relationships between isolates.\u003c/p\u003e"},{"header":"Materials and Methods","content":"\u003cp\u003e\u003cstrong\u003eStudy isolates\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eBetween July 2018 and March 2021, we collected 58 non-duplicate, carbapenem-resistant Pseudomonas aeruginosa (CRPA) isolates, defined as resistant to imipenem and/or meropenem according to EUCAST 2021 break-points [14]. Each isolate represented a single patient in one of three clinical settings: intensive-care units (ICU, 29/58 = 50%), general hospital wards (19/58 = 33%), or out-patient clinics (10/58 = 17%). Specimen sources comprised respiratory tract samples\u0026mdash;sputum, tracheal aspirate, or broncho-alveolar lavage\u0026mdash;(22/58 = 38%) and non-respiratory samples (36/58 = 62%), the latter including tissue or wound swabs (12/58 = 21%), urine (10/58 = 17%), ear discharge (7/58 = 12%), blood or catheter tips (5/58 = 9%), and sterile body fluid obtained by paracentesis (2/58 = 3 %). Species identification and preliminary antimicrobial-susceptibility testing were performed with the VITEK-2 Compact system (bioM\u0026eacute;rieux, France). Isolate-level epidemiological and molecular characteristics (location, specimen type, phenotypic resistance, virulence and quorum-sensing markers, and PFGE phylotypes) are summarized in Table 1.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAntimicrobial susceptibility testing\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAntimicrobial susceptibility was determined with the VITEK-2 Compact automated system (bioM\u0026eacute;rieux, France) using the AST-GN13 card (\u003cem\u003ePseudomonas\u003c/em\u003e panel, REF 413400). The antibiotic panel comprised imipenem, meropenem, amikacin, gentamicin, tobramycin, ceftazidime, cefepime, ciprofloxacin, levofloxacin and piperacillin/tazobactam. Results were interpreted according to EUCAST breakpoint tables, version 11.0 (2021) (EUCAST 2021) [14].\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ePolymerase chain reaction (PCR) assays\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eIsolates stored in 20 % glycerol at \u0026ndash;80 \u0026deg;C were revived on 5 % sheep-blood agar. Genomic DNA of the isolates was extracted by the boiling method [15]. six carbapenemase genes\u0026mdash;\u003cem\u003ebla\u003c/em\u003e\u003csub\u003eIMP\u003c/sub\u003e, \u003cem\u003ebla\u003c/em\u003e\u003csub\u003eVIM\u003c/sub\u003e, \u003cem\u003ebla\u003c/em\u003e\u003csub\u003eOXA-48\u003c/sub\u003e, \u003cem\u003eblaKPC\u003c/em\u003e, \u003cem\u003ebla\u003c/em\u003e\u003csub\u003eNDM\u003c/sub\u003e, \u003cem\u003ebla\u003c/em\u003e\u003csub\u003eSIM\u003c/sub\u003e\u0026mdash;; the efflux-associated \u003cem\u003emexY\u003c/em\u003e\u0026mdash; as well as six virulence or quorum-sensing genes (\u003cem\u003eexoA\u003c/em\u003e, \u003cem\u003eexoT\u003c/em\u003e, \u003cem\u003eexoY\u003c/em\u003e, \u003cem\u003ealgD\u003c/em\u003e, \u003cem\u003elasR\u003c/em\u003e and \u003cem\u003erhlR\u003c/em\u003e) were detected by in-house conventional PCR. Primer sequences are listed in Table 2; cycling parameters and reaction mixtures are provided in the publications [16-24] in the Supplementary Table S1. Amplicons were resolved on 1 % agarose gels (100 V, 60 min) and visualised with a MiniLumi gel documentation system (DNR Bio-Imaging Systems, Israel).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ePulsed field gel electrophoresis (PFGE)\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe PFGE protocol as previously described [25] was modified and then applied. The DNA extracted from the isolates were digested with \u003cem\u003eSpe\u003c/em\u003eI enzyme and run for 18 hours at 200 V (6 V/cm), 14 \u0026deg;C temperature, 5 seconds start and 20 seconds end pulse time in CHEF-DR II electrophoresis device (Bio-Rad Laboratories, Nazareth, Belgium) [25]. \u003cem\u003ePseudomonas aeruginosa\u003c/em\u003e ATCC27853 was used as a marker in the evaluation phase. After electrophoresis, the gel was stained with ethidium bromide (Amresco, USA) for 20 minutes, visualised with a UV transilluminator (Vilber Lourmat, Germany) and then was evaluated according to the principles as described prevously [26]. The gel was photographed with a gel imaging system (DNR MiniLumi, Israel). PyElph 1.3 software [27] was used for dendogram analysis. The proximity distance of the gel bands was determined as 2%.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStatistical analysis\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll analyses were performed in Python 3.11 (Anaconda Inc., Austin TX, USA); descriptive cross-checks were carried out in SPSS v25 (IBM, Chicago IL). Categorical variables were compared with two-tailed Fisher\u0026rsquo;s exact test [28]. An initial significance level of \u003cem\u003ep\u003c/em\u003e \u0026lt; 0.05 was applied, and effect size was expressed as an odds ratio (OR) with 95 % confidence intervals (CI) calculated by the Woolf log method. Zero-cell tables were adjusted with the Haldane\u0026ndash;Anscombe 0.5 continuity correction. To control for multiple testing, raw \u003cem\u003ep\u003c/em\u003e-values were adjusted with the Benjamini\u0026ndash;Hochberg step-up procedure (false-discovery rate 0.05) [29]. Adjusted probabilities are reported as \u003cem\u003eq\u003c/em\u003e-values, computed with the statsmodels package [30]. Statistical significance was judged after adjustment; hence a comparison was considered significant when \u003cem\u003eq\u003c/em\u003e \u0026lt; 0.05, while 0.05 \u0026le; \u003cem\u003eq\u003c/em\u003e \u0026lt; 0.10 was interpreted as a borderline trend. Plots were generated with Matplotlib v3.8, and descriptive percentages combine the \u0026ldquo;susceptible\u0026rdquo; and \u0026ldquo;intermediate\u0026rdquo; EUCAST categories. All Python code, Conda environment specifications used in these analyses are available in Supplementary Material.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eUse of AI-assisted tools\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eParts of manuscript preparation were assisted by an artificial-intelligence tool (\u003cstrong\u003eChatGPT; OpenAI; accessed August 2025\u003c/strong\u003e). The tool was used to: (i) assist with English language editing and formatting; (ii) generate and refactor Python code to reproduce the statistical analyses from our raw count tables (two-tailed Fisher\u0026rsquo;s exact tests; Benjamini\u0026ndash;Hochberg false discovery rate adjustment; figure generation with matplotlib); and (iii) check internal consistency among tables, figures, and file names. \u003cstrong\u003eAll outputs were re-run locally and independently verified\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003eagainst the raw data provided in the Supplementary Materials. \u003cstrong\u003eNo confidential or patient-identifying information\u003c/strong\u003e was entered. The tool had no role in study design, data collection, or the decision to submit and \u003cstrong\u003eis not listed as an author\u003c/strong\u003e.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003e\u003cstrong\u003eAntimicrobial susceptibility testing\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eComposite susceptibility data are shown in \u003cem\u003eFig 1\u003c/em\u003e\u003cem\u003e.\u003c/em\u003e Isolates with an intermediate were pooled with the susceptible category. Resistance was highest to piperacillin\u0026ndash;tazobactam, observed in 53 of 58 isolates (91%). Ceftazidime and cefepime shared the next-highest rates, each resisted by 47 isolates (81%). Twenty isolates (34%) exhibited a pan-drug-resistant profile, i.e. non-susceptibility to all ten agents tested. Detailed isolate-level metadata are shown in Table 1.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ePCR findings\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eQuorum-sensing regulators \u003cem\u003elasR\u003c/em\u003e and \u003cem\u003erhlR\u003c/em\u003e were most frequent (53/58; 91% and 55/58; 95%, respectively). The efflux determinant \u003cem\u003emexY\u003c/em\u003e was detected in 28/58 isolates (48%).\u003c/p\u003e\n\u003ch3\u003e\u003cstrong\u003eDistribution of carbapenemase/virulence genes by sample type\u003c/strong\u003e\u003c/h3\u003e\n\u003cp\u003ePrevalence of 11 genes in respiratory (n = 22) versus non-respiratory (n = 36) isolates is summarised in Table 3. Only \u003cem\u003ebla\u003c/em\u003e\u003csub\u003eVIM\u003c/sub\u003e appeared more common in respiratory samples in the unadjusted analysis (\u003cem\u003ep\u003c/em\u003e = 0.046). After Benjamini\u0026ndash;Hochberg correction, the lowest \u003cem\u003eq\u003c/em\u003e-value was 0.65; no comparison remained significant (Supplementary Fig S1). Sample type therefore did not independently explain gene distribution in this cohort.\u003c/p\u003e\n\u003ch1\u003e\u003cstrong\u003eRelationship between \u003cem\u003eexoT\u003c/em\u003e / \u003cem\u003eexoY\u003c/em\u003e presence and antibiotic susceptibility\u003c/strong\u003e\u003c/h1\u003e\n\u003cp\u003eSusceptibility to eight antibiotics was compared between \u003cem\u003eexoT\u003c/em\u003e/\u003cem\u003eexoY\u003c/em\u003e-positive and -negative subgroups (2\u0026times;2 Fisher\u0026rsquo;s exact tests, two-tailed; Woolf log OR; BH-FDR across 8 comparisons per gene). For \u003cem\u003eexoT\u003c/em\u003e, piperacillin/tazobactam showed a nominal association (\u003cem\u003ep\u003c/em\u003e = 0.012, OR = 17.98, 95% CI 0.94\u0026ndash;342.35), but did not remain significant after FDR correction (\u003cem\u003eq\u003c/em\u003e = 0.093). For \u003cem\u003eexoY\u003c/em\u003e, gentamicin exhibited a nominal association (\u003cem\u003ep\u003c/em\u003e = 0.044, OR = 0.24, 95% CI 0.06\u0026ndash;0.97), which also did not survive FDR (\u003cem\u003eq\u003c/em\u003e = 0.351). No \u003cem\u003eexoT\u003c/em\u003e/\u003cem\u003eexoY\u003c/em\u003e\u0026ndash;antibiotic association remained significant after multiple-testing correction, consistent with Supplementary Fig S2 (BH-adjusted \u003cem\u003eq\u003c/em\u003e-values) and Table 4 (counts, OR, 95% CI, \u003cem\u003ep\u003c/em\u003e, \u003cem\u003eq\u003c/em\u003e).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ePFGE results\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003ePFGE patterns were interpretable for 55/58 CRPA isolates; three isolates (H4, H20, H36) lacked evaluable banding and were excluded. No dominant outbreak PFGE type was detected. Using Dice similarity (position tolerance 2.0%, optimization 1.0%) and UPGMA clustering with an 85% similarity cut-off, 12 clusters comprising 26/55 (47%) isolates were identified (Fig 2). The largest clusters (PFGE types 30 and 34) each contained three isolates; the remaining clusters (PFGE types 1, 2, 3, 6, 8, 23, 26, 31, 38, and 41) comprised two isolates each. Cluster membership did not segregate by sample origin; identical or highly similar PFGE types occurred in both respiratory and non-respiratory isolates. For example, PFGE type 31 (H23, H24; Surgical ICU) and PFGE type 38 (H53, H55; temporary COVID-19 wards) grouped phenotypically similar isolates but lacked definitive epidemiological linkage. PFGE type 34 (three isolates; Internal-medicine ICU) carried fewer virulence markers and showed broader antibiotic susceptibility, consistent with a less concerning local clone. Overall, the dendrogram supports a polyclonal CRPA population with occasional small clusters rather than a single epidemic lineage. Isolate-level PFGE types and associated metadata are detailed in Table 1.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eCarbapenem-resistant \u003cem\u003ePseudomonas aeruginosa\u003c/em\u003e is a serious global health concern. In May 2024, the World Health Organization upgraded CRPA from the 'critical' to the 'high priority' category on its 'List of Bacterial Priority Pathogens', highlighting the ongoing need for investment in research, infection control and treatment due to persistently high resistance rates in certain regions [31].\u003c/p\u003e\u003cp\u003eRespiratory tract isolates are commonly encountered in intensive care units. A study conducted in 2025 revealed that CRPA isolation was an independent predictor of respiratory failure, the requirement for mechanical ventilation, and an extended hospital stay. It was also noted that the production of metallo-β-lactamase (MBL) in respiratory isolates makes treatment and infection control more difficult for these patients [32]. We suggest that the high resistance rate may be due to the fact that half of the samples were collected from the intensive care unit, in which carbapenems are commonly used for in-hospital treatment. Another reason for the high incidence of antibiotic resistance in our study may be the excessive number of hospital admissions, which has led to an increased frequency of antibiotic use. The low resistance to aminoglycosides, particularly amikacin, observed in our study is consistent with findings from the studies [33\u0026ndash;35]. It was thought that this may be due to the substrate specificity of the aminoglycoside modifying enzyme responsible for aminoglycoside resistance and its less frequent use.