The prevalence of aminoglycoside-modifying enzyme genes (aac (6′)-I, aac (6′)-II, ant (2″)-I, aph (3′)-VI) in Pseudomonas aeruginosa

array:24 ["pii" => "S1807593222019366" "issn" => "18075932" "doi" => "10.1590/S1807-59322011000900002" "estado" => "S300" "fechaPublicacion" => "2011-09-01" "aid" => "1936" "copyright" => "CLINICS" "copyrightAnyo" => "2011" "documento" => "article" "crossmark" => 0 "licencia" => "https://creativecommons.org/licenses/by-nc/3.0/" "subdocumento" => "fla" "cita" => "Clinics. 2011;66:1519-22" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "itemSiguiente" => array:19 [ "pii" => "S1807593222019378" "issn" => "18075932" "doi" => "10.1590/S1807-59322011000900003" "estado" => "S300" "fechaPublicacion" => "2011-09-01" "aid" => "1937" "copyright" => "CLINICS" "documento" => "article" "crossmark" => 0 "licencia" => "https://creativecommons.org/licenses/by-nc/3.0/" "subdocumento" => "fla" "cita" => "Clinics. 2011;66:1523-9" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "en" => array:12 [ "idiomaDefecto" => true "cabecera" => "CLINICAL SCIENCE" "titulo" => "Impaired hemodynamic response to mental stress in subjects with prehypertension is improved after a single bout of maximal dynamic exercise" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "1523" "paginaFinal" => "1529" ] ] "contieneResumen" => array:1 [ "en" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig1" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 382 "Ancho" => 662 "Tamanyo" => 38655 ] ] "descripcion" => array:1 [ "en" => "Absolute hemodynamic responses to mental stress, adjusted for gender, before and after an exercise bout in subjects with prehypertension or normotension. Values are the mean ± SEM. ∗, p<0.05 vs. within-group baseline; †, p<0.05 vs. same condition between groups; ‡, p<0.05 vs. before-exercise within group." ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Renata Frauches Medeiros, Bruno Moreira Silva, Fabricia Junqueira Neves, Natalia Galito Rocha, Allan Robson Kluser Sales, Antonio Claudio Nobrega" "autores" => array:6 [ 0 => array:2 [ "nombre" => "Renata Frauches" "apellidos" => "Medeiros" ] 1 => array:2 [ "nombre" => "Bruno Moreira" "apellidos" => "Silva" ] 2 => array:2 [ "nombre" => "Fabricia Junqueira" "apellidos" => "Neves" ] 3 => array:2 [ "nombre" => "Natalia Galito" "apellidos" => "Rocha" ] 4 => array:2 [ "nombre" => "Allan Robson Kluser" "apellidos" => "Sales" ] 5 => array:2 [ "nombre" => "Antonio Claudio" "apellidos" => "Nobrega" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1807593222019378?idApp=UINPBA00004N" "url" => "/18075932/0000006600000009/v1_202212011637/S1807593222019378/v1_202212011637/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S1807593222019354" "issn" => "18075932" "doi" => "10.1590/S1807-59322011000900001" "estado" => "S300" "fechaPublicacion" => "2011-09-01" "aid" => "1935" "copyright" => "CLINICS" "documento" => "article" "crossmark" => 0 "licencia" => "https://creativecommons.org/licenses/by-nc/3.0/" "subdocumento" => "fla" "cita" => "Clinics. 2011;66:1513-8" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "CLINICAL SCIENCE" "titulo" => "Adiposity and postural balance control: Correlations between bioelectrical impedance and stabilometric signals in elderly Brazilian women" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "1513" "paginaFinal" => "1518" ] ] "contieneResumen" => array:1 [ "en" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Míriam Raquel Meira Mainenti, Érika de Carvalho Rodrigues, Juliana Flávia de Oliveira, Arthur de Sá Ferreira, Cristina Márcia Dias, André Luís dos Santos Silva" "autores" => array:6 [ 0 => array:2 [ "nombre" => "Míriam Raquel Meira" "apellidos" => "Mainenti" ] 1 => array:2 [ "nombre" => "Érika" "apellidos" => "de Carvalho Rodrigues" ] 2 => array:2 [ "nombre" => "Juliana Flávia" "apellidos" => "de Oliveira" ] 3 => array:2 [ "nombre" => "Arthur" "apellidos" => "de Sá Ferreira" ] 4 => array:2 [ "nombre" => "Cristina Márcia" "apellidos" => "Dias" ] 5 => array:2 [ "nombre" => "André Luís" "apellidos" => "dos Santos Silva" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1807593222019354?idApp=UINPBA00004N" "url" => "/18075932/0000006600000009/v1_202212011637/S1807593222019354/v1_202212011637/en/main.assets" ] "en" => array:19 [ "idiomaDefecto" => true "cabecera" => "CLINICAL SCIENCE" "titulo" => "The prevalence of aminoglycoside-modifying enzyme genes (aac (6′)-I, aac (6′)-II, ant (2″)-I, aph (3′)-VI) in Pseudomonas aeruginosa" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "1519" "paginaFinal" => "1522" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Farzam Vaziri, Shahin Najar Peerayeh, Qorban Behzadian Nejad, Abbas Farhadian" "autores" => array:4 [ 0 => array:3 [ "nombre" => "Farzam" "apellidos" => "Vaziri" "email" => array:1 [ 0 => "vaziri@modares.ac.ir" ] ] 1 => array:4 [ "nombre" => "Shahin Najar" "apellidos" => "Peerayeh" "email" => array:1 [ 0 => "najarp_s@modares.ac.ir" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "*" "identificador" => "cor1" ] ] ] 2 => array:2 [ "nombre" => "Qorban Behzadian" "apellidos" => "Nejad" ] 3 => array:2 [ "nombre" => "Abbas" "apellidos" => "Farhadian" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Department of Bacteriology, School of Medical Sciences, Tarbiat Modares University, Tehran, Iran." "identificador" => "aff1" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor1" "etiqueta" => "*" "correspondencia" => "/ Tel.: 00 98 021 82883870" ] ] ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig2" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 483 "Ancho" => 415 "Tamanyo" => 11318 ] ] "descripcion" => array:1 [ "en" => "Lane 1, 1000 bp DNA size marker; Lane 2, aac(6′)-II (125 bp); Lane 5, aph(3′)-VI (800 bp); Lane 7, ant(2″)-I (524 bp); Lanes 8 and 9, aac(6′)-I (392 bp)." ] ] ] "textoCompleto" => "INTRODUCTIONPseudomonas aeruginosa (P. aeruginosa) is one of the primary opportunistic pathogens responsible for nosocomial infections. The most important problem in the eradication of P. aeruginosa is the frequently observed multi-drug resistance of the species.<a class="elsevierStyleCrossRef" href="#bib1">1</a> In addition, P. aeruginosa can also acquire resistance to various antimicrobial agents, such as aminoglycosides, β-lactams<a class="elsevierStyleCrossRef" href="#bib2">2</a> and fluoroquinolones.<a class="elsevierStyleCrossRef" href="#bib3">3</a> Aminoglycosides are an important component of antipseudomonal chemotherapy,<a class="elsevierStyleCrossRef" href="#bib4">4</a> and they exhibit synergy with β-lactams.<a class="elsevierStyleCrossRef" href="#bib5">5</a> Resistance to aminoglycosides occurs via enzymatic modification, impermeability, the activity of efflux pumps (MexXY-OprM),<a class="elsevierStyleCrossRef" href="#bib6">6</a> the PhoP-PhoQ system,<a class="elsevierStyleCrossRef" href="#bib7">7</a> ndvB-dependent biofilm formation,<a class="elsevierStyleCrossRef" href="#bib8">8</a> and the activity of 16s rRNA methylases.<a class="elsevierStyleCrossRef" href="#bib9">9</a> Among these mechanisms, the inactivation of drugs by plasmid- or chromosome-encoded modifying enzymes is the most common. These modifying enzymes include aminoglycoside phosphoryl transferase (aph), aminoglycoside acetyltransferase (aac), and aminoglycoside nucleotidyl transferase (ant).