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Article ; Online: The NICU flora: An effective technique to sample surfaces.

Sultan, Naomi / Shchors, Irina / Assous, Marc V / Bar-Meir, Maskit

PloS one

2021 Volume 16, Issue 9, Page(s) e0257821

Abstract: Objective: Environmental surface sampling in healthcare settings is not routinely recommended. There are several methods for environmental surface sampling, however the yield of these methods is not well defined. The aim of the present study is to ... ...

Abstract	Objective: Environmental surface sampling in healthcare settings is not routinely recommended. There are several methods for environmental surface sampling, however the yield of these methods is not well defined. The aim of the present study is to compare two methods of environmental surface sampling, to characterize the neonatal intensive care unit (NICU) flora, compare it with rates of infection and colonization and correlate it with the workload. Design and setting: First, the yield of the swab and the gauze-pad methods were compared. Then, longitudinal surveillance of environmental surface sampling was performed over 6 months,once weekly, from pre-specified locations in the NICU. Samples were streaked onto selective media and bacterial colonies were identified using matrix-assisted laser desorption-ionization time-of-flight (MALDI-TOF). Results: The number of colonies isolated using the gauze pad method was significantly higher compared with the swab method. Overall, 87 bacterial species of 30 different bacterial genera were identified on the NICU environmental surfaces. Of these, 18% species were potential pathogens, and the other represent skin and environmental flora. In 20% of clinical cultures and in 60% of colonization cultures, the pathogen was isolated from the infant's environment as well. The number of bacteria in environmental cultures was negatively correlated with nurse/patient ratio in the day prior to the culture. Conclusion: The gauze pad method for environmental sampling is robust and readily available. The NICU flora is very diverse and is closely related with the infants' flora, therefore it may serve as a reservoir for potential pathogens.
MeSH term(s)	Bacteria/classification ; Bacteria/genetics ; Bacteria/isolation & purification ; Cross Infection/epidemiology ; Environmental Monitoring/methods ; Equipment Contamination/statistics & numerical data ; Humans ; Infant ; Infant, Newborn ; Intensive Care Units, Neonatal ; Longitudinal Studies ; Phylogeny
Language	English
Publishing date	2021-09-23
Publishing country	United States
Document type	Comparative Study ; Journal Article
ISSN	1932-6203
ISSN (online)	1932-6203
DOI	10.1371/journal.pone.0257821
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Article ; Online: An unforeseen complication of a folk remedy for joint pain.

Assous, M V / Schwartz, Y / Ben-Chetrit, E

Medecine et maladies infectieuses

2018 Volume 48, Issue 5, Page(s) 374–375

MeSH term(s)	Aged ; Amoxicillin/therapeutic use ; Animals ; Anti-Bacterial Agents/therapeutic use ; Arthralgia/therapy ; Bacteremia/drug therapy ; Bacteremia/etiology ; Bacteremia/microbiology ; Feces/microbiology ; Female ; Horses ; Humans ; Medicine, Traditional/adverse effects ; Metatarsal Bones ; Onychomycosis/etiology ; Onychomycosis/microbiology ; Streptococcal Infections/drug therapy ; Streptococcal Infections/etiology ; Streptococcal Infections/microbiology ; Streptococcus equi/isolation & purification ; Tarsal Bones
Chemical Substances	Anti-Bacterial Agents ; Amoxicillin (804826J2HU)
Language	English
Publishing date	2018-04-12
Publishing country	France
Document type	Case Reports ; Letter
ZDB-ID	423536-8
ISSN	1769-6690 ; 0399-077X ; 1166-8237
ISSN (online)	1769-6690
ISSN	0399-077X ; 1166-8237
DOI	10.1016/j.medmal.2018.03.004
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Article: Rate and Risk Factors for Carbapenem Resistant Acinetobacter baumannii Clinical Infections in Colonized Patients.

Wiener-Well, Yonit / Tordgman, Daniel / Bnaya, Alon / Wolfovitz-Barchad, Orit / Assous, Marc V / Yinnon, Amos M / Ben-Chetrit, Eli

The Israel Medical Association journal : IMAJ

2022 Volume 24, Issue 4, Page(s) 235–240

Abstract: Background: Carbapenem-resistant Acinetobacter baumannii (CRAB) is an important cause of nosocomial infections. Active surveillance for CRAB carriage to identify and isolate colonized patients is used to reduce transmission.: Objectives: To assess ... ...

