382
187755989012055111
NOORA5777160243148316484600748
AL13817160243148236
ZAROONI16737160243100248364532700848904
Department577955014684161240319358394506583655691
of1302955014677110
Microbiology14469550146108137213252329408437513542619698768
College5771115014694170199228305384461
of10711115014677111
Medicine121511150146108185264293370399471548
and17961115014679151231
Health20601115014682159238267303375
Sciences24681115014663139168245317394471523
Title438180601344673106132202
Virulence1418172701887398141202232281342391440
Factors,18861727018873128177207262305348376
Clonality,22891727018873104159220275306336367416439
Antibiotic27521727018873134165195250281336366397446
And32211727018874135190
Disinfectant34381727018880110153184245281330379410465526556
Resistance40221727018873122165195238269324385434483
Of45321727018880116
Enterobacteriaceae46761727018873134165214256311366421470501550593623678727776831880
Isolated5583172701884386141171226257306361
in5971172701883192
the6090172701883192141
Arabian14181867018873116171226257312373
Peninsula18181867018868116178208269312373404459
Faculty4382101013453125196262288321385
Advisor8542101013481154215242290361396
Prof.14182098016061100159194220
Tibor1672209801606490150210250
Pál19562098016061119144
Defense4382319013477147178249315363433
Date9022319013477150183253
0414182316016060120
April15732316016066126166191216
201618242316016060120180240
Abstract4383975013481154202235271343414447
The14182522014658114167
emergence16162522014657141194230285337393439492
and21392522014657113168
rapid2339252201464091146169224
spread25952522014648104140192244300
of2926252201465991
multi-drug30522522014684140163197220256311347403458
resistant3542252201464092137160204238290346379
(MDR)39532522014643120187250288
Enterobacteriaceae42722522014661116150202238292348400446480532568591644690742795847
is5151252201462772
one52542522014659115167
of5453252201465890
the5575252201463793146
most57572522014684138183216
challenging60042522014651107159182205258314369392448503
problem1418267201465591145200223276360
currently18092672014658113149185238293327350400
we22402672014685138
face.2409267201464495141194224
Locally,26642672014661116162214237260310332
no30272672014667121
details31802672014666119152205228251295
on35072672014665121
the36592672014645101153
strains3844267201465689125176199255299
causing41752672014657110165210233289344
outbreaks45502672014666122155210246299351401445
are50272672014664100152
available52102672014664113164187209262317340393
and56342672014664120175
we58402672014686138
still6010267201465689112135158
do61992672014667121
not63522672014667121154
understand14182822014656112167219256300334386442497
what19462822014686142194228
makes22052822014696148198250294
certain25312822014658110146180232255311
clones2873282201465881135191243288
capable31922822014658111166218274297349
of3572282201466698
spreading37012822014657112148200253308331387442
widely41742822014686109164217240289
while44952822014685141164187240
others4766282201466699155208244288
are50862822014664100152
confined52692822014658112168195221277330385
to56852822014645100
sporadic58162822014656112166202253308331377
cases,62242822014658110155208252283
only.14182972014654110133183204
Our16542972014671126162
aim1848297201465375159
was20392972014674126170
to2241297201463488
characterize23602972014647102155191242288321374410433477529
the2921297201463489142
virulence3094297201465073109165188241296343395
factors,3520297201463384130163218254298329
antibiotic38802972014653109142165220243297331354400
and43112972014653109164
disinfectant4506297201465679123146202234285331365417473507
susceptibilities50442972014645101145191244299333356411434457480513536589633
of5709297201465486
local5826297201462478124177200
clonal6057297201464669123179232255
and63432972014653109164
sporadic14183122014645100154190241296319365
Escherichia18053122014656101147203256292315361416439492
coli23193122014646100123146
and24873122014653108164
Klebsiella2673312201465881134189234257309332355408
pneumoniae31033122014655111164219303358413436489541
strains3666312201464578114165188244289
and39773122014652108163
to4172312201462478
reveal4281312201462779129181233256
which45593122014674130153199255
particular48363122014655108144177200246302325377413
feature5281312201462274126160216252304
might56073122014684107162218251
be58803122014656108
responsible6019312201462779124179234289334357412435488
for1418327201463285121
the1570327201463085138
outbreak17353272014654110143199235287339389