<a class="elsevierStyleCrossRefs" href="#bib10">10–12</a> Four of these enzymes, encoded by aac (6′)-I, aac (6′)-II, ant (2″)-I, and aph (3′)-VI, are of particular significance because they are among the most common modifying enzymes present in P. aeruginosa, and their substrates are the most important antipseudomonal aminoglycosides. aac (6′)-I confers resistance to tobramycin and amikacin, aac (6′)-II and ant (2″)-I inactivate tobramycin and gentamicin, and amikacin is the substrate of aph (3′)-VI.<a class="elsevierStyleCrossRefs" href="#bib13">13,14</a>The aim of the present nationwide study was to investigate the occurrence of aminoglycoside resistance and the prevalence of the resistance-modifying enzyme genes, aac (6′)-I, aac (6′)-II, ant (2″)-I and aph (3′)-VI, in P. aeruginosa isolated from several hospitals in seven Iranian cities.METHODS AND MATERIALSCollection of bacterial isolatesA total of 250 non-duplicate, clinical isolates of P. aeruginosa were collected from a nationwide distribution of several hospitals in seven cities in Iran (Tehran, Shiraz, Zahedan, Tabriz, Sannandaj, Sari, and Ahvaz) between May 2007 and January 2008. Strain data and the demographic and clinical data for each patient were regularly forwarded to our laboratory. The study population was 62% male and 38% female. The specimens were isolated from urine (38%), wounds (18%), the trachea (18%), blood (10%), sputum (9%), and other sources (7%). Isolate confirmations were conducted using conventional biochemical tests, and then the isolates were stored at –76°C in glycerol skim milk broth.Antimicrobial susceptibility testingAntimicrobial susceptibility tests were performed using the disk diffusion method according to Clinical and Laboratory Standards Institute (CLSI) guidelines<a class="elsevierStyleCrossRef" href="#bib15">15</a> for three aminoglycosides [gentamicin (10 μg), amikacin (30 μg), and tobramycin (10 μg)] and for five other antibiotics [imipenem (10 μg), piperacillin (100 μg), ticarcillin (75 μg), ceftazidime (30 μg), and ciprofloxacin (5 μg)]. All drugs were obtained from Mast laboratories (Merseyside, United Kingdom). For all 250 isolates, the minimum inhibitory concentrations (MIC) of amikacin, gentamicin, and tobramycin were determined using the E-test (Biodisk, Dalvagen, Sweden) according to CLSI guidelines. P. aeruginosa (ATCC 27853) served as a control for the disk diffusion and E-tests.Polymerase chain reaction amplificationPolymerase chain reaction (PCR) was used to screen all 250 isolates for the presence of the modifying enzyme genes, aac (6′)-I, aac (6′)-II, ant (2″)-I and aph (3′)-VI. The total template DNA for the PCR amplification was extracted from the supernatant of a mixture of P. aeruginosa cells produced by the boiling method. PCR amplification was performed using 2.5 μL of the template DNA, 1 μL of each primer,<a class="elsevierStyleCrossRef" href="#bib16">16</a> 19.5 μL master mix, and 1 μL of Taq DNA polymerase (CinnaGen) in a total volume of 25 μL. A thermocycler (Mastercycler gradient; Eppendorf, Hamburg, Germany) was programmed with the appropriate conditions. Then, 5 μl of each PCR product was analyzed by electrophoresis on a 1% (w/v) TAE agarose gel (Fermentas UAB, Vilnius, Lithuania) containing 0.1 μl/ml ethidium bromide. The amplicons were then visualized on a UV transilluminator and photographed (BioDoc-Analyse; Biometra, Goettingen, Germany).Statistical analysisAll statistical analyses were performed using Statistical Package for Social Sciences (SPSS) software (version 11.5) for Windows (χ2-test and Fisher's exact test). P-values of <0.05 were considered significant.RESULTS AND DISCUSSIONThe resistance rates as determined using the disk diffusion method are presented in <a class="elsevierStyleCrossRef" href="#fig1">Figure 1</a>. According to the disk diffusion method, 135 isolates were resistant to aminoglycosides. The resistance rates according to the E-test (base on MICs) were as follows: gentamicin 40%, tobramycin 36%, and amikacin 21%. The aminoglycoside susceptibility profiles according to the disk diffusion and E-test results for the 250 isolates are listed in <a class="elsevierStyleCrossRef" href="#tbl1">Table 1</a>.<elsevierMultimedia ident="fig1"></elsevierMultimedia><elsevierMultimedia ident="tbl1"></elsevierMultimedia>PCR analysis revealed the absence of resistance genes in susceptible isolates. The prevalence of aminoglycoside resistance genes in the 135 resistant isolates (as determined by the disk diffusion method) was as follows: aac (6′)-II was detected in 36% of the resistant isolates, ant (2″)-I was detected in 28%, aph (3′)-VI in 11%, and aac (6′)-I was found in 7% of the resistant isolates (<a class="elsevierStyleCrossRef" href="#fig2">Figure 2</a>). Interestingly, individual aminoglycoside-resistant isolates carried multiple (two to four) modifying enzyme genes. Six isolates harbored ant(2″)-I and aac(6′)-II; three harbored aph(3′)-VI and ant(2″)-I; two harbored ant(2″)-I and aac(6′)-I; and three isolates harbored ant(2″)-I, aac(6′)-II and aph(3′)-VI. Only one isolate harbored all four genes.<elsevierMultimedia ident="fig2"></elsevierMultimedia>Several previous studies have examined the occurrence of aminoglycoside resistance mechanisms in P. aeruginosa isolated from different countries. The overall incidence of aminoglycoside resistance found in our study (according to the disk diffusion test and the E-test) was much higher than the incidence that has been reported previously in different countries worldwide.<a class="elsevierStyleCrossRefs" href="#bib14">14,16,17</a> However, Estahbanati and co-workers reported that 53.3% of clinical isolates from Iranian burn patients were resistant to amikacin, and 90.7% were resistant to gentamicin, a result that reveals a high level of aminoglycoside resistance in their study.<a class="elsevierStyleCrossRef" href="#bib18">18</a>The aminoglycoside resistance rate was almost as high in our isolates, and most of the resistant isolates harbored modifying enzyme genes. In addition, none of the susceptible isolates harbored these resistance genes. These results highlight the importance of aminoglycoside-modification-related mechanisms in aminoglycoside resistance in P. aeruginosa. Two genes, aac (6′)-II and ant (2″)-I, were the most frequent resistance genes observed in these isolates. These results are similar to what has been observed in different studies in other countries.<a class="elsevierStyleCrossRefs" href="#bib19">19–21</a> All isolates harboring the aac (6′)-II gene were resistant to gentamicin and tobramycin (100% concordance), which indicates that aac (6′)-II is a significant determinant of gentamicin and tobramycin resistance in P. aeruginosa. It is important to mention that we encountered an unexpected phenotype in some isolates (<a class="elsevierStyleCrossRef" href="#tbl2">Table 2</a>). For example, when an isolate harbored only the aph (3′)-VI gene, which has amikacin as a substrate, resistance to gentamicin, tobramycin, and amikacin was observed. We presume that the reason for this phenomenon might be the action of other resistance mechanisms, such as impermeability, efflux pumps, or other types of modifying enzymes. On the other hand, we detected 15 isolates which co-harbored two, three, or four aminoglycoside-modifying enzyme genes simultaneously, which is in contrast to several studies conducted in the USA and Europe, which reported that the majority of isolates exhibit only a single aminoglycoside modifying gene.