\u003c/p\u003e\u003cp\u003eCarbapenemases were first identified in Europe in the 1990s and have since increased at an alarming rate. These enzymes are mostly transported via plasmids, with KPC, VIM, IPM, NDM and OXA-48 species being the most common. Carbapenemase production was primarily detected in the \u003cem\u003eEnterobacterales\u003c/em\u003e species, as well as in the \u003cem\u003ePseudomonas aeruginosa\u003c/em\u003e and \u003cem\u003eAcinetobacter baumannii\u003c/em\u003e species [36]. In the literature, researchers have carried out phenotypic analyses studies profiling antibiotic resistance profile studies before genotypic screening to detect the presence of carbapenemases [6]. The reason for following such an algorithm may be to detect carbapenem resistance genes at a higher rate, as well as the high cost of genotypic tests compared to other tests, the need for experienced personnel, and the desire to prevent unnecessary work because the working conditions are sensitive. This study evaluated 58 \u003cem\u003eP. aeruginosa\u003c/em\u003e isolates with carbapenem resistance and detected the \u003cem\u003ebla\u003c/em\u003e\u003csub\u003eVIM\u003c/sub\u003e gene in three of them (5%). No positivity was observed in any of the other carbapenemase genes, nor was any gene association found. The low prevalence of carbapenemase genes among carbapenem-resistant isolates suggests that \u003cem\u003ePseudomonas\u003c/em\u003e's resistance profile may be heterogeneous, with mechanisms related to alternative resistance genes, porin loss, or efflux pump activity potentially playing a role [5, 37]. A study showed the similar low carbapenemase gene rates to those in our study [38]. The finding that only the \u003cem\u003ebla\u003c/em\u003e\u003csub\u003eVIM\u003c/sub\u003e gene tested positive is consistent with previous studies [5, 6], indicating the prevalence of the \u003cem\u003ebla\u003c/em\u003e\u003csub\u003eVIM\u003c/sub\u003e and \u003cem\u003ebla\u003c/em\u003e\u003csub\u003eIMP\u003c/sub\u003e genes in \u003cem\u003ePseudomonas\u003c/em\u003e. In the literature, there are studies that overlap with the findings of this study, as well as publications reporting higher gene detection rates. The studies carried out in our country are the most parallel to the results of this study. It has been predicted that genetic diversity can be revealed more comprehensively if the sample size increases [39]. Analysis of the relationship between resistance genes and sample source revealed that all three \u003cem\u003ebla\u003c/em\u003e\u003csub\u003eVIM\u003c/sub\u003e-positive isolates were obtained from respiratory tract samples. However, the small sample size makes statistical interpretation difficult.\u003c/p\u003e\u003cp\u003eIn this study, 28 (48%) of the isolates were found to be \u003cem\u003emexY\u003c/em\u003e-positive. Similar rates of \u003cem\u003emexY\u003c/em\u003e positivity were also found in other studies [40]. Only one isolate showed \u003cem\u003ebla\u003c/em\u003e\u003csub\u003eVIM\u003c/sub\u003e and \u003cem\u003emexY\u003c/em\u003e positivity together. Although this isolate was a respiratory tract sample, no statistically significant relationship was found between \u003cem\u003emexY\u003c/em\u003e positivity and sample source (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003cem\u003eexoA\u003c/em\u003e, \u003cem\u003eexoS\u003c/em\u003e, \u003cem\u003eexoT\u003c/em\u003e, \u003cem\u003eexoY\u003c/em\u003e and \u003cem\u003eexoU\u003c/em\u003e, biofilm formation are common virulence factors of \u003cem\u003ePseudomonas aeruginosa\u003c/em\u003e. Quorum Sensing (QS) is the system that regulates virulence factors; it is regulated by las and \u003cem\u003erhl\u003c/em\u003e genes [13]. In this study, the QS genes rhlR and lasR were frequent (\u003cem\u003erhlR\u003c/em\u003e 95%; \u003cem\u003elasR\u003c/em\u003e 91%), while the virulence genes \u003cem\u003eexoY\u003c/em\u003e, \u003cem\u003eexoT\u003c/em\u003e, and \u003cem\u003ealgD\u003c/em\u003e were found to be highly positive. This shows that these bacteria have high pathogenic potential and are capable of attacking in a coordinated manner by detecting environmental signals. The Las system is effective at the early stage of biofilm formation, whereas the Rhl system is effective at the later stage [13]. Some studies have found that strains containing a deficient \u003cem\u003elasR\u003c/em\u003e gene are less virulent, and that there is a relationship between a mutation in the \u003cem\u003elasR\u003c/em\u003e gene and decreased biofilm formation [41]. The high detection rate of QS gene, virulence genes and high resistance profile in our study may be related to the fact that half of the isolates were collected from the intensive care unit.\u003c/p\u003e\u003cp\u003eMany studies indicate that \u003cem\u003eexoT\u003c/em\u003e and \u003cem\u003eexoY\u003c/em\u003e, two genes belonging to the T3SS family, are detected with a frequency above 90% [12]. As in our study, other studies [12, 42] have found that \u003cem\u003eexoA\u003c/em\u003e is detected at a lower rate than \u003cem\u003eexoT\u003c/em\u003e and \u003cem\u003eexoY\u003c/em\u003e. In addition to studies in which the \u003cem\u003ealgD\u003c/em\u003e gene was detected in all isolates, or at high rates of up to 98% and 87%, there are also studies that detected it at a rate closer to that of our study, at around 58%. In this study, the T3SS effector genes \u003cem\u003eexoT\u003c/em\u003e and \u003cem\u003eexoY\u003c/em\u003e do not co-segregate with β-lactam, aminoglycoside, or fluoroquinolone resistance in this small cohort. The mechanisms mediating drug escape (efflux, porin loss, carbapenemase) appear to evolve independently of these effectors. There are studies showing that the detection rate of many \u003cem\u003eP. aeruginosa\u003c/em\u003e virulence factors and genes, including \u003cem\u003ealgD\u003c/em\u003e, is higher in respiratory tract samples compared to other sample types [12]. In this study, no statistically significant relationship was found between virulence gene prevalence and respiratory tract and other sample types (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e). After false-discovery-rate adjustment no \u003cem\u003eexoT\u003c/em\u003e or \u003cem\u003eexoY\u003c/em\u003e association with antibiotic resistance remained significant (lowest \u003cem\u003eq\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.093 for \u003cem\u003eexoT\u003c/em\u003e\u0026ndash;TZP) (Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e). Tang et al. [43] reported significant differences in TZP, levofloxacin and amikacin resistance across virulence-level groups (n\u0026thinsp;=\u0026thinsp;45); \u003cem\u003eexoT\u003c/em\u003e was found in 100% of strains and correlated with higher resistance rates. Ullah et al. [44] (burn patients) detected \u003cem\u003eexoT\u003c/em\u003e in 100%, \u003cem\u003eexoY\u003c/em\u003e\u0026thinsp;\u0026asymp;\u0026thinsp;88%; although they did not apply FDR, they noted lower resistance to imipenem/TZP in \u003cem\u003eexoY\u003c/em\u003e-positive isolates. Together, Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e and Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e show a sample-type-independent, polyclonal gene pool and a virulence-gene-independent resistance profile in our CRPA isolates, supporting horizontal gene transfer\u0026mdash;rather than clonal expansion\u0026mdash;as the primary driver of resistance dissemination.\u003c/p\u003e\u003cp\u003eMany clustered isolates originate from intensive care units (ICUs), yet clusters cut across different ICUs and even outpatient units, suggesting \u003cem\u003esporadic introductions\u003c/em\u003e rather than sustained ward-specific outbreaks. Pan-drug-resistant profiles appear on multiple, genetically distant branches, supporting the idea that horizontal gene transfer (e.g., integrons, plasmids) rather than clonal spread explains the uniform resistance burden. Similar epidemiological results were presented in a study conducted in Poland with isolates collected from 11 different hospitals [45]. This finding differs from other studies reporting similar cross-contamination in intensive care units. In some studies conducted in Kosovo [46] and Europe [47], cross-contamination and clonal clusters were found more frequently in intensive care units. In a study [48] conducted in our country, genomic diversity was observed similar to this study, but no correlation was found between genotypic and phenotypic characteristics. In another study, the clustering rate of \u003cem\u003eP. aeruginosa\u003c/em\u003e was 53%, which is in parallel with this study. There are studies suggesting that the relatively high recombination frequency of \u003cem\u003eP. aeruginosa\u003c/em\u003e strains plays an important role in the multi-clone population structure [49].\u003c/p\u003e\u003cp\u003eInfection control should focus on broad horizontal-gene-transfer barriers (hand hygiene, environmental decontamination, antibiotic stewardship) rather than chasing a single clone. Surveillance schemes would benefit from whole-genome sequencing to disentangle the relative contributions of plasmid-borne resistance versus clonal spread. Our integrative re-analysis\u0026mdash;backed by stringent BH-FDR control\u0026mdash;aligns with the majority of recent genomic epidemiology reports (Pan et al. 2024)[50] portraying CRPA as a recombinant, gene-flux community. Outlier studies [35, 44] that tie T3SS genes to resistance likely reflect clone-specific contexts or uncorrected statistical noise [43, 44].\u003c/p\u003e\u003cp\u003eConsequently, it should be underscored the need to blend high-resolution genomics with disciplined statistics to disentangle true resistance-virulence synergies from epidemiological coincidences.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003e\u003cstrong\u003eAK\u003c/strong\u003e: Amikacin\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eBH\u003c/strong\u003e: Benjamini\u0026ndash;Hochberg\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCAZ\u003c/strong\u003e: Ceftazidime\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCIP\u003c/strong\u003e: Ciprofloxacin\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCI\u003c/strong\u003e: Confidence interval\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCN\u003c/strong\u003e: Gentamicin\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCRPA\u003c/strong\u003e: Carbapenem-resistant \u003cem\u003ePseudomonas aeruginosa\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEUCAST\u003c/strong\u003e: European Committee on Antimicrobial Susceptibility Testing\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFDR\u003c/strong\u003e: False discovery rate\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFEP\u003c/strong\u003e: Cefepime\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eHGT\u003c/strong\u003e: Horizontal gene transfer\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eICU\u003c/strong\u003e: Intensive care unit\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eI\u003c/strong\u003e: Intermediate (EUCAST category)\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eKPC\u003c/strong\u003e:\u0026nbsp;\u003cem\u003eKlebsiella pneumoniae\u003c/em\u003e carbapenemase\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eLEV\u003c/strong\u003e: Levofloxacin\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMDR\u003c/strong\u003e: Multidrug-resistant\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eNDM\u003c/strong\u003e: New Delhi metallo-\u0026beta;-lactamase\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eOR\u003c/strong\u003e: Odds ratio\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eOXA-48\u003c/strong\u003e: OXA-48-like class D carbapenemase\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ePCR\u003c/strong\u003e: Polymerase chain reaction\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ePFGE\u003c/strong\u003e: Pulsed-field gel electrophoresis\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ePDR\u003c/strong\u003e: Pan-drug-resistant\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eq-value\u003c/strong\u003e: FDR-adjusted\u0026nbsp;\u003cem\u003ep\u003c/em\u003e-value\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eR\u003c/strong\u003e: Resistant (EUCAST category)\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSIM\u003c/strong\u003e: Seoul imipenemase\u003c/p\u003e\n\u003cp\u003eS: Susceptible (EUCAST category)\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSpeI\u003c/strong\u003e: Type II restriction endonuclease SpeI\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eT3SS\u003c/strong\u003e: Type III secretion system\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTOB\u003c/strong\u003e: Tobramycin\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTZP\u003c/strong\u003e: Piperacillin/tazobactam\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eVIM\u003c/strong\u003e: Verona integron-encoded metallo-\u0026beta;-lactamase\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eENT\u003c/strong\u003e: Ear, nose and throat\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTA\u003c/strong\u003e: Tracheal aspirate\u003c/p\u003e"},{"header":"Declarations","content":"\u003ch3\u003eEthics approval and consent to participate\u003c/h3\u003e\n\u003cp\u003eThis study was reviewed by the\u0026nbsp;Recep Tayyip Erdoğan University Non-Interventional Clinical Research Ethics Committee (Recep Tayyip Erdoğan \u0026Uuml;niversitesi Girişimsel Olmayan Klinik Araştırmalar Etik Kurulu) (decision No.