Abstract	Background: Carbapenem-resistant Acinetobacter baumannii (CRAB) is an important cause of nosocomial infections. Active surveillance for CRAB carriage to identify and isolate colonized patients is used to reduce transmission. Objectives: To assess the rate and risks of clinical infection among CRAB-carrier and non-carrier patients. Methods: Hospitalized patients from whom CRAB screening-cultures were obtained between January and June 2018 were identified retrospectively. All CRAB-carriers were compared to a convenient sample of non-carriers and were followed to detect development of CRAB clinical infection during admission. Results: We compared 115 CRAB carriers to 166 non-carriers. The median age in the study group was 76 years (IQR 71-87) vs. 65 years (55-79) in the non-carriers group (P < 0.001). Residence in a nursing facility, debilitated state, and admission to medical wards vs. intensive care units were more frequent among CRAB-carriers (P < 0.001). Mechanically ventilated patients included 51 CRAB carriers (44%) and 102 non-carriers (61%). Clinical infection developed in 49 patients (17%), primarily CRAB pneumonia. Of the CRAB-carriers and non-carriers, 26/115 (23%) and 23/166 (14%), respectively, developed a clinical infection (P = 0.05). One-third of the ventilated patients were infected. Debilitated state and antibiotic treatment during hospitalization were linked to higher infection rates (P = 0.01). Adjusted analysis showed that mechanical ventilation and CRAB colonization were strongly associated with clinical infection (P < 0.05). Conclusions: The rate of CRAB infection among carriers was high. Mechanical ventilation and CRAB colonization were associated with CRAB clinical infection, primarily pneumonia.
MeSH term(s)	Acinetobacter Infections/drug therapy ; Acinetobacter Infections/epidemiology ; Acinetobacter baumannii ; Aged ; Aged, 80 and over ; Anti-Bacterial Agents/pharmacology ; Anti-Bacterial Agents/therapeutic use ; Carbapenems/pharmacology ; Carbapenems/therapeutic use ; Cross Infection/epidemiology ; Drug Resistance, Multiple, Bacterial ; Humans ; Microbial Sensitivity Tests ; Pneumonia/drug therapy ; Retrospective Studies ; Risk Factors
Chemical Substances	Anti-Bacterial Agents ; Carbapenems
Language	English
Publishing date	2022-04-12
Publishing country	Israel
Document type	Journal Article
ZDB-ID	2008291-5
ISSN	1565-1088 ; 0021-2180
ISSN	1565-1088 ; 0021-2180
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Zs.A 5470: Show issues

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Article ; Online: Misidentification of Candida dubliniensis isolates with the VITEK MS.

Korem, Maya / Cohen, Matan Joel / Michael-Gayego, Ayelet / Castiel, Dafna / Assous, Marc V / Amit, Sharon

Journal de mycologie medicale

2021 Volume 31, Issue 1, Page(s) 101107

Abstract: The phylogenetic relatedness of Candida dubliniensis and C. albicans may lead to misidentification of C. dubliniensis and underestimation of its clinical significance. We evaluated the performance of VITEK-MS in identifying C. dubliniensis isolates ... ...

Abstract	The phylogenetic relatedness of Candida dubliniensis and C. albicans may lead to misidentification of C. dubliniensis and underestimation of its clinical significance. We evaluated the performance of VITEK-MS in identifying C. dubliniensis isolates following growth on different culture media. Correct identification was documented in 98% of the isolates grown on blood agar media whereas only 44% were correctly identified from SDA or CHROMagar. The use of non-manufacturer validated media for identifying C. dubliniensis with VITEK-MS, may result in misidentification of these isolates as C. albicans. This finding calls for reassessing the accuracy of fungal isolates identification in local workflows using non-validated culture media.
MeSH term(s)	Agar/chemistry ; Blood ; Candida/genetics ; Candida/growth & development ; Candida/isolation & purification ; Candida albicans/genetics ; Candida albicans/growth & development ; Culture Media/standards ; DNA, Fungal/genetics ; Humans ; Mycological Typing Techniques/standards ; Phylogeny
Chemical Substances	Culture Media ; DNA, Fungal ; Agar (9002-18-0)
Language	English
Publishing date	2021-01-01
Publishing country	France
Document type	Journal Article
ZDB-ID	1067006-3
ISSN	1773-0449 ; 1156-5233
ISSN (online)	1773-0449
ISSN	1156-5233
DOI	10.1016/j.mycmed.2020.101107
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Article ; Online: The use of a diversion tube to reduce blood culture contamination: A "real-life" quality improvement intervention study.