<a class="elsevierStyleCrossRef" href="#bib22">22</a><elsevierMultimedia ident="tbl2"></elsevierMultimedia>Miller et al. brought together the results of several studies of aminoglycoside resistance in P. aeruginosa carried out worldwide.<a class="elsevierStyleCrossRef" href="#bib22">22</a> Their results indicated that in Europe, aac(6′)-II was the most prevalent resistance gene (32.5%), followed by ant(2″)-I (16.9%). These results are in concordance with our study. In contrast to our results, a Korean nationwide study of 250 isolates of P. aeruginosa reported that aph(3′)-VI, ant(2″)-I, and aac(6′)-I were all prevalent, but none harbored aac(6′)-II.<a class="elsevierStyleCrossRef" href="#bib16">16</a> The difference in the distribution of modifying enzymes may derive from differences in aminoglycoside prescription patterns, the selection of bacterial population or geographical differences in the occurrence of aminoglycoside resistance genes.CONCLUSIONSIn conclusion, although aminoglycosides remain useful antipseudomonal agents, resistance to these drugs continues to be a major issue, especially in Iran. Because these aminoglycoside resistance genes are usually located on mobile genetic elements (i.e., plasmid, transposon, or integrons),<a class="elsevierStyleCrossRefs" href="#bib23">23,24</a> there is a growing concern that they could easily spread and be disseminated among other bacteria. Integrons that carry gene cassettes encoding both aacs and carbapenemases will only exacerbate this problem.<a class="elsevierStyleCrossRef" href="#bib25">25</a> The design of novel aminoglycosides with stronger affinity for their targets and resistance to these modifying enzymes is inevitable,<a class="elsevierStyleCrossRef" href="#bib26">26</a> and the new generation of anti-Pseudomonas therapy is forthcoming.<a class="elsevierStyleCrossRef" href="#bib27">27</a> Aminoglycoside resistance among clinical isolates of P. aeruginosa promises to become a major clinical concern in the future, and continuous local surveillance of aminoglycoside resistance is crucial." "textoCompletoSecciones" => array:1 [ "secciones" => array:7 [ 0 => array:2 [ "identificador" => "xpalclavsec1582733" "titulo" => "KEYWORDS" ] 1 => array:2 [ "identificador" => "cesec10" "titulo" => "INTRODUCTION" ] 2 => array:3 [ "identificador" => "cesec20" "titulo" => "METHODS AND MATERIALS" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "cesec30" "titulo" => "Collection of bacterial isolates" ] 1 => array:2 [ "identificador" => "cesec40" "titulo" => "Antimicrobial susceptibility testing" ] 2 => array:2 [ "identificador" => "cesec50" "titulo" => "Polymerase chain reaction amplification" ] 3 => array:2 [ "identificador" => "cesec60" "titulo" => "Statistical analysis" ] ] ] 3 => array:2 [ "identificador" => "cesec70" "titulo" => "RESULTS AND DISCUSSION" ] 4 => array:2 [ "identificador" => "cesec80" "titulo" => "CONCLUSIONS" ] 5 => array:2 [ "identificador" => "xack639490" "titulo" => "ACKNOWLEDGEMENTS" ] 6 => array:1 [ "titulo" => "REFERENCES" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2011-02-01" "fechaAceptado" => "2011-05-16" "PalabrasClave" => array:1 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "KEYWORDS" "identificador" => "xpalclavsec1582733" "palabras" => array:5 [ 0 => "Pseudomonas aeruginosa" 1 => "Antibiotic" 2 => "Resistance" 3 => "aac (6′)-II" 4 => "ant (2″)-I" ] ] ] ] "tieneResumen" => true "resumen" => array:1 [ "en" => array:2 [ "resumen" => "INTRODUCTION:Pseudomonas aeruginosa (P. aeruginosa) is one of the primary opportunistic pathogens responsible for nosocomial infections. Aminoglycosides are an important component of antipseudomonal chemotherapy. The inactivation of drugs by modifying enzymes is the most common mechanism of aminoglycoside resistance. OBJECTIVES:The inactivation of aminoglycosides by modifying enzymes is the primary resistance mechanism employed by P. aeruginosa. The aim of the present study was to investigate the occurrence of aminoglycoside resistance and the prevalence of four important modifying enzyme genes (aac (6′)-I, aac (6′)-II, ant (2″)-I, aph (3′)-VI) in P. aeruginosa in Iran. METHODS:A total of 250 clinical isolates of P. aeruginosa were collected from several hospitals in seven cities in Iran. Antimicrobial susceptibility tests (using the disk diffusion method and E-tests) were performed for all 250 isolates. In addition, all isolates were screened for the presence of modifying enzyme genes by polymerase chain reaction. RESULTS:The resistance rates, as determined by the disk diffusion method, were as follows: gentamicin 43%, tobramycin 38%, and amikacin 24%. Of the genes examined, aac (6′)-II (36%) was the most frequently identified gene in phenotypic resistant isolates, followed by ant (2″)-I, aph (3′)-VI, and aac (6′)-I. CONCLUSIONS:Aminoglycoside resistance in P. aeruginosa remains a significant problem in Iran. Therefore, there is considerable local surveillance of aminoglycoside resistance." "secciones" => array:5 [ 0 => array:2 [ "identificador" => "ceabs10" "titulo" => "INTRODUCTION:" ] 1 => array:2 [ "identificador" => "ceabs20" "titulo" => "OBJECTIVES:" ] 2 => array:2 [ "identificador" => "ceabs30" "titulo" => "METHODS:" ] 3 => array:2 [ "identificador" => "ceabs40" "titulo" => "RESULTS:" ] 4 => array:2 [ "identificador" => "ceabs50" "titulo" => "CONCLUSIONS:" ] ] ] ] "multimedia" => array:4 [ 0 => array:7 [ "identificador" => "fig1" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 235 "Ancho" => 558 "Tamanyo" => 13358 ] ] "descripcion" => array:1 [ "en" => "The antimicrobial resistance rate of 250 P. aeruginosa isolates as determined by the disk diffusion method AMI: amikacin, GEN: gentamicin, TOB: tobramycin, IMI: imipenem, PIP: piperacillin, TIC: ticarcillin, CAZ: ceftazidime, CIP: ciprofloxacin." ] ] 1 => array:7 [ "identificador" => "fig2" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 483 "Ancho" => 415 "Tamanyo" => 11318 ] ] "descripcion" => array:1 [ "en" => "Lane 1, 1000 bp DNA size marker; Lane 2, aac(6′)-II (125 bp); Lane 5, aph(3′)-VI (800 bp); Lane 7, ant(2″)-I (524 bp); Lanes 8 and 9, aac(6′)-I (392 bp)." ] ] 2 => array:7 [ "identificador" => "tbl1" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:2 [ "tablatextoimagen" => array:2 [ 0 => array:1 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " colspan="3" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Disk Diffusion<a class="elsevierStyleCrossRef" href="#tfn1">1</a></th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " colspan="6" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">E-test<a class="elsevierStyleCrossRef" href="#tfn2">2</a></th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="top" scope="col">MIC 50% (ug/mL) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="top" scope="col">MIC 90% (ug/mL). \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " colspan="3" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Resistant</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Intermediate \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Susceptible</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " colspan="3" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">No. (%) of isolates</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " colspan="3" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">MIC(μg/ml)</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">MIC(μg/ml) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">MIC(μg/ml)</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="top" scope="col">Resistant \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="top" scope="col">Intermediate \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="top" scope="col">Susceptible \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="top" scope="col">–1024128 \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="top" scope="col">64–128 \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="top" scope="col">16–64 \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="top" scope="col">8 \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="top" scope="col">2–4 \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="top" scope="col"><2 \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="top">Gentamicin \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="top">108(43.