\u0026nbsp;2020/181, date\u0026nbsp;20 August 2020). The Committee\u0026nbsp;waived the requirement for informed consent to participate, as the research used fully\u0026nbsp;de-identified residual bacterial isolates and routine laboratory data with\u0026nbsp;no patient contact and\u0026nbsp;no access to identifiable personal information. This waiver was granted\u0026nbsp;in accordance with applicable national regulations for non-interventional research on anonymized data and institutional policy. The study was conducted in accordance with the\u0026nbsp;Declaration of Helsinki and relevant institutional/national guidelines and regulations.\u003c/p\u003e\n\u003ch3\u003eConsent for publication\u003c/h3\u003e\n\u003cp\u003eNot applicable. No individual person\u0026rsquo;s data are included.\u003c/p\u003e\n\u003ch3\u003eClinical trial number:\u0026nbsp;\u003c/h3\u003e\n\u003cp\u003enot applicable.\u003c/p\u003e\n\u003ch3\u003eCompeting interests\u003c/h3\u003e\n\u003cp\u003eThe authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.\u003c/p\u003e\n\u003ch3\u003eFunding\u003c/h3\u003e\n\u003cp\u003eThis work was financially supported by the Recep Tayyip Erdogan University Scientific Research Projects Coordination Unit (Project Number TTU-2020-1191). The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.\u003c/p\u003e\n\u003ch3\u003eAuthors\u0026rsquo; contributions\u003c/h3\u003e\n\u003cp\u003eHBG and OB\u0026Ouml; conceived and designed the study. HBG, ER, NE, and A\u0026Ccedil;\u0026Ccedil; carried out the laboratory investigations and sample processing. OB\u0026Ouml; performed the formal statistical analyses and generated the figures; HBG cross-checked descriptive statistics. A\u0026Ccedil;\u0026Ccedil; and NE provided resources and laboratory support. HBG drafted the initial version of the manuscript. OB\u0026Ouml; coordinated the revisions and, together with all authors, critically reviewed and edited the manuscript. OB\u0026Ouml; acquired funding and supervised the study. All authors read and approved the final manuscript.\u0026nbsp;\u0026nbsp;\u003c/p\u003e\n\u003ch3\u003eAcknowledgements\u003c/h3\u003e\n\u003cp\u003eNone\u003c/p\u003e\n\u003ch3\u003eAvailability of data and materials\u003c/h3\u003e\n\u003cp\u003eAll data supporting the results are provided within the article and its Additional files. Machine-readable raw counts (\u003cem\u003etable3_counts.csv\u003c/em\u003e, \u003cem\u003etable4_counts_corrected.csv\u003c/em\u003e) and the analysis script (\u003cem\u003ereproduce_analysis_corrected.py\u003c/em\u003e) with the environment file (\u003cem\u003eenvironment.yml\u003c/em\u003e) are packaged in Additional file 4 (ZIP) and archived on Zenodo (https://doi.org/10.5281/zenodo.16029015), enabling full reproducibility. De-identified isolate-level metadata underlying Table 1 are available from the corresponding author upon reasonable request; no patient-identifying information is included.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eHilliam Y, Kaye S, Winstanley C. \u003cem\u003ePseudomonas aeruginosa\u003c/em\u003e and microbial keratitis. J Med Microbiol\u003cem\u003e. \u003c/em\u003e2020;69(1):3-13. https://doi.org/10.1099/jmm.0.001110\u003c/li\u003e\n\u003cli\u003ePang Z, Raudonis R, Glick BR, Lin TJ, Cheng Z. 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Ann Intensive Care. 2025;15(1):42. doi: 10.1186/s13613-025-01461-z.\u003c/li\u003e\n\u003cli\u003eHolbrook SYL, Garneau-Tsodikova S. Evaluation of aminoglycoside and carbapenem resistance in a collection of drug-resistant \u003cem\u003ePseudomonas aeruginosa\u003c/em\u003e clinical isolates. Microb Drug Resist. 2018;24(7):1020-1030. doi: 10.1089/mdr.2017.0101.\u003c/li\u003e\n\u003cli\u003eNasser M, Gayen S, Kharat AS. Prevalence of \u0026beta;-lactamase and antibiotic-resistant \u003cem\u003ePseudomonas aeruginosa\u003c/em\u003e in the Arab region. J Glob Antimicrob Resist. 2020;22:152-160. doi: 10.1016/j.jgar.2020.01.011.\u003c/li\u003e\n\u003cli\u003eIbik YE, Ejder N, Sevim E, Rakici E, Tanriverdi ES, Copur Cicek A. Evaluating molecular epidemiology of carbapenem non-susceptible \u003cem\u003eKlebsiella pneumoniae\u003c/em\u003e isolates with MLST, MALDI-TOF MS, PFGE. Ann Clin Microbiol Antimicrob. 2023 Oct 27;22(1):93. doi: 10.1186/s12941-023-00640-9.\u003c/li\u003e\n\u003cli\u003eAksoy MD, Tuğrul HM. Investigation of metallo-beta-lactamases in carbapenem-resistant \u003cem\u003ePseudomonas aeruginosa\u003c/em\u003e strains by phenotypic and genotypic methods. FLORA Infect Dis Clin Microbiol. 2020;25(3):301-307. doi: 10.5578/flora.68921.\u003c/li\u003e\n\u003cli\u003eAltan G, Rakici E, \u0026Ouml;zg\u0026uuml;m\u0026uuml;ş OB. Klinik \u0026ouml;rneklerden izole edilen karbapenem diren\u0026ccedil;li \u003cem\u003ePseudomonas aeruginosa\u003c/em\u003e izolatlarındaki antibiyotik direncinin molek\u0026uuml;ler analizi [Molecular analysis of antibiotic resistance in carbapenem resistant \u003cem\u003ePseudomonas aeruginosa\u003c/em\u003e isolates isolated from clinical samples]. Mikrobiyol Bul. 2024;58(2):148-170. Turkish. doi: 10.5578/mb.202498200\u003c/li\u003e\n\u003cli\u003eRostami S, Farajzadeh Sheikh A, Shoja S, Farahani A, Tabatabaiefar MA, Jolodar A, et al. Investigating of four main carbapenem-resistance mechanisms ın high-level carbapenem resistant \u003cem\u003ePseudomonas aeruginosa\u003c/em\u003e isolated from burn patients. J Chin Med Assoc. 2018;81(2):127-132. doi: 10.1016/j.jcma.2017.08.016.\u003c/li\u003e\n\u003cli\u003eZhu H, Bandara R, Conibear TC, Thuruthyil SJ, Rice SA, Kjelleberg S, Givskov M, Willcox MD. \u003cem\u003ePseudomonas aeruginosa\u003c/em\u003e with \u003cem\u003elasI\u003c/em\u003e quorum-sensing deficiency during corneal ınfection. Invest Ophthalmol Vis Sci. 2004;45(6):1897-903. doi: 10.1167/iovs.03-0980.\u003c/li\u003e\n\u003cli\u003eAl Dawodeyah HY, Obeidat N, Abu-Qatouseh LF, Shehabi AA. Antimicrobial resistance and putative virulence genes of \u003cem\u003ePseudomonas aeruginosa\u003c/em\u003e isolates from patients with respiratory tract infection. Germs. 2018;8(1):31-40. doi: 10.18683/germs.2018.1130.\u003c/li\u003e\n\u003cli\u003eTang J, Pu J, Zhao L, Zhan X, Pang Q, Meng X, Feng R, Fan H. Carbapenem-resistant \u003cem\u003ePseudomonas aeruginosa\u003c/em\u003e T3SS virulence genes and correlation between virulence and drug resistance and molecular epidemiology studies. Front Pharmacol. 2025;16:1591724. doi: 10.3389/fphar.2025.1591724.\u003c/li\u003e\n\u003cli\u003eUllah R, Amir M, Anjum S, Ur Rehman M, Noorul Hasan T, Sajjad Naqvi S, et al. Presence of T3SS (\u003cem\u003eexoS\u003c/em\u003e, \u003cem\u003eexoT\u003c/em\u003e, \u003cem\u003eexoU\u003c/em\u003e and \u003cem\u003eexoY\u003c/em\u003e), susceptibility pattern and MIC of MDR-\u003cem\u003ePseudomonas aeruginosa \u003c/em\u003efrom burn wounds. J Infect Dev Ctries. 2023;17(8):1130-1137. doi: 10.3855/jidc.17580.\u003c/li\u003e\n\u003cli\u003eBrzozowski M, Krukowska Ż, Galant K, Jursa-Kulesza J, Kosik-Bogacka D. Genotypic characterisation and antimicrobial resistance of \u003cem\u003ePseudomonas aeruginosa\u003c/em\u003e strains isolated from patients of different hospitals and medical centres in Poland. BMC Infect Dis. 2020;20(1):693. doi: 10.1186/s12879-020-05404-w.\u003c/li\u003e\n\u003cli\u003eLila G, Mulliqi G, Raka L, Kurti A, Bajrami R, Azizi E. Molecular Epidemiology of \u003cem\u003ePseudomonas aeruginosa\u003c/em\u003e In University Clinical Center of Kosovo. Infect Drug Resist. 2018;11:2039-2046. doi: 10.2147/IDR.S174940.\u003c/li\u003e\n\u003cli\u003eSlekovec C, Robert J, van der Mee-Marquet N, Berthelot P, Rogues AM, Derouin V, et al. Molecular epidemiology of \u003cem\u003ePseudomonas aeruginosa\u003c/em\u003e isolated from infected ICU patients: a French multicenter 2012-2013 study. Eur J Clin Microbiol Infect Dis. 2019;38(5):921-926. doi: 10.1007/s10096-019-03519-w.\u003c/li\u003e\n\u003cli\u003eSener Okur D, Yuruyen C, Gungor O, Aktas Z, Erturan Z, Akcakaya N, et al. Genotypic characterization of \u003cem\u003ePseudomonas aeruginosa\u003c/em\u003e isolates from Turkish children with cystic fibrosis. Infect Drug Resist. 2019;12:675-685. doi: 10.2147/IDR.S183151.\u003c/li\u003e\n\u003cli\u003eKidd TJ, Ritchie SR, Ramsay KA, Grimwood K, Bell SC, Rainey PB. \u003cem\u003ePseudomonas aeru\u003c/em\u003eginosa exhibits frequent recombination, but only a limited association between genotype and ecological setting. PLoS One. 2012;7(9):e44199. doi: 10.1371/journal.pone.0044199.\u003c/li\u003e\n\u003cli\u003ePan Y, Zhao M, Liu W, Jia W, Li G. Study on molecular epidemiology of carbapenem resistant \u003cem\u003ePseudomonas aeruginosa\u003c/em\u003e and related genes of quorum sensing signal system. Microb Pathog. 2024;196:106899. doi: 10.1016/j.micpath.2024.106899.\u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp\u003e\u003cstrong\u003eTable 1\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eEpidemiological and molecular characteristics of the 58 CRPA isolates analysed in this study.\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003eRows are ordered first by specimen group (top panel, respiratory; bottom panel, non-respiratory) and then by isolate code (H1\u0026ndash;H58). For each isolate we report the hospital location, specimen source, phenotypic resistance pattern.\u0026nbsp;\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" align=\"\" width=\"101%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 15px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003ePseudomonas aeruginosa\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;isolate\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eHospital Unit\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSource\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAntibiotic Resistance Pattern\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eResistance Gene(s)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVirulence Gene(s)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eQuorum Sensing Gene(s)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePFGE Phylotype\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"22\" valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eRespiratory tract sample (n= 22)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 6px;\"\u003e\n \u003cp\u003eH4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003eAnaesthesia ICU\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003eTA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26px;\"\u003e\n \u003cp\u003eIPM, MEM, \u0026nbsp;CAZ, FEP, TZP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u003cem\u003emexY\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u003cem\u003e-\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cem\u003elasR, rhlR\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003eND\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 6px;\"\u003e\n \u003cp\u003eH5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003eSurgical ICU\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003eSputum\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePDR\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u003cem\u003emexY\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u003cem\u003eexoT\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cem\u003elasR, rhlR\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 6px;\"\u003e\n \u003cp\u003eH7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003eSurgical ICU\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003eTA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26px;\"\u003e\n \u003cp\u003eIPM, MEM, CAZ, FEP, CIP, LEV, TZP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u003cem\u003emexY\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u003cem\u003e-\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cem\u003elasR, rhlR\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e23\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 