Wiener-Well, Yonit / Levin, Phillip D / Assous, Marc V / Algur, Nurit / Barchad, Orit Wolfovitz / Lachish, Tamar / Zalut, Todd / Yinnon, Amos M / Ben-Chetrit, Eli

American journal of infection control

2023 Volume 51, Issue 9, Page(s) 999–1003

Abstract: Background: Blood culture contamination is associated with health care costs and potential patient harm. Diversion of the initial blood specimen reduces blood culture contamination. We report results of the "real-life" clinical implementation of this ... ...

Abstract	Background: Blood culture contamination is associated with health care costs and potential patient harm. Diversion of the initial blood specimen reduces blood culture contamination. We report results of the "real-life" clinical implementation of this technique. Methods: Following an educational campaign, use of a dedicated diversion tube was recommended prior to all blood cultures. Blood culture sets taken from adults using a diversion tube were defined as "diversion sets," those without, "non-diversion" sets. Blood culture contamination and true positive rates were compared for diversion and nondiversion sets and to nondiversion historical controls. A secondary analysis investigated efficacy of diversion by patient age. Results: Out of 20,107 blood culture sets drawn, the diversion group included 12,774 (60.5%) and the nondiversion group 8,333 (39.5%) sets. The historical control group included 32,472 sets. Comparing nondiversion to diversion, contamination decreased by 31% (5.5% [461/8333] to 3.8% [489/12744], P < .0001]. Contamination was also 12% lower in diversion than historical controls [3.8% (489/12744) vs 4.3% (1,396/33,174) P = .02)]. The rate of true bacteremia was similar. In older patients, contamination rate was higher, and the relative reduction associated with diversion decreased (54.3% amongst 20-40-year-olds vs 14.5% amongst >80-year-olds). Conclusions: Use of a diversion tube in the ED reduced blood culture contamination in this large real life observational study. Efficacy decreased with increasing age, which requires further investigation.
MeSH term(s)	Adult ; Humans ; Aged ; Blood Specimen Collection ; Blood Culture/methods ; Quality Improvement ; Bacteremia/prevention & control ; Health Care Costs ; Equipment Contamination
Language	English
Publishing date	2023-03-10
Publishing country	United States
Document type	Observational Study ; Journal Article
ZDB-ID	392362-9
ISSN	1527-3296 ; 0196-6553
ISSN (online)	1527-3296
ISSN	0196-6553
DOI	10.1016/j.ajic.2023.02.015
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Article: Méthodes du diagnostic biologique au cours des différentes manifestations de la borréliose de Lyme.

Assous, M-V

Medecine et maladies infectieuses

2007 Volume 37, Issue 7-8, Page(s) 487–495

Abstract: Methods used to diagnose Lyme borreliosis (LB) vary according to clinical presentations. A very good basis to clarify this nosological and clinical entity is the study published by the "European Concerted Action on Lyme Borreliosis" (EUCALB). In fact, ... ...