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="top">8(3.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="top">134(53.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="top">10 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="top">41 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="top">49 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="top">8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="top">98 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="top">44 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="top">4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="top">64 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="top">Tobramycin \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="top">95(38) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="top">7(2.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="top">148(59.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="top">8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="top">45 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="top">37 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="top">5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="top">103 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="top">52 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="top">4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="top">64 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] ] 1 => array:1 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " colspan="3" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">MIC(μg/ml)</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">MIC(μg/ml) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">MIC(μg/ml)</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="top" scope="col">MIC 50% (ug/mL) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="top" scope="col">MIC 90% (ug/mL). \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="top" scope="col">>256 \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="top" scope="col">–256128 \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="top" scope="col">64–128 \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="top" scope="col">32 \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="top" scope="col">4–16 \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="top" scope="col"><4 \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="top" style="border-bottom: 2px solid black">Amikacin \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="top" style="border-bottom: 2px solid black">59(23.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="top" style="border-bottom: 2px solid black">7(2.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="top" style="border-bottom: 2px solid black">184(73.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="top" style="border-bottom: 2px solid black">4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="top" style="border-bottom: 2px solid black">17 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="top" style="border-bottom: 2px solid black">32 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="top" style="border-bottom: 2px solid black">6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="top" style="border-bottom: 2px solid black">134 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="top" style="border-bottom: 2px solid black">57 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="top" style="border-bottom: 2px solid black">8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="top" style="border-bottom: 2px solid black">128 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] ] ] "notaPie" => array:2 [ 0 => array:3 [ "identificador" => "tfn1" "etiqueta" => "1." "nota" => "Zone diameter (mm) for gentamicin and tobramycin, R:<12, I:13-14, S:>15; for amikacin, R:<14, I:15-16, S:>17." ] 1 => array:3 [ "identificador" => "tfn2" "etiqueta" => "2." "nota" => "MIC breakpoint(μg/ml) for gentamicin and tobramycin, R:>16, I:8; S:<4; for amikacin, R:>64, I:32, S:<16." ] ] ] "descripcion" => array:1 [ "en" => "Aminoglycoside susceptibility profiles according to the disk diffusion method and MIC results (E-test) for 250 P. aeruginosa isolates (according to CLSI guidelines).<a class="elsevierStyleCrossRef" href="#bib15">15</a>" ] ] 3 => array:7 [ "identificador" => "tbl2" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:2 [ "tablatextoimagen" => array:1 [ 0 => array:1 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="top" scope="col">Gene \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="top" scope="col">no. of isolates (%)<a class="elsevierStyleCrossRef" href="#tfn3">1</a> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="top" scope="col">Expected resistance<a class="elsevierStyleCrossRef" href="#tfn4">2</a> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="top" scope="col">Observed resistance phenotypes (no. of isolates)<a class="elsevierStyleCrossRef" href="#tfn5">3</a> \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="top">aac(6′)-I \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="top">9(7%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="top">TOB,AMI \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="top">Unexpected resistance to GEN(2) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="top">aac(6′)-II \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="top">49(36%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="top">GEN,TOB \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="top">Unexpected resistance to AMI(16) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="top">ant(2″)-I \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="top">38(28%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="top">GEN,TOB \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="top">As expected(38) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="top">aph(3′)-VI \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="top">15(11%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="top">AMI \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="top">Unexpected resistance to GEN and TOB(2) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="top">aac(6′)-II+ ant(2″)-I \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="top">6(4%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="top">GEN,TOB \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="top">As expected(6) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="top">ant(2″)-I+ aph(3′)-VI \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="top">3(2%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="top">AMI,GEN,TOB \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="top">As expected(3) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="top">aac(6′)-I+ ant(2″)-I \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="top">2(1%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="top">AMI,GEN,TOB \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="top">As expected(2) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="top">ant(2″)-I + aac(6′)-II +aph(3′)-VI \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="top">3(2%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="top">AMI,GEN,TOB \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="top">As expected(3) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="top" style="border-bottom: 2px solid black">aac(6′)-II ant(2″)-I+ + aph(3′)-VI + aac(6′)-I \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="top" style="border-bottom: 2px solid black">1(∼1%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="top" style="border-bottom: 2px solid black">AMI,GEN,TOB \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="top" style="border-bottom: 2px solid black">As expected(1) \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] ] ] "notaPie" => array:3 [ 0 => array:3 [ "identificador" => "tfn3" "etiqueta" => "1." "nota" => "According to the disk diffusion method, a total of 135 resistant isolates were identified." ] 1 => array:3 [ "identificador" => "tfn4" "etiqueta" => "2." "nota" => "AMI: amikacin, GEN: gentamicin, TOB: tobramycin." ] 2 => array:3 [ "identificador" => "tfn5" "etiqueta" => "3." "nota" => "Described in greater detail in the text." ] ] ] "descripcion" => array:1 [ "en" => "Prevalence of aminoglycoside modifying enzymes genes and the correlation between these genes and phenotypic patterns in aminoglycoside resistant P. aeruginosa isolates." ] ] ] "bibliografia" => array:2 [ "titulo" => "REFERENCES" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "cebibsec10" "bibliografiaReferencia" => array:27 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Mechanisms of antibiotic resistance in Pseudomonas aeruginosa" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => """ PA Lambert \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "J R Soc Med" "fecha" => "2002" "volumen" => "95" "numero" => "suppl 41" "paginaInicial" => "22" "paginaFinal" => "26" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12216271" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib2" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Prevalence of Ambler class A and D β-lactamases among clinical isolates of Pseudomonas aeruginosa in Korea" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => """ YJ Park \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:2 [ 0 => array:2 [ "doi" => "10.1093/jac/dki160" "Revista" => array:6 [ "tituloSerie" => "J Antimicrob Chemother" "fecha" => "2005" "volumen" => "56" "paginaInicial" => "122" "paginaFinal" => "127" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15890715" "web" => "Medline" ] ] ] ] 1 => array:2 [ "doi" => "10.1093/jac/dki160" "WWW" => array:1 [ "link" => "10.1093/jac/dki160" ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib3" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:1 [ "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => """ S Jalal \n \t\t\t\t\t\t\t\t """ 1 => """ O Ciofu \n \t\t\t\t\t\t\t\t """ 2 => """ N H⊘iby \n \t\t\t\t\t\t\t\t """ 3 => """ N Gotoh \n \t\t\t\t\t\t\t\t """ 4 => """ patients Wretlind B. Molecular mechanisms of fluoroquinolone resistance in Pseudomonas aeruginosa isolates from cystic fibrosis \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1128/AAC.44.3.710-712.2000" "Revista" => array:6 [ "tituloSerie" => "Antimicrob Agents Chemother" "fecha" => "2000" "volumen" => "44" "paginaInicial" => "710" "paginaFinal" => "712" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10681343" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib4" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Therapeutic guidelines for Pseudomonas aeruginosa infections" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => """ H Giamarellou \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:2 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Int J antimicrob Agen" "fecha" => "2000" "volumen" => "16" "paginaInicial" => "103" "paginaFinal" => "106" ] ] 1 => array:1 [ "WWW" => array:1 [ "link" => "10.1016/S0924-8579(00)00212-0" ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib5" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "β-lactam and aminoglycoside resistance rates and mechanisms among Pseudomonas aeruginosa in French general practice (community and private healthcare centres)" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => """ V Dubois \n \t\t\t\t\t\t\t\t """ 1 => """ C Arpin \n \t\t\t\t\t\t\t\t """ 2 => """ V Dupart \n \t\t\t\t\t\t\t\t """ 3 => """ A Scavelli \n \t\t\t\t\t\t\t\t """ 4 => """ L Coulange \n \t\t\t\t\t\t\t\t """ 5 => """ C Andre \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:2 [ 0 => array:2 [ "doi" => "10.1093/jac/dkn174" "Revista" => array:6 [ "tituloSerie" => "J Antimicrob Chemother" "fecha" => "2008" "volumen" => "62" "paginaInicial" => "316" "paginaFinal" => "323" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18467306" "web" => "Medline" ] ] ] ] 1 => array:2 [ "doi" => "10.1093/jac/dkn174" "WWW" => array:1 [ "link" => "10.1093/jac/dkn174" ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib6" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Chromosomal mechanisms of aminoglycoside resistance in Pseudomonas aeruginosa isolates from cystic fibrosis patients" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => """ S Islam \n \t\t\t\t\t\t\t\t """ 1 => """ H Oh \n \t\t\t\t\t\t\t\t """ 2 => """ S Jalal \n \t\t\t\t\t\t\t\t """ 3 => """ F Karpati \n \t\t\t\t\t\t\t\t """ 4 => """ O Ciofu \n \t\t\t\t\t\t\t\t """ 5 => """ N H⊘iby \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:2 [ 0 => array:2 [ "doi" => "10.1111/j.1469-0691.2009.02999.x" "Revista" => array:6 [ "tituloSerie" => "Clin Microbiol Infect" "fecha" => "2009" "volumen" => "15" "paginaInicial" => "60" "paginaFinal" => "66" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19754760" "web" => "Medline" ] ] ] ] 1 => array:2 [ "doi" => "10.1111/j.1469-0691.2009.02999.x" "WWW" => array:1 [ "link" => "10.1111/j.1469-0691.2008.02097.x" ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib7" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Role of Pseudomonas aeruginosa PhoP-PhoQ in resistance to antimicrobial cationic peptides and aminoglycosides" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => """ E Macfarlane \n \t\t\t\t\t\t\t\t """ 1 => """ A Kwasnicka \n \t\t\t\t\t\t\t\t """ 2 => """ R Hancock \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Microbiol" "fecha" => "2000" "volumen" => "146" "paginaInicial" => "2543" "paginaFinal" => "2554" ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib8" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "High-level antibiotic resistance in Pseudomonas aeruginosa biofilm: the ndvB gene is involved in the production of highly glycerol-phosphorylated β-(1→3)-glucans, which bind aminoglycosides" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => """ I Sadovskaya \n \t\t\t\t\t\t\t\t """ 1 => """ E Vinogradov \n \t\t\t\t\t\t\t\t """ 2 => """ J Li \n \t\t\t\t\t\t\t\t """ 3 => """ A Hachani \n \t\t\t\t\t\t\t\t """ 4 => """ K Kowalska \n \t\t\t\t\t\t\t\t """ 