6px;\"\u003e\n \u003cp\u003eH12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003eSurgical ICU\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003eTA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26px;\"\u003e\n \u003cp\u003eIPM, MEM, CIP, LEV, TZP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u003cem\u003emexY\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u003cem\u003eexoT, exoY\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cem\u003elasR, rhlR\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 6px;\"\u003e\n \u003cp\u003eH14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003eChest diseases service\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003eLavage\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePDR\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u003cem\u003emexY\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u003cem\u003eexoT\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cem\u003elasR, rhlR\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e3b\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 6px;\"\u003e\n \u003cp\u003eH17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003eSurgical ICU\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003eTA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePDR\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u003cem\u003e-\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u003cem\u003erhlR\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cem\u003erhlR\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e32\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 6px;\"\u003e\n \u003cp\u003eH24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003eSurgical ICU\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003eTA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePDR\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u003cem\u003e-\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u003cem\u003eexoY\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cem\u003elasR\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e31a\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 6px;\"\u003e\n \u003cp\u003eH26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003eInternal medicine ICU\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003eTA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26px;\"\u003e\n \u003cp\u003eIPM, MEM, CAZ, FEP, \u0026nbsp;TZP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u003cem\u003e-\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u003cem\u003eexoT, exoY\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cem\u003elasR, rhlR\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e36\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 6px;\"\u003e\n \u003cp\u003eH27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003eSurgical ICU\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003eTA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26px;\"\u003e\n \u003cp\u003eIPM, MEM, CAZ, FEP, CIP, LEV, TZP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u003cem\u003e-\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u003cem\u003eexoT, exoY\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cem\u003elasR, rhlR\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e40\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 6px;\"\u003e\n \u003cp\u003eH28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003eInternal medicine ICU\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003eTA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePDR\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u003cem\u003ebla\u003csub\u003eVIM\u003c/sub\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u003cem\u003eexoT, exoY\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cem\u003elasR, rhlR\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e22\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 6px;\"\u003e\n \u003cp\u003eH31\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003eInternal medicine ICU\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003eTA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePDR\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u003cem\u003e-\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u003cem\u003eexoT, algD, exoY\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cem\u003elasR, rhlR\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 6px;\"\u003e\n \u003cp\u003eH34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003eChest diseases service\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003eTA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26px;\"\u003e\n \u003cp\u003eIPM, MEM, TZP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u003cem\u003e-\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u003cem\u003eexoT, algD, exoY\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cem\u003elasR, rhlR\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e27\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 6px;\"\u003e\n \u003cp\u003eH36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003eSurgical ICU\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003eTA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePDR\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u003cem\u003e-\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u003cem\u003eexoY\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cem\u003erhlR\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003eND\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 6px;\"\u003e\n \u003cp\u003eH41\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003eInternal medicine ICU\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003eTA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26px;\"\u003e\n \u003cp\u003eIPM, MEM, \u0026nbsp;CN, TOB, CAZ, FEP, CIP, LEV, TZP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u003cem\u003ebla\u003csub\u003eVIM\u003c/sub\u003e, mexY\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u003cem\u003eexoT, exoY, exoA\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cem\u003elasR, rhlR\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 6px;\"\u003e\n \u003cp\u003eH42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003e2nd line ICU\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003eSputum\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26px;\"\u003e\n \u003cp\u003eIPM, MEM, \u0026nbsp;CAZ, FEP, CIP, LEV, TZP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u003cem\u003emexY\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u003cem\u003eexoT, algD, exoY\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cem\u003elasR, rhlR\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 6px;\"\u003e\n \u003cp\u003eH43\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003eInternal medicine ICU\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003eTA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26px;\"\u003e\n \u003cp\u003eIPM, MEM, CAZ, FEP, CIP, LEV, TZP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u003cem\u003e-\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u003cem\u003eexoT, algD, exoY\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cem\u003elasR, rhlR\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e17\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 6px;\"\u003e\n \u003cp\u003eH44\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003eChest diseases service\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003eTA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26px;\"\u003e\n \u003cp\u003eIPM, MEM, \u0026nbsp;TZP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u003cem\u003emexY\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u003cem\u003eexoT, exoY\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cem\u003elasR, rhlR\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e37\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 6px;\"\u003e\n \u003cp\u003eH45\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003eInternal medicine ICU\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003eTA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26px;\"\u003e\n \u003cp\u003eIPM, MEM, CAZ, FEP, LEV, TZP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u003cem\u003emexY\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u003cem\u003ealgD, exoY\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cem\u003elasR, rhlR\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e19\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 6px;\"\u003e\n \u003cp\u003eH47\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003eChest diseases service\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003eSputum\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26px;\"\u003e\n \u003cp\u003eIPM, CAZ, FEP, TZP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u003cem\u003emexY\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u003cem\u003eexoT, algD, exoY\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cem\u003elasR, rhlR\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e24\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 6px;\"\u003e\n \u003cp\u003eH48\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003eAnaesthesia ICU\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003eTA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePDR\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u003cem\u003ebla\u003csub\u003eVIM\u003c/sub\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u003cem\u003eexoT, algD, exoY, exoA\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cem\u003elasR, rhlR\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 6px;\"\u003e\n \u003cp\u003eH50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003eSurgical ICU\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003eTA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26px;\"\u003e\n \u003cp\u003eIPM, MEM\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u003cem\u003e-\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u003cem\u003ealgD, exoY, exoA\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cem\u003elasR, rhlR\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e25\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 6px;\"\u003e\n \u003cp\u003eH55\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003eCovid service-9 (brain surgery)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003eTA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26px;\"\u003e\n \u003cp\u003eIPM, MEM, CN, CAZ, FEP, CIP, LEV, TZP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u003cem\u003e-\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u003cem\u003eexoT, algD, exoY, exoA\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cem\u003elasR, rhlR\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e38b\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"36\" valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eNon-Respiratory tract sample (n=36)\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 6px;\"\u003e\n \u003cp\u003eH1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003eOrthopaedic service\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003eTissue\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26px;\"\u003e\n \u003cp\u003eIPM, MEM, CN, CAZ, FEP, CIP, LEV, TZP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u003cem\u003emexY\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u003cem\u003eexoT\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cem\u003elasR, rhlR\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 6px;\"\u003e\n \u003cp\u003eH2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003eAnaesthesia ICU\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003eBlood/Catheter\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePDR\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u003cem\u003e-\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u003cem\u003ealgD\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cem\u003elasR, rhlR\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 6px;\"\u003e\n \u003cp\u003eH3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003eInternal medicine service\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003eWound swab\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePDR\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u003cem\u003emexY\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u003cem\u003e-\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cem\u003elasR, rhlR\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 6px;\"\u003e\n \u003cp\u003eH6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003eInternal medicine