potential21513272014655110143196252285308360383
of2561327201465586
clonal2679327201464164119174227250
isolates.2960327201461963117140193226279323354
E.3341327201465686
coli3458327201464296119142
and36323272014648104159
K.3818327201465989
pneumoniae39343272014655111163219303358413436489541
strains4507327201464073109160183239283
collected4822327201464196119142194240274327382
from5235327201462863117201
countries5467327201464296152208241277300353397
of5892327201465486
the6009327201462985137
Arabian6173327201466096147202225278334
Peninsula14183422014655105161184240285340363416
were18653422014681134170222
subjected21193422014652107163191244290323376431
to2581342201464195
genotyping27083422014662115171225259307363386441497
by32363422014663112
PCR33793422014663123185
targeting3595342201464194130185237271293349405
a40313422014660
broad4122342201466399152205260
spectrum44143422014652107159206239275331415
of4860342201466294
virulence4985342201465780116172195247303349402
and54183422014660116171
antibiotic56203422014660116149172228251305338361407
resistance6059342201464395140163207241293349395448
genes,14183572014655108164216261291
to1740357201464195
antibiotic18663572014660116149172227250304338361407
susceptibility23043572014651107152198251306339362417440463486520569
tests,2904357201464093137171215246
serum31813572014652104140196280
resistance3492357201464395140163207241293349395448
and39713572014660115171
biofilm4173357201466285139166193216300
formation4504357201463992128212264298321375431
assays49663572014660104149201250295
and52923572014660115171
to5494357201464095
molecular56273572014684138161214260315338391427
typing6085357201464089145167223279
by63953572014662111
macro-restriction14183722014684137183219272309345397442475511534580613636691746
analysis21963722014670125178201251295318363
and25903722014670126181
by28023722014673123
multilocus295637220146101157180213236259314360416460
sequence34473722014662115170226279335381433
typing.3912372201465099155178233289319
We426237220146108157
established44503722014670115148200256279302346402455510
that49913722014651107159193
among52153722014670154208264319
E.55663722014673104
coli57013722014663118141164
blood5896372201467295150204259
stream6187372201466295131183236320
isolates1418387201462368122145197231283328
the1777387201462985138
rate1946387201463283116169
of2142387201465486
strains2259387201464174110161184240284
expressing2574387201464998154190242286331354410465
R430663872014662117
core3214387201464296132184
type3430387201462978133186
is3647387201461963
currently3741387201464298134170222278312334384
much41523872014684140186242
higher4421387201465679134190242278
than4731387201462985137193
seen4955387201464193146202
before51843872014655108139193229281
and54963872014648104160
it5687387201461852
was57663872014674126171
due59643872014655111163
to6159387201462983
a62733872014649
few6353387201462879153
multi-resistant14184022014684140163196219255291344388411456489542597631
clones2080402201464265119175228272
recently2384402201463184130182238271294344
emerged.27594022014649133186222276329384415
We32014022014690139
have33674022014656108157209
also3608402201464871115170
shown3809402201464096151225281
that4121402201462985137171
the4323402201462985138
majority44884022014684136165219255278311360
of4875402201465586
local4993402201461973119171194
K.5214402201465990
pneumoniae53314022014655111163219303357413436489541
clones5904402201464164119174227272
did6203402201465578133
not63634022014656110144
possess14184172014655110154199251296341
considerably17904172014653107163207230285338374425480503553
more23814172014684138174226
virulent-related2638417201465779115171194247303336370406459481534567620675
features3345417201463889142175231267319364
than3740417201464096148204
sporadic39764172014651106160196247302325371
isolates.4379417201462974128151203237289334364
Rather,47744172014669121154210262298315
they5121417201463995148198
were53504172014681133169221
clearly5603417201465275128180216239289
distinguished5923417201466285130163186242297353376420476529584
from1418432201463267121205
the1655432201463691144
latter1830432201462679112145197233
group2095432201465894147203259
by23854322014658107
their2524432201463692144167203
broader2759432201465894147200255308344
spectrum31344322014648103156202235271327411
of3576432201465789
resistance3696432201463991136159203237289345391444
to4171432201463691
non-ß-lactam42934322014659113169205260296319372418451504588
antibiotics49124322014655111144167223245300333356402447