Title translation	Laboratory methods for the diagnosis of clinical forms of Lyme borreliosis.
Abstract	Methods used to diagnose Lyme borreliosis (LB) vary according to clinical presentations. A very good basis to clarify this nosological and clinical entity is the study published by the "European Concerted Action on Lyme Borreliosis" (EUCALB). In fact, only few studies were performed on cohorts of patients including all clinical forms of LB. For Erythema migrans, serology sensitivity is low (20% to 50%), while the sensitivity of culture or PCR reaches 50%. In early-complicated forms, serology is more sensitive (70 to 90%) with the presence of concomitant IgG and IgM. Screening for antibodies in CSF is very useful for the diagnosis of neuroborreliosis. For this clinical form, culture or PCR sensitivity is disappointing (10 to 30%). In arthritis and acrodermatitis chronica atrophicans (ACA), IgG serology is 100% positive with very high titers; however IgM serology is only positive in 5 to 10% of the cases. In ACA, culture sensitivity ranges from 20 to 60% and PCR sensitivity from 60 to 90%. Specificity of antibodies, natural exposure to the etiologic agent, and cross-reactivity are critical for the final interpretation of serological assessment. Only the use of "serological profiles" allows the exploitation of detailed results (isotypes, intensity). In this approach, IgG avidity could be constructive. The western-blot is intended to confirm the specificity of antibodies found in screening methods (Elisa).
MeSH term(s)	Biopsy ; Blotting, Western ; Enzyme-Linked Immunosorbent Assay ; Erythema/microbiology ; Humans ; Immunoglobulin G/blood ; Immunoglobulin M/blood ; Lyme Disease/classification ; Lyme Disease/diagnosis ; Lyme Disease/immunology ; Lyme Disease/pathology ; Polymerase Chain Reaction/methods ; Sensitivity and Specificity
Chemical Substances	Immunoglobulin G ; Immunoglobulin M
Language	French
Publishing date	2007-07
Publishing country	France
Document type	English Abstract ; Journal Article ; Review
ZDB-ID	423536-8
ISSN	0399-077X ; 1166-8237
ISSN	0399-077X ; 1166-8237
DOI	10.1016/j.medmal.2006.01.019
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Article ; Online: Vancomycin-resistant enterococcus bacteraemia in an endemic region: clinical features and genomic analysis: a 12-year cohort.

Abu-Lybdeh, O / Murik, O / Oster, Y / Assous, M V / Mann, T / Zeevi, D A / Benenson, S / Wiener-Well, Y

The Journal of hospital infection

2021 Volume 121, Page(s) 105–113

Abstract: Background: Vancomycin-resistant enterococci (VRE) are important nosocomial pathogens with increasing prevalence worldwide. Hospitals in Jerusalem, Israel are known to have high rates of VRE carriage. However, the clonicity of this pathogen in endemic ... ...

Abstract	Background: Vancomycin-resistant enterococci (VRE) are important nosocomial pathogens with increasing prevalence worldwide. Hospitals in Jerusalem, Israel are known to have high rates of VRE carriage. However, the clonicity of this pathogen in endemic areas remains unclear. Methods: The medical files of patients with VRE bacteraemia (N=182) hospitalized in the three major hospitals in Jerusalem between 2009 and 2020 were reviewed. These were compared with 100 patients with vancomycin-susceptible enterococcus (VSE) bacteraemia during the same period, and their clinical and demographic characters were analysed. Whole-genome sequencing (WGS) of the VRE isolates was performed, and the results were analysed considering the demographic, epidemiologic and clinical outcome data. Results: Patients with VRE bacteraemia had higher rates of central line use, haematologic malignancy and immunosuppression compared with patients with VSE bacteraemia (63% vs 27%, P<0.001; 25% vs 13%, P=0.02; 24% vs 13%, P=0.04, respectively). Patients with VRE bacteraemia had significantly higher 7- and 30-day in-hospital mortality rates (31% vs 18%, P= 0.02; 57% vs 34%, P<0.001, respectively) and a longer mean hospital stay (39 vs 24 days, P=0.005) than patients with VSE bacteraemia. The WGS results of VRE isolates showed diversity rather than endemicity of a single clone. No clones were associated with specific ethnicity, geographical distribution or worse prognosis. Conclusions: WGS revealed the occurrence of small unrelated outbreaks rather than the expansion of large clusters in Jerusalem. VRE bacteraemia was found in sicker patients, and was associated with higher mortality and longer hospitalization compared with VSE bacteraemia.
MeSH term(s)	Anti-Bacterial Agents/pharmacology ; Anti-Bacterial Agents/therapeutic use ; Bacteremia ; Enterococcus faecium/genetics ; Genomics ; Gram-Positive Bacterial Infections/epidemiology ; Humans ; Vancomycin ; Vancomycin-Resistant Enterococci/genetics
Chemical Substances	Anti-Bacterial Agents ; Vancomycin (6Q205EH1VU)
Language	English
Publishing date	2021-12-09
Publishing country	England
Document type	Journal Article
ZDB-ID	779366-2
ISSN	1532-2939 ; 0195-6701
ISSN (online)	1532-2939
ISSN	0195-6701
DOI	10.1016/j.jhin.2021.11.021
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Zs.A 1586: Show issues