ICU\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003eBlood\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePDR\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u003cem\u003emexY\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u003cem\u003e-\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cem\u003elasR, rhlR\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 6px;\"\u003e\n \u003cp\u003eH8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003eENT Outpatient polyclinic\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003eEar discharge\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26px;\"\u003e\n \u003cp\u003eIPM, MEM, AK, CN, TOB, CAZ, CIP, LEV, TZP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u003cem\u003emexY\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u003cem\u003e-\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cem\u003elasR, rhlR\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e23b\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 6px;\"\u003e\n \u003cp\u003eH9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003eAnaesthesia ICU\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003eUrine\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePDR\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u003cem\u003emexY\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u003cem\u003e-\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cem\u003elasR, rhlR\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 6px;\"\u003e\n \u003cp\u003eH10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003eENT outpatient polyclinic\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003eEar discharge\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePDR\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u003cem\u003emexY\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u003cem\u003eexoT\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cem\u003elasR, rhlR\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e18\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 6px;\"\u003e\n \u003cp\u003eH11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003ePlastic surgery polyclinic\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003eTissue\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePDR\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u003cem\u003emexY\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u003cem\u003eexoT\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cem\u003elasR, rhlR\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 6px;\"\u003e\n \u003cp\u003eH13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003eSurgical ICU\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003eWound swab\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePDR\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u003cem\u003emexY\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u003cem\u003eexoT, algD\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cem\u003elasR, rhlR\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e6b\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 6px;\"\u003e\n \u003cp\u003eH15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003eENT outpatient polyclinic\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003eEar discharge\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26px;\"\u003e\n \u003cp\u003eIPM, MEM, AK, CN, TOB, FEP, CIP, LEV, TZP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u003cem\u003emexY\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u003cem\u003ealgD\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cem\u003elasR, rhlR\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e30\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 6px;\"\u003e\n \u003cp\u003eH16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003eInternal medicine service\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003eUrine\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26px;\"\u003e\n \u003cp\u003eIPM, MEM, CAZ, FEP, CIP, LEV, TZP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u003cem\u003emexY\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u003cem\u003eexoT, algD\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cem\u003e-\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e30\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 6px;\"\u003e\n \u003cp\u003eH18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003eInternal medicine ICU\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003eTissue\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26px;\"\u003e\n \u003cp\u003eIPM, MEM, CN\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u003cem\u003e-\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u003cem\u003e-\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cem\u003e-\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e34\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 6px;\"\u003e\n \u003cp\u003eH19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003eInternal medicine ICU\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003eWound swab\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26px;\"\u003e\n \u003cp\u003eIPM, MEM, CN,\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u003cem\u003e-\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u003cem\u003eexoY\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cem\u003e-\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e30\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 6px;\"\u003e\n \u003cp\u003eH20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003eHome health services\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003eUrine\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26px;\"\u003e\n \u003cp\u003eIPM, MEM, CAZ, FEP, CIP, LEV, TZP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u003cem\u003e-\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u003cem\u003eexoT, exoY\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cem\u003elasR, rhlR\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003eND\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 6px;\"\u003e\n \u003cp\u003eH21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003eInternal medicine ICU\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003eBlood\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26px;\"\u003e\n \u003cp\u003eIPM, MEM, \u0026nbsp;CN, CAZ, FEP, LEV, TZP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u003cem\u003e-\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u003cem\u003elasR, rhlR\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cem\u003elasR, rhlR\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e34\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 6px;\"\u003e\n \u003cp\u003eH22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003eInternal medicine ICU\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003eTissue\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26px;\"\u003e\n \u003cp\u003eIPM, MEM, \u0026nbsp;CN, CAZ, FEP, LEV, TZP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u003cem\u003e-\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u003cem\u003elasR, rhlR\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cem\u003elasR, rhlR\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e34b\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 6px;\"\u003e\n \u003cp\u003eH23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003eSurgical ICU\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003eBlood\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePDR\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u003cem\u003e-\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u003cem\u003eexoY, lasR, rhlR\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cem\u003elasR, rhlR\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e31\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 6px;\"\u003e\n \u003cp\u003eH25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003eENT outpatient polyclinic\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003eEar discharge\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePDR\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u003cem\u003e-\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u003cem\u003eexoT, \u0026nbsp;algD, exoY\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cem\u003elasR, rhlR\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e33\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 6px;\"\u003e\n \u003cp\u003eH29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003eOrthopaedic service\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003eTissue\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26px;\"\u003e\n \u003cp\u003eIPM, MEM, \u0026nbsp;CN, CAZ, FEP, \u0026nbsp;TZP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u003cem\u003e-\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u003cem\u003eexoT, exoY, exoA\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cem\u003erhlR\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 6px;\"\u003e\n \u003cp\u003eH30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003eInfectious diseases service\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003eTissue\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePDR\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u003cem\u003emexY\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u003cem\u003eexoT, algD, exoY\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cem\u003elasR, rhlR\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 6px;\"\u003e\n \u003cp\u003eH32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003eInternal medicine Service\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003eUrine\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26px;\"\u003e\n \u003cp\u003eIPM, MEM, \u0026nbsp;TOB, CAZ, FEP, \u0026nbsp;TZP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u003cem\u003emexY\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u003cem\u003eexoT, exoY\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cem\u003elasR, rhlR\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e41\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 6px;\"\u003e\n \u003cp\u003eH33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003ePalliative care unit\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003eAscites\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26px;\"\u003e\n \u003cp\u003eIPM, MEM\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u003cem\u003emexY\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u003cem\u003eexoY\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cem\u003elasR, rhlR\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e41a\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 6px;\"\u003e\n \u003cp\u003eH35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003eInternal medicine service\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003eWound swab\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26px;\"\u003e\n \u003cp\u003eIPM, MEM\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u003cem\u003e-\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u003cem\u003ealgD, exoY\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cem\u003elasR, rhlR\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e39\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 6px;\"\u003e\n \u003cp\u003eH37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003eInternal medicine ICU\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003eUrine\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26px;\"\u003e\n \u003cp\u003eIPM, MEM, CN, TOB, CAZ, FEP, CIP, LEV, TZP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u003cem\u003e-\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u003cem\u003eexoT, exoY\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cem\u003elasR, rhlR\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e35\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 6px;\"\u003e\n \u003cp\u003eH38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003eInternal medicine polyclinic\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003eUrine\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26px;\"\u003e\n \u003cp\u003eIPM, MEM, CAZ, FEP, LEV, TZP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u003cem\u003e-\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u003cem\u003ealgD, exoY\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cem\u003elasR, rhlR\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 6px;\"\u003e\n \u003cp\u003eH39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003eInternal medicine service\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003eUrine\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26px;\"\u003e\n \u003cp\u003eIPM, MEM, \u0026nbsp;CAZ, CIP, LEV, TZP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u003cem\u003e-\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u003cem\u003eexoY\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cem\u003elasR, rhlR\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 6px;\"\u003e\n \u003cp\u003eH40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003eENT outpatient polyclinic\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003eEar discharge\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26px;\"\u003e\n \u003cp\u003eIPM, MEM, AK, CN, TOB, FEP, CIP, LEV, TZP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u003cem\u003emexY\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u003cem\u003eexoT, algD, exoY\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cem\u003elasR, rhlR\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 6px;\"\u003e\n \u003cp\u003eH46\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003eENT outpatient polyclinic\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003eEar discharge\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26px;\"\u003e\n \u003cp\u003eIPM, MEM, AK, CN, TOB, FEP, CIP, LEV, TZP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u003cem\u003emexY\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u003cem\u003eexoT, algD, exoY\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cem\u003elasR, rhlR\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e21\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 6px;\"\u003e\n \u003cp\u003eH49\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003eSurgical ICU\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003eTissue\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26px;\"\u003e\n \u003cp\u003eIPM, MEM, CN, TOB, CAZ, FEP, CIP, LEV, TZP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u003cem\u003e-\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u003cem\u003ealgD, exoY, exoA\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cem\u003elasR, rhlR\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e8b\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 6px;\"\u003e\n \u003cp\u003eH51\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003eInternal medicine service\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003eCatheter\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26px;\"\u003e\n \u003cp\u003eIPM, MEM, \u0026nbsp;CN, TOB, CAZ, FEP, CIP, LEV, TZP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u003cem\u003e-\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u003cem\u003eexoT, algD\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cem\u003elasR, rhlR\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e26\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 6px;\"\u003e\n \u003cp\u003eH52\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003eInternal medicine service\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003eParacentesis\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePDR\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u003cem\u003emexY\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u003cem\u003eexoT, algD, exoY\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cem\u003elasR, rhlR\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e26a\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 6px;\"\u003e\n \u003cp\u003eH53\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003eCovid service-9 (brain surgery)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003eWound swab\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26px;\"\u003e\n \u003cp\u003eIPM, MEM, \u0026nbsp;CN, CAZ, FEP, CIP, LEV, TZP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u003cem\u003emexY\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u003cem\u003eexoT, exoY, exoA\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cem\u003elasR, rhlR\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e38\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 6px;\"\u003e\n \u003cp\u003eH54\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003eAnaesthesia ICU\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003eUrine\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26px;\"\u003e\n \u003cp\u003eIPM, MEM, \u0026nbsp;CN, CAZ, FEP, TZP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u003cem\u003e-\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u003cem\u003eexoT, algD, exoY\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cem\u003elasR, rhlR\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 6px;\"\u003e\n \u003cp\u003eH56\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003eENT outpatient polyclinic\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003eEar discharge\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePDR\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u003cem\u003emexY\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u003cem\u003ealgD, exoY, exoA\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cem\u003elasR, rhlR\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 6px;\"\u003e\n \u003cp\u003eH57\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003eChest diseases service\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003eUrine\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26px;\"\u003e\n \u003cp\u003eIPM, MEM, \u0026nbsp;CN, CAZ, FEP, TZP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u003cem\u003e-\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u003cem\u003eexoT, algD, exoY\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cem\u003elasR, rhlR\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e28\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 6px;\"\u003e\n \u003cp\u003eH58\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12px;\"\u003e\n \u003cp\u003eEmergency polyclinic\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003eUrine\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 26px;\"\u003e\n \u003cp\u003eIPM, MEM, CN, CAZ, LEV, TZP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u003cem\u003e-\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 9px;\"\u003e\n \u003cp\u003e\u003cem\u003ealgD, exoY, exoA\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 10px;\"\u003e\n \u003cp\u003e\u003cem\u003elasR, rhlR\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e29\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eIMI = imipenem, MEM = meropenem, AK = amikacin, CN = gentamicin, TOB = tobramycin, CAZ = ceftazidime, FEP = cefepime, CIP = ciprofloxacin, LEV = levofloxacin, TZP = piperacillin/tazobactam; \u003cstrong\u003ePDR\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e= pan-drug resistance, the carbapenemase and efflux genes detected (e.g. \u003cstrong\u003e\u003cem\u003ebla\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u003csub\u003eVIM\u003c/sub\u003e\u003c/strong\u003e, \u003cstrong\u003e\u003cem\u003emexY\u003c/em\u003e\u003c/strong\u003e), virulence genes (e.g. \u003cstrong\u003e\u003cem\u003eexoT\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e,\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003e\u003cem\u003ealgD\u003c/em\u003e\u003c/strong\u003e), quorum-sensing regulators (\u003cstrong\u003e\u003cem\u003elasR\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e,\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003e\u003cem\u003erhlR\u003c/em\u003e\u003c/strong\u003e), and the corresponding PFGE phylotype (PT 1\u0026ndash;41; \u003cstrong\u003eND\u003c/strong\u003e, band pattern not obtained for isolates H4, H20, and H36) \u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 2\u003c/strong\u003e PCR primer sequences, expected amplicon sizes, and references used in this study.\u003c/p\u003e\n\u003cdiv align=\"\"\u003e\n \u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGroup Primer\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 58px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTarget Gene\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 221px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePrimer Sequence (5\u0026acute;\u0026rarr; 3\u0026acute;)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 79px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAmplicon size (bp)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 87px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eReferences\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"6\" style=\"width: 94px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCarbapenemase genes\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 58px;\"\u003e\n \u003cp\u003e\u003cem\u003ebla\u003c/em\u003e\u003csub\u003eIMP\u003c/sub\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 221px;\"\u003e\n \u003cp\u003eF: CATGGTTTGGTGGTTCTTGT\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eR: ATAATTTGGCGGACTTTGGC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e488\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e[16]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 58px;\"\u003e\n \u003cp\u003e\u003cem\u003ebla\u003c/em\u003e\u003csub\u003eVIM\u003c/sub\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 221px;\"\u003e\n \u003cp\u003eF: ATTGGTCTATTTGACCGCGTC\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eR: TGCTACTCAACGACTGAGCG\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e780\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e[16]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 58px;\"\u003e\n \u003cp\u003e\u003cem\u003ebla\u003c/em\u003e\u003csub\u003eOXA-48\u003c/sub\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 221px;\"\u003e\n \u003cp\u003eF: GCGTGGTTAAGGATGAACAC\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eR: CATCAAGTTCAACCCAACCG\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e442\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e[17]\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 58px;\"\u003e\n \u003cp\u003e\u003cem\u003ebla\u003c/em\u003e\u003csub\u003eKPC\u003c/sub\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 221px;\"\u003e\n \u003cp\u003eF: ATGTCACTGTATCGCCGTCT\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eR: TTTTCAGAGCCTTACTGCCC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e893\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e[18]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 58px;\"\u003e\n \u003cp\u003e\u003cem\u003ebla\u003c/em\u003e\u003csub\u003eNDM\u003c/sub\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 221px;\"\u003e\n \u003cp\u003eF: GAGATTGCCGAGCGACTTG\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eR: CGAATGTCTGGCAGCACACTT\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e497\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e[19]\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 58px;\"\u003e\n \u003cp\u003e\u003cem\u003ebla\u003c/em\u003e\u003csub\u003eSIM\u003c/sub\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 221px;\"\u003e\n \u003cp\u003eF: TACAAGGGATTCGGCATCG\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eR: TAATGGCCTGTTCCCATGTG\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e570\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e[20]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"4\" style=\"width: 94px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVirulence Factor\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eGenes\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 58px;\"\u003e\n \u003cp\u003e\u003cem\u003eexoA\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 221px;\"\u003e\n \u003cp\u003eF: AACCAGCTCAGCCACATGTC\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eR: CGCTGGCCCATTCGCTCCAGCGCT\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e396\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e[21]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 58px;\"\u003e\n \u003cp\u003e\u003cem\u003eexoT\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 221px;\"\u003e\n \u003cp\u003eF: AATCGCCGTCCAACTGCATGCG\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eR: TGTTCGCCGAGGTACTGCTC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e152\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 87px;\"\u003e\n \u003cp\u003e[21]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 58px;\"\u003e\n \u003cp\u003e\u003cem\u003eexoY\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 221px;\"\u003e\n \u003cp\u003eF: CGGATTCTATGGCAGGGAGG\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eR: GCCCTTGATGCACTCGACCA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e289\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 87px;\"\u003e\n \u003cp\u003e[21]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 58px;\"\u003e\n \u003cp\u003e\u003cem\u003ealgD\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 221px;\"\u003e\n \u003cp\u003eF: ATGCGAATCAGCATCTTTGGT\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eR: CTACCAGCAGATGCCCTCGGC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e1311\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e[22]\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 94px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eQuorum Sensing Genes\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 58px;\"\u003e\n \u003cp\u003e\u003cem\u003elasR\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 221px;\"\u003e\n \u003cp\u003eF:AAGTGGAAAATTGGAGTGGAG\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eR: GTAGTTGCCGACGACGATGAAG\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e130\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e[23]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 58px;\"\u003e\n \u003cp\u003e\u003cem\u003erhlR\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 221px;\"\u003e\n \u003cp\u003eF: TGCATTTTATCGATCAGGGC\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eR: CACTTCCTTTTCCAGGACG\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e133\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e[23]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 94px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eEfflux/Resistance marker\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 58px;\"\u003e\n \u003cp\u003e\u003cem\u003emexY\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 221px;\"\u003e\n \u003cp\u003eF: CGCCGCAACTGACCCGCTACA\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eR: GGACCACGCCGAAACCGAACG\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 79px;\"\u003e\n \u003cp\u003e236\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 87px;\"\u003e\n \u003cp\u003e[24]\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 3\u0026nbsp;\u003c/strong\u003ePrevalence of resistance- and virulence-associated genes in respiratory versus non-respiratory CRPA isolates\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eGene\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 62px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eRespiratory n(%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNon-respiratory n(%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eOR\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e95% CI\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003ep\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eq\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cem\u003ebla\u003c/em\u003e\u003csub\u003eOXA-48\u003c/sub\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 62px;\"\u003e\n \u003cp\u003e0 (0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e0 (0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003e1.622\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e0.03\u0026ndash;84.68\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cem\u003ebla\u003c/em\u003e\u003csub\u003eSIM\u003c/sub\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 62px;\"\u003e\n \u003cp\u003e0 (0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e0 (0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003e1.622\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e0.03\u0026ndash;84.68\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cem\u003ebla\u003c/em\u003e\u003csub\u003eVIM\u003c/sub\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 62px;\"\u003e\n \u003cp\u003e3 (14%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e0 (0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003e13.103\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e0.64\u0026ndash;266.83\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e0.050\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e0.649\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cem\u003ebla\u003c/em\u003e\u003csub\u003eIMP\u003c/sub\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 62px;\"\u003e\n \u003cp\u003e0 (0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e0 (0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003e1.622\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e0.03\u0026ndash;84.68\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cem\u003ebla\u003c/em\u003e\u003csub\u003eKPC\u003c/sub\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 62px;\"\u003e\n \u003cp\u003e0 (0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e0 (0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003e1.622\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e0.03\u0026ndash;84.68\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cem\u003ebla\u003c/em\u003e\u003csub\u003eNDM\u003c/sub\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 62px;\"\u003e\n \u003cp\u003e0 (0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e0 (0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003e1.622\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e0.03\u0026ndash;84.68\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cem\u003eexoA\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 62px;\"\u003e\n \u003cp\u003e4 (18%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e5 (14%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003e1.393\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e0.35\u0026ndash;5.49\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e0.718\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cem\u003eexoY\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 62px;\"\u003e\n \u003cp\u003e17 (77%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e21 (58%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003e2.294\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e0.72\u0026ndash;7.31\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e0.166\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cem\u003eexoT\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 62px;\"\u003e\n \u003cp\u003e15 (68%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e18 (50%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003e2.067\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e0.70\u0026ndash;6.11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e0.274\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cem\u003ealgD\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 62px;\"\u003e\n \u003cp\u003e9 (41%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e17 (47%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003e0.784\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e0.27\u0026ndash;2.24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e0.787\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cem\u003emexY\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 62px;\"\u003e\n \u003cp\u003e10 (45%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e18 (50%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003e0.840\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e0.30\u0026ndash;2.38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e0.791\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cem\u003elasR\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 62px;\"\u003e\n \u003cp\u003e20 (91%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e33 (92%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003e0.857\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e0.15\u0026ndash;4.75\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cem\u003erhlR\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 62px;\"\u003e\n \u003cp\u003e21 (95%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003e34 (94%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 86px;\"\u003e\n \u003cp\u003e1.039\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 63px;\"\u003e\n \u003cp\u003e0.13\u0026ndash;8.44\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 60px;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eCounts (n) and within-group proportions (%) are shown for each gene among respiratory (n = 22) and non-respiratory (n = 36) isolates. Odds ratios (OR) and 95% confidence intervals (CI) were calculated with a Haldane\u0026ndash;Anscombe 0.5 correction to accommodate zero cells. Two-tailed Fisher\u0026rsquo;s exact test \u003cem\u003ep\u003c/em\u003e-values were adjusted for multiple comparisons with the Benjamini\u0026ndash;Hochberg procedure (FDR = 0.05); adjusted values are reported as \u003cem\u003eq\u003c/em\u003e-values. No gene remained significant after FDR correction (lowest \u003cem\u003eq\u003c/em\u003e = 0.65).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 4\u0026nbsp;\u003c/strong\u003eAssociation between type III-secretion effector genes (\u003cem\u003eexoT\u003c/em\u003e, \u003cem\u003eexoY\u003c/em\u003e) and antibiotic resistance.\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAntibiotic\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eexoT\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;Resistant Gene+ n(%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eexoT\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;Susceptible Gene+ n(%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eexoT\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;Resistant Gene\u0026ndash; n(%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eexoT\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;Susceptible Gene\u0026ndash; n(%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eexoT\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;OR\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eexoT\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;95% CI\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eexoT\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;p\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eexoT\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;q\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eexoY\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;Resistant Gene+ n(%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eexoY\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;Susceptible Gene+ n(%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eexoY\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;Resistant Gene\u0026ndash; n(%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eexoY\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;Susceptible Gene\u0026ndash; n(%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eexoY\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;OR\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eexoY\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;95% CI\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eexoY\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;p\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eexoY\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;q\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003eAmikacin\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e16 (48%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e17 (52%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e13 (52%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e12 (48%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e0.869\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e0.31\u0026ndash;2.46\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e16 (42%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e22 (58%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e13 (65%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e7 (35%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e0.392\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e0.13\u0026ndash;1.20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e0.167\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e0.373\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003eGentamicin\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e22 (67%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e11 (33%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e17 (68%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e8 (32%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e0.941\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e0.31\u0026ndash;2.85\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e22 (58%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e16 (42%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e17 (85%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e3 (15%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e0.243\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e0.06\u0026ndash;0.97\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e0.044\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e0.351\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003eTobramycin\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e17 (52%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e16 (48%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e11 (44%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e14 (56%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e1.352\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e0.48\u0026ndash;3.84\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e0.606\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e0.969\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e15 (39%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e23 (61%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e13 (65%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e7 (35%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e0.351\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e0.11\u0026ndash;1.08\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e0.097\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e0.373\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003eCeftazidime\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e28 (85%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e5 (15%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e19 (76%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e6 (24%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e1.768\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e0.47\u0026ndash;6.63\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e0.504\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e0.969\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e29 (76%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e9 (24%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e18 (90%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e2 (10%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e0.358\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e0.07\u0026ndash;1.85\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e0.299\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e0.478\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003eCefepime\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e30 (91%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e3 (9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e18 (72%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e7 (28%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e3.889\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e0.89\u0026ndash;16.97\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e0.083\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e0.221\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e30 (79%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e8 (21%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e18 (90%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e2 (10%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e0.417\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e0.08\u0026ndash;2.18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e0.468\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e0.614\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003eCiprofloxacin\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e27 (82%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e6 (18%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e15 (60%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e10 (40%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e3.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e0.91\u0026ndash;9.89\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e0.081\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e0.221\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e26 (68%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e12 (32%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e16 (80%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e4 (20%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e0.542\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e0.15\u0026ndash;1.97\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e0.538\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e0.614\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003eLevofloxacin\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e27 (82%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e6 (18%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e19 (76%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e6 (24%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e1.421\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e0.40\u0026ndash;5.08\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e0.745\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e0.994\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e28 (74%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e10 (26%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e18 (90%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e2 (10%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e0.311\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e0.06\u0026ndash;1.59\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e0.187\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e0.373\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003ePiperacillin/tazobactam\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e33 (100%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e0 (0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e20 (80%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e5 (20%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e17.976\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e0.94\u0026ndash;342.35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e0.012\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e0.093\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e34 (89%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e4 (11%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e19 (95%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e1 (5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e0.447\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e0.05\u0026ndash;4.30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e0.650\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e0.650\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eFor each antibiotic, resistant and susceptible isolate counts plus proportions (%) are provided for gene-positive and gene-negative subgroups (\u003cem\u003eexoT\u003c/em\u003e or \u003cem\u003eexoY\u003c/em\u003e). Odds ratios (OR) and 95% CIs use the Woolf log method; zero cells were handled with a Haldane\u0026ndash;Anscombe 0.5 continuity correction. Two-tailed Fisher\u0026rsquo;s exact test \u003cem\u003ep\u003c/em\u003e-values were adjusted for eight comparisons per gene using Benjamini\u0026ndash;Hochberg FDR (\u0026alpha; = 0.05); \u003cem\u003eq\u003c/em\u003e-values are reported. After adjustment, no \u003cem\u003eexoT\u003c/em\u003e or \u003cem\u003eexoY\u003c/em\u003e association reached significance (lowest \u003cem\u003eq\u003c/em\u003e corresponds to \u003cem\u003eexoT\u003c/em\u003e vs piperacillin/tazobactam).\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e"},{"header":"Supplementary Information","content":"\u003cp\u003eAdditional files 1-3 are not available with this version.\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-microbiology","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"mcro","sideBox":"Learn more about [BMC Microbiology](http://bmcmicrobiol.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/mcro","title":"BMC Microbiology","twitterHandle":"#bmcmicrobiology","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Pseudomonas aeruginosa, CRPA, carbapenem resistance, exoT, exoY, PFGE, Fisher’s exact test, FDR, BH, EUCAST, reproducible research","lastPublishedDoi":"10.21203/rs.3.rs-7690655/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7690655/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e\u003cp\u003eThe World Health Organization lists carbapenem-resistant \u003cem\u003ePseudomonas aeruginosa\u003c/em\u003e (CRPA) as a critical priority, yet links among resistance, virulence, and clonal spread remain unclear. We aimed to characterise the genotypic and phenotypic landscape of clinical CRPA and test whether specimen source or type III secretion effectors \u003cem\u003eexoT\u003c/em\u003e\u003cb\u003e/\u003c/b\u003e\u003cem\u003eexoY\u003c/em\u003e predict antibiotic resistance.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e\u003cp\u003eFifty-eight consecutive CRPA isolates from respiratory and non-respiratory specimens were analysed. Susceptibility to 10 agents was determined with an automated system. Seven carbapenemase genes, six virulence/quorum-sensing genes, and the efflux marker \u003cem\u003emexY\u003c/em\u003e were screened by PCR. Macrorestriction patterns were typed by \u003cem\u003eSpe\u003c/em\u003eI PFGE. Associations were assessed using two-tailed Fisher\u0026rsquo;s exact tests with Benjamini\u0026ndash;Hochberg false-discovery-rate correction (α\u0026thinsp;=\u0026thinsp;0.05).\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e\u003cp\u003eResistance was highest to piperacillin/tazobactam (91%), ceftazidime (81%) and cefepime (81%); 34% of isolates were pan-drug-resistant. Only three strains (5%) carried \u003cem\u003ebla\u003c/em\u003e\u003csub\u003eVIM\u003c/sub\u003e; no additional carbapenemase genes were detected. Virulence markers were frequent (exoY 66%, \u003cem\u003eexoT\u003c/em\u003e 57%, \u003cem\u003ealgD\u003c/em\u003e 45%; \u003cem\u003elasR\u003c/em\u003e 91%, \u003cem\u003erhlR\u003c/em\u003e 95%). After FDR adjustment, neither \u003cem\u003eexoT\u003c/em\u003e, \u003cem\u003eexoY\u003c/em\u003e nor specimen origin correlated with β-lactam, aminoglycoside, or fluoroquinolone resistance (lowest \u003cem\u003eq\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.093); gene prevalence did not differ between respiratory and non-respiratory isolates (lowest \u003cem\u003eq\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.65). PFGE revealed 41 pulsotypes without a dominant clone, suggesting sporadic horizontal gene transfer rather than clonal expansion.\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e\u003cp\u003eThis CRPA cohort is genetically diverse, multidrug-resistant, and anatomically non-segregated. \u003cem\u003eexoT\u003c/em\u003e/\u003cem\u003eexoY\u003c/em\u003e status does not shape resistance phenotypes. Infection-control strategies should prioritise containment of mobile genetic elements and genome-based surveillance rather than focusing on specific clones or body sites.\u003c/p\u003e","manuscriptTitle":"Genotypic and Phenotypic Landscape of Carbapenem-Resistant Pseudomonas aeruginosa Isolated From Respiratory and Non-Respiratory Samples in a Tertiary Hospital","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-09-29 15:21:01","doi":"10.21203/rs.3.rs-7690655/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-11-26T17:03:48+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-11-20T15:43:37+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-11-20T12:18:07+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"83038798703544753219207137734867328942","date":"2025-10-23T11:27:02+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"317773973912574868126775707590350563749","date":"2025-10-23T11:09:28+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"79394068477739542085976190224267356271","date":"2025-10-21T10:22:29+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"61408992369263819632927883209644407714","date":"2025-10-21T09:34:07+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-10-21T09:30:21+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-09-30T11:18:35+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-09-25T14:04:16+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-09-25T14:03:22+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Microbiology","date":"2025-09-23T06:49:26+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-microbiology","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"mcro","sideBox":"Learn more about [BMC Microbiology](http://bmcmicrobiol.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/mcro","title":"BMC Microbiology","twitterHandle":"#bmcmicrobiology","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"8ad3ac79-44fc-481e-a4c8-255d05bca264","owner":[],"postedDate":"September 29th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2026-03-16T16:04:42+00:00","versionOfRecord":{"articleIdentity":"rs-7690655","link":"https://doi.org/10.1186/s12866-026-04756-8","journal":{"identity":"bmc-microbiology","isVorOnly":false,"title":"BMC Microbiology"},"publishedOn":"2026-03-14 15:58:04","publishedOnDateReadable":"March 14th, 2026"},"versionCreatedAt":"2025-09-29 15:21:01","video":"","vorDoi":"10.1186/s12866-026-04756-8","vorDoiUrl":"https://doi.org/10.1186/s12866-026-04756-8","workflowStages":[]},"version":"v1","identity":"rs-7690655","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7690655","identity":"rs-7690655","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}