well53934322014674127149173
substantiated55974322014647103158203236289345378401453487539595
by62234322014658108
the6362432201463692145
increased1418447201462379125161213265310363418
carriage18674472014658110146182205258313365
of2264447201466697
the23934472014644100153
respective25774472014647100144200252298332355404456
resistance3065447201464799144167211245297353399452
genes.35484472014667119175228272303
Resistance38824472014673124169192236270322378424477
to4390447201464599
disinfectants4520447201466790135158213245297343376429484518562
were51144472014685138174226
more53724472014695149185237
common56414472014657111195279334390
among60624472014664148202258313
K.64064472014670101
pneumoniae14184622014655111164219304358414437489542
strains1991462201466093129180203259304
non-susceptible23264622014671126181218262318363409461517550573628651704
to30614622014649103
carbapenems31964622014662114150205258313366422474558603
than38304622014649105157213
among40754622014668152206262317
the44234622014649105158
antibiotic46124622014668124157180236258313346369415
sensitive50584622014661113169214237270293343395
isolates.5484462201463983137160213246299343374
We588946220146106155
speculate60754622014660116168214270293346379432
that1418477201463389142175
this1624477201463591113158
may18144772014684137186
also2031477201465477121175
increase2238477201462479125161214266311363
the2633477201463490142
outbreak28074772014655111144199235288340390
potential32284772014656111144197253286309361384
of3644477201465587
the3762477201463490143
strains.3936477201464579115166189244289319
Finally,4287477201465375131184207230280301
we46204772014674127
have47784772014657110159211
shown50204772014645101156230286
that5337477201463490142176
a55444772014654
considerable56294772014647101157202225280332368419475497550
part62104772014657109145178
of6420477201465587
local1418492201462377123176199
carbapenem1648492201464496132187240295348404456540
resistant2219492201463486131154198232284340373
K.2621492201465989
pneumoniae27424922014652108161217301355411434486539
strains3312492201464275111162185241285
are3629492201465086138
still379849220146427699122145
susceptible3974492201464298142189241296330353408431484
to4489492201463185
fosfomycin,4605492201463083128159213297346391414470500
although5136492201465073107162217273328384
the5551492201463187139
rate5721492201463485118171
of5923492201465284
resistance,6038492201463486130153198231284339386438468
particularly14185072014655108144177200246302325377413436486
among19355072014663147202257313
blood2279507201466688143197252
stream2563507201465588124176229313
isolates,2907507201463378132155208241294338368
is3307507201463378
already3416507201466386122174226282331
alarming.3779507201466386138174258281337392422
Our42335072014681136172
data44375072014665118151204
show46725072014655111165239
that4943507201464499152185
it5160507201463366
is5258507201463378
particularly53675072014666118154188210257312335388424447496
the5895507201464499152
increased6078507201463489135171224276321373429
resistance1418522201463688133156200234286342388441
rather1890522201464292126182234270
than2192522201463994147203
any24265222014658114163
specific26205222014650105158204227254280326
virulence-related2978522201465578114170193245301347400436472524547600633686741
feature3750522201463889142175231267319
that4100522201463995148181
makes43185222014684136186238283
strains4632522201465084120170193249294
spread49575222014650105141194246301
as52905222014658102
clones.5424522201465174128184237281312
A57675222014666
well-organized58695222014675127150173210264300355407463486530582638
surveillance14185372014645100136186238261284307360415461514
system1963537201464292136170222306
based23015372014652104149202257
on25895372014652107
molecular27255372014684138161213259315338391427
typing3183537201463079134157213268
is3483537201461964
needed35785372014653106158214266321
in3931537201462075
the4038537201463086138
country,4208537201464397153209242278328349
to4589537201463084
follow4705537201462882105128182256
the4993537201463086138
characteristics5163537201464399151187238284317370406429474507530576621
of5815537201465183
the5929537201463187139
spread6099537201464297133186238293
of6424537201465183
multidrug14185522014684140163196219274310366421
resistance1871552201464193137160205238291347393445
organisms2348552201465995150202258281325409454
in2833552201462884
the2948552201463894147
region.3126552201464193148171225281312
Dissertation3971558017098132193255344389431524566599689773