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Article ; Online: False-positive galactomannan antigen testing in pulmonary nocardiosis.

Haran, Arnon / Temper, Violeta / Assous, Marc / Bergel, Michael / Chahanian, Noga / Elinav, Hila / Korem, Maya

Medical mycology

2020 Volume 59, Issue 2, Page(s) 206–209

Abstract: Early diagnosis of invasive aspergillosis (IA) is facilitated by detection of galactomannan (GM) in serum and bronchoalveolar lavage fluid (BALF) using an enzyme-linked immunosorbent assay (ELISA). Although accurate, false positive results have been ... ...

Abstract	Early diagnosis of invasive aspergillosis (IA) is facilitated by detection of galactomannan (GM) in serum and bronchoalveolar lavage fluid (BALF) using an enzyme-linked immunosorbent assay (ELISA). Although accurate, false positive results have been reported with these tests in numerous contexts. We report for the first time the occurrence of false positive GM ELISA due to nocardiosis, initially in a clinical sample of BALF from a patient with pulmonary nocardiosis, and subsequently corroborated by in vitro reactivity of 26% of tested isolates. Since patients at risk for IA are also at risk for nocardiosis, this finding has important clinical implications. Lay summary: Early diagnosis of aspergillosis has been facilitated by the routine use of antibody-based detection of galactomannan in various bodily fluids. We report for the first time the occurrence of false positive results of this assay in the context of nocardiosis.
MeSH term(s)	Aged ; Antigens, Fungal/analysis ; Antigens, Fungal/blood ; Aspergillus/chemistry ; Bronchoalveolar Lavage Fluid/microbiology ; Enzyme-Linked Immunosorbent Assay/standards ; False Positive Reactions ; Galactose/analogs & derivatives ; Humans ; Invasive Pulmonary Aspergillosis/blood ; Invasive Pulmonary Aspergillosis/diagnosis ; Male ; Mannans/analysis ; Mannans/blood ; Nocardia Infections/blood ; Nocardia Infections/diagnosis ; Sensitivity and Specificity
Chemical Substances	Antigens, Fungal ; Mannans ; galactomannan (11078-30-1) ; Galactose (X2RN3Q8DNE)
Language	English
Publishing date	2020-08-07
Publishing country	England
Document type	Case Reports ; Journal Article
ZDB-ID	1421796-x
ISSN	1460-2709 ; 1369-3786
ISSN (online)	1460-2709
ISSN	1369-3786
DOI	10.1093/mmy/myaa084
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Article ; Online: The utility of MALDI-TOF MS for outbreak investigation in the neonatal intensive care unit.

Bar-Meir, Maskit / Berliner, Elihay / Kashat, Livnat / Zeevi, David A / Assous, Marc V

European journal of pediatrics

2020 Volume 179, Issue 12, Page(s) 1843–1849

Abstract: Our aim was to evaluate the performance of matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS), routinely used in the microbiology laboratory for bacterial identification, for bacterial typing in the setting of ... ...