5 => """ A Filloux \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:2 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Glycobiol" "fecha" => "2010" "volumen" => "20" "paginaInicial" => "895" "paginaFinal" => "904" ] ] 1 => array:1 [ "WWW" => array:1 [ "link" => "10.1093/glycob/cwq047" ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib9" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "High prevalence of metallo- β-lactamase and 16S rRNA methylase coproduction among imipenem- resistant Pseudomonas aeruginosa isolates in Brazil" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => """ Y Doi \n \t\t\t\t\t\t\t\t """ 1 => """ AC Ghilardi \n \t\t\t\t\t\t\t\t """ 2 => """ J Adams \n \t\t\t\t\t\t\t\t """ 3 => """ GD de Oliveira \n \t\t\t\t\t\t\t\t """ 4 => """ DL Paterson \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:2 [ 0 => array:2 [ "doi" => "10.1128/AAC.00443-07" "Revista" => array:6 [ "tituloSerie" => "Antimicrob Agents Chemother" "fecha" => "2007" "volumen" => "51" "paginaInicial" => "3388" "paginaFinal" => "3390" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17576840" "web" => "Medline" ] ] ] ] 1 => array:2 [ "doi" => "10.1128/AAC.00443-07" "WWW" => array:1 [ "link" => "10.1128/AAC.00443-07" ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib10" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Molecular genetics aminoglycoside resistance genes and familial relationship of the aminoglycoside modifying enzymes" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => """ KJ Shaw \n \t\t\t\t\t\t\t\t """ 1 => """ PN Rather \n \t\t\t\t\t\t\t\t """ 2 => """ RS Hare \n \t\t\t\t\t\t\t\t """ 3 => """ GH Miller \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1128/mr.57.1.138-163.1993" "Revista" => array:6 [ "tituloSerie" => "Microbiol Rev" "fecha" => "1993" "volumen" => "57" "paginaInicial" => "138" "paginaFinal" => "163" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8385262" "web" => "Medline" ] ] ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib11" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Aminoglycoside antibiotic resistance by enzymatic deactivation" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => """ CA Smith \n \t\t\t\t\t\t\t\t """ 1 => """ EN Baker \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:2 [ 0 => array:2 [ "doi" => "10.2174/1568005023342533" "Revista" => array:6 [ "tituloSerie" => "Curr Drug Targets Infect Disord" "fecha" => "2002" "volumen" => "2" "paginaInicial" => "143" "paginaFinal" => "160" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12462145" "web" => "Medline" ] ] ] ] 1 => array:2 [ "doi" => "10.2174/1568005023342533" "WWW" => array:1 [ "link" => "10.2174/1568005023342533" ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib12" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Global spread of multiple aminoglycoside resistance genes" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => """ K Yamane \n \t\t\t\t\t\t\t\t """ 1 => """ J Wachino \n \t\t\t\t\t\t\t\t """ 2 => """ Y Doi \n \t\t\t\t\t\t\t\t """ 3 => """ H Kurokawa \n \t\t\t\t\t\t\t\t """ 4 => """ Y Arakawa \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3201/eid1106.040924" "Revista" => array:6 [ "tituloSerie" => "Emerg Infect Dis" "fecha" => "2005" "volumen" => "11" "paginaInicial" => "951" "paginaFinal" => "953" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15963295" "web" => "Medline" ] ] ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib13" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The most frequently occurring aminoglycoside resistance mechanisms— combined results of surveys in eight regions of the world" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => """ GH Miller \n \t\t\t\t\t\t\t\t """ 1 => """ FJ Sabatelli \n \t\t\t\t\t\t\t\t """ 2 => """ L Naples \n \t\t\t\t\t\t\t\t """ 3 => """ RS Hare \n \t\t\t\t\t\t\t\t """ 4 => """ KJ Shaw \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "J Chemother" "fecha" => "1995" "volumen" => "7" "numero" => "Suppl. 2" "paginaInicial" => "17" "paginaFinal" => "30" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8622108" "web" => "Medline" ] ] ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib14" "etiqueta" => "14" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Aminoglycoside resistance in Pseudomonas aeruginosa" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => """ K Poole \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:2 [ 0 => array:2 [ "doi" => "10.1128/AAC.49.2.479-487.2005" "Revista" => array:6 [ "tituloSerie" => "Antimicrob Agents Chemother" "fecha" => "2005" "volumen" => "49" "paginaInicial" => "479" "paginaFinal" => "487" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15673721" "web" => "Medline" ] ] ] ] 1 => array:2 [ "doi" => "10.1128/AAC.49.2.479-487.2005" "WWW" => array:1 [ "link" => "10.1128/AAC.49.2.479-487.2005" ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib15" "etiqueta" => "15" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Clinical and Laboratory Standards Institute. Performance standards for antimicrobial susceptibility testing; seventeenth informational supplement. CLSI document M100-S17. CLSI, 2007 Wayne, PA" ] ] ] 15 => array:3 [ "identificador" => "bib16" "etiqueta" => "16" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Occurrence and mechanisms of amikacin resistance and its association with β-lactamases in Pseudomonas aeruginosa: a Korean nationwide study" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => """ JY Kim \n \t\t\t\t\t\t\t\t """ 1 => """ YJ Park \n \t\t\t\t\t\t\t\t """ 2 => """ HJ Kwon \n \t\t\t\t\t\t\t\t """ 3 => """ K Han \n \t\t\t\t\t\t\t\t """ 4 => """ MW Kang \n \t\t\t\t\t\t\t\t """ 5 => """ GJ Woo \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:2 [ 0 => array:2 [ "doi" => "10.1093/jac/dkn244" "Revista" => array:6 [ "tituloSerie" => "J Antimicrob Chemother" "fecha" => "2008" "volumen" => "62" "paginaInicial" => "479" "paginaFinal" => "483" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18606785" "web" => "Medline" ] ] ] ] 1 => array:2 [ "doi" => "10.1093/jac/dkn244" "WWW" => array:1 [ "link" => "10.1093/jac/dkn244" ] ] ] ] ] ] 16 => array:3 [ "identificador" => "bib17" "etiqueta" => "17" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Susceptibility of Pseudomonas aeruginosa to antimicrobials: a 2004 French multicentre hospital study" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => """ J Cavallo \n \t\t\t\t\t\t\t\t """ 1 => """ D Hocquet \n \t\t\t\t\t\t\t\t """ 2 => """ P Plesiat \n \t\t\t\t\t\t\t\t """ 3 => """ R Fabre \n \t\t\t\t\t\t\t\t """ 4 => """ M Roussel-Delvallez \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:2 [ 0 => array:2 [ "doi" => "10.1093/jac/dkm076" "Revista" => array:6 [ "tituloSerie" => "J Antimicrob Chemother" "fecha" => "2007" "volumen" => "59" "paginaInicial" => "1021" "paginaFinal" => "1024" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17412726" "web" => "Medline" ] ] ] ] 1 => array:2 [ "doi" => "10.1093/jac/dkm076" "WWW" => array:1 [ "link" => "10.1093/jac/dkm076" ] ] ] ] ] ] 17 => array:3 [ "identificador" => "bib18" "etiqueta" => "18" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Frequency of Pseudomonas aeruginosa serotypes in burn wound infections and their resistance to antibiotics" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => """ H Estahbanati \n \t\t\t\t\t\t\t\t """ 1 => """ P Kashani \n \t\t\t\t\t\t\t\t """ 2 => """ F Ghanaatpisheh \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:2 [ 0 => array:2 [ "doi" => "10.1016/s0305-4179(02)00024-4" "Revista" => array:6 [ "tituloSerie" => "Burns" "fecha" => "2002" "volumen" => "28" "paginaInicial" => "340" "paginaFinal" => "348" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12052372" "web" => "Medline" ] ] ] ] 1 => array:2 [ "doi" => "10.1016/s0305-4179(02)00024-4" "WWW" => array:1 [ "link" => "10.1016/S0305-4179(02)00024-4" ] ] ] ] ] ] 18 => array:3 [ "identificador" => "bib19" "etiqueta" => "19" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Aminoglycoside resistance mechanisms in Enterobacteriaceae and Pseudomonas spp. from two Danish hospitals: correlation with type of aminoglycoside used" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => """ C Busch-Sorensen \n \t\t\t\t\t\t\t\t """ 1 => """ M Sonmezoglu \n \t\t\t\t\t\t\t\t """ 2 => """ N Frimodt-Moller \n \t\t\t\t\t\t\t\t """ 3 => """ T Hojbjerg \n \t\t\t\t\t\t\t\t """ 4 => """ GH Miller \n \t\t\t\t\t\t\t\t """ 5 => """ F Espersen \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "APMIS" "fecha" => "1996" "volumen" => "104" "paginaInicial" => "763" "paginaFinal" => "768" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8980628" "web" => "Medline" ] ] ] ] ] ] ] ] 19 => array:3 [ "identificador" => "bib20" "etiqueta" => "20" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The changing nature of aminoglycoside resistance mechanisms and prevalence of newly recognized resistance mechanisms in Turkey" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => """ U Over \n \t\t\t\t\t\t\t\t """ 1 => """ D Gur \n \t\t\t\t\t\t\t\t """ 2 => """ S Unal \n \t\t\t\t\t\t\t\t """ 3 => """ GH Miller \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1046/j.1198-743x.2001.00284.x" "Revista" => array:6 [ "tituloSerie" => "Clin Microbiol Infect" "fecha" => "2001" "volumen" => "7" "paginaInicial" => "470" "paginaFinal" => "478" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11678929" "web" => "Medline" ] ] ] ] ] ] ] ] 20 => array:3 [ "identificador" => "bib21" "etiqueta" => "21" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Prevalence and mechanisms of aminoglycoside resistance" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => """ I Phillips \n \t\t\t\t\t\t\t\t """ 1 => """ A King \n \t\t\t\t\t\t\t\t """ 2 => """ K Shannon \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/0002-9343(86)90479-1" "Revista" => array:6 [ "tituloSerie" => "A ten-year study. Am J Med" "fecha" => "1986" "volumen" => "80" "paginaInicial" => "48" "paginaFinal" => "55" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3728534" "web" => "Medline" ] ] ] ] ] ] ] ] 21 => array:3 [ "identificador" => "bib22" "etiqueta" => "22" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The most frequent aminoglycoside resistance mechanisms changes with time and geographic area: a reflection of aminoglycoside usage patterns" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => """ GH Miller \n \t\t\t\t\t\t\t\t """ 1 => """ FJ Sabatelli \n \t\t\t\t\t\t\t\t """ 2 => """ RS Hare \n \t\t\t\t\t\t\t\t """ 3 => """ Y Glupczynski \n \t\t\t\t\t\t\t\t """ 4 => """ P Mackey \n \t\t\t\t\t\t\t\t """ 5 => """ D Shlaes \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:2 [ 0 => array:2 [ "doi" => "10.1093/clinids/24.supplement_1.s46" "Revista" => array:6 [ "tituloSerie" => "Clin Infect Dis" "fecha" => "1997" "volumen" => "24" "paginaInicial" => "S46" "paginaFinal" => "S62" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8994779" "web" => "Medline" ] ] ] ] 1 => array:2 [ "doi" => "10.1093/clinids/24.supplement_1.s46" "WWW" => array:1 [ "link" => "10.1093/clinids/24.Supplement_1.S46" ] ] ] ] ] ] 22 => array:3 [ "identificador" => "bib23" "etiqueta" => "23" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Aminoglycoside Resistance in Gram-negative Bacilli" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => """ YJ Park \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Korean J Clin Microbiol" "fecha" => "2009" "volumen" => "12" "paginaInicial" => "57" "paginaFinal" => "61" ] ] ] ] ] ] 23 => array:3 [ "identificador" => "bib24" "etiqueta" => "24" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Aminoglycoside modifying enzymes" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => """ MS Ramirez \n \t\t\t\t\t\t\t\t """ 1 => """ ME Tolmasky \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:2 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Drug Resist" "fecha" => "2010" "volumen" => "13" "paginaInicial" => "151" "paginaFinal" => "171" ] ] 1 => array:1 [ "WWW" => array:1 [ "link" => "10.1016/j.drup.2010.08.003" ] ] ] ] ] ] 24 => array:3 [ "identificador" => "bib25" "etiqueta" => "25" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Pseudomonas aeruginosa – a phenomenon of bacterial resistance" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => """ T Strateva \n \t\t\t\t\t\t\t\t """ 1 => """ D Yordanov \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:2 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J Medic Microbiol" "fecha" => "2009" "volumen" => "58" "paginaInicial" => "1133" "paginaFinal" => "1148" ] ] 1 => array:1 [ "WWW" => array:1 [ "link" => "10.1099/jmm.0.009142-0" ] ] ] ] ] ] 25 => array:3 [ "identificador" => "bib26" "etiqueta" => "26" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Design of novel antibiotics that bind to the ribosomal acyltransfer site" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => """ J Haddad \n \t\t\t\t\t\t\t\t """ 1 => """ LP Kotra \n \t\t\t\t\t\t\t\t """ 2 => """ B Llano-Sotelo \n \t\t\t\t\t\t\t\t """ 3 => """ C Kim \n \t\t\t\t\t\t\t\t """ 4 => """ EF Azucena \n \t\t\t\t\t\t\t\t """ 5 => """ M Liu \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:2 [ 0 => array:2 [ "doi" => "10.1021/ja011695m" "Revista" => array:6 [ "tituloSerie" => "J Am Chem Soc" "fecha" => "2002" "volumen" => "124" "paginaInicial" => "3229" "paginaFinal" => "3237" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11916405" "web" => "Medline" ] ] ] ] 1 => array:2 [ "doi" => "10.1021/ja011695m" "WWW" => array:1 [ "link" => "10.1021/ja011695m" ] ] ] ] ] ] 26 => array:3 [ "identificador" => "bib27" "etiqueta" => "27" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Prospects for the next anti-Pseudomonas drug" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => """ M Page \n \t\t\t\t\t\t\t\t """ 1 => """ J Heim \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:2 [ 0 => array:2 [ "doi" => "10.1016/j.coph.2009.08.006" "Revista" => array:6 [ "tituloSerie" => "Curr Opin Pharmacol" "fecha" => "2009" "volumen" => "9" "paginaInicial" => "558" "paginaFinal" => "565" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19748829" "web" => "Medline" ] ] ] ] 1 => array:2 [ "doi" => "10.1016/j.coph.2009.08.006" "WWW" => array:1 [ "link" => "10.1016/j.coph.2009.08.006" ] ] ] ] ] ] ] ] ] ] "agradecimientos" => array:1 [ 0 => array:4 [ "identificador" => "xack639490" "titulo" => "ACKNOWLEDGEMENTS" "texto" => "This study was funded by a M.Sc. grant from the Tarbiat Modares University, Tehran, Iran." "vista" => "all" ] ] ] "idiomaDefecto" => "en" "url" => "/18075932/0000006600000009/v1_202212011637/S1807593222019366/v1_202212011637/en/main.assets" "Apartado" => null "PDF" => "https://static.elsevier.es/multimedia/18075932/0000006600000009/v1_202212011637/S1807593222019366/v1_202212011637/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1807593222019366?idApp=UINPBA00004N"]