Abstract	Our aim was to evaluate the performance of matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS), routinely used in the microbiology laboratory for bacterial identification, for bacterial typing in the setting of extended spectrum beta-lactamase producing Klebsiella pneumoniae (ESBL-KP) outbreak in the neonatal intensive care unit (NICU). Isolates from a 2011 outbreak in the NICU were retrieved from frozen stocks and analyzed by MALDI-TOF. The MALDI typing was compared with core genome multilocus sequence typing (cg-MLST). MALDI typing divided the 33 outbreak isolates into 2 clones: sequence type (ST)-290 and 405. These results were in complete agreement with cg-MLST results. The differentiation of the outbreak isolates into two clones correlated with the patients' location in the NICU, but also with their place of residence.Conclusion: Here, we show that MALDI-TOF MS, which has been integrated into the microbiology laboratory workflow for microbial species identification, can be secondarily used for epidemiological typing at no added cost. What is Known: • Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) is now routinely used in the microbiology laboratory for bacterial identification What is New: • MALDI typing was used for outbreak investigation in the NICU and divided the outbreak isolates into two clones • MALDI-TOF MS may be secondarily used for epidemiological typing at no added cost.
MeSH term(s)	Disease Outbreaks ; Humans ; Infant, Newborn ; Intensive Care Units, Neonatal ; Klebsiella Infections/diagnosis ; Klebsiella pneumoniae/genetics ; Multilocus Sequence Typing ; Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization
Keywords	covid19
Language	English
Publishing date	2020-06-10
Publishing country	Germany
Document type	Journal Article
ZDB-ID	194196-3
ISSN	1432-1076 ; 0340-6199 ; 0943-9676
ISSN (online)	1432-1076
ISSN	0340-6199 ; 0943-9676
DOI	10.1007/s00431-020-03696-3
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Article ; Online: Clinical and molecular features of NDM-producing Acinetobacter baumannii in a multicenter study in Israel.

Adler, Amos / Ghosh, Hiren / Gross, Andrea / Rechavi, Amit / Lasnoy, Michal / Assous, Marc V / Geffen, Yuval / Darawsha, Basel / Wiener-Well, Yonit / Alony, Anat / Grundmann, Hajo / Reuter, Sandra

Annals of clinical microbiology and antimicrobials

2023 Volume 22, Issue 1, Page(s) 52

Abstract: Background: NDM-producing Acinetobacter baumannii (NDMAb) were reported sporadically worldwide but little is known about the transmission, epidemiology and clinical features of NDMAb-infected patients. The goals of this study were to characterize (1) ... ...

Abstract	Background: NDM-producing Acinetobacter baumannii (NDMAb) were reported sporadically worldwide but little is known about the transmission, epidemiology and clinical features of NDMAb-infected patients. The goals of this study were to characterize (1) the epidemiology and clinical features of NDMAb-infected patients; (2) the microbiological and molecular features of NDMAb isolates and (3) the transmission networks of NDMAb within healthcare facilities. Methods: The study was conducted at the Tel-Aviv Sourasky, Rambam and Sha'are-Zedek Medical centers (TASMC, RMC and SZMC, respectively) in Israel. All cases detected between January 2018 and July 2019 were included. Phylogenetic analysis was based on core genome SNP distances. Clonal transmission was defined according to molecular (≤ 5 SNP) and epidemiological criteria (overlapping hospital stay). NDMAb cases were compared at a ratio of 1:2 with non-NDM carbapenem-resistant A. baumannii (CRAb) cases. Results: The study included 54 NDMAb-positive out of 857 CRAb patients, including 6/179 (3.3%) in TASMC, 18/441 (4.0%) in SZMC and 30/237 (12.6%) in RMC. Patients infected by NDMAb had similar clinical features and risk factors as patients with non-NDM CRAb. The length-of-stay was higher in NDMAb cases (48.5 days vs. 36 days, respectively, p = 0.097) and the in-hospital mortality was similarly high in both groups. Most isolates (41/54, 76%) were first detected from surveillance culture. The majority of isolates harbored the bla Conclusion: NDMAb constitutes a minor part of CRAb cases and are clinically similar to non-NDM CRAb. Transmission of NDMAb occurs mostly by clonal spread.
MeSH term(s)	Humans ; Israel/epidemiology ; Acinetobacter baumannii/genetics ; Phylogeny ; Alleles ; Carbapenems/pharmacology
Chemical Substances	Carbapenems
Language	English
Publishing date	2023-06-30
Publishing country	England
Document type	Multicenter Study ; Journal Article
ZDB-ID	2097873-X
ISSN	1476-0711 ; 1476-0711
ISSN (online)	1476-0711
ISSN	1476-0711
DOI	10.1186/s12941-023-00607-w
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