Statistics

CLINICAL SCIENCE

Farzam Vaziri, Shahin Najar Peerayeh

Corresponding author

najarp_s@modares.ac.ir

/ Tel.: 00 98 021 82883870

, Qorban Behzadian Nejad, Abbas Farhadian

Department of Bacteriology, School of Medical Sciences, Tarbiat Modares University, Tehran, Iran.

Read

850

Times
was read the article

378

Total PDF

472

Total HTML

Share statistics

 array:24 [
  "pii" => "S1807593222019366"
  "issn" => "18075932"
  "doi" => "10.1590/S1807-59322011000900002"
  "estado" => "S300"
  "fechaPublicacion" => "2011-09-01"
  "aid" => "1936"
  "copyright" => "CLINICS"
  "copyrightAnyo" => "2011"
  "documento" => "article"
  "crossmark" => 0
  "licencia" => "https://creativecommons.org/licenses/by-nc/3.0/"
  "subdocumento" => "fla"
  "cita" => "Clinics. 2011;66:1519-22"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:1 [
    "total" => 0
  ]
  "itemSiguiente" => array:19 [
    "pii" => "S1807593222019378"
    "issn" => "18075932"
    "doi" => "10.1590/S1807-59322011000900003"
    "estado" => "S300"
    "fechaPublicacion" => "2011-09-01"
    "aid" => "1937"
    "copyright" => "CLINICS"
    "documento" => "article"
    "crossmark" => 0
    "licencia" => "https://creativecommons.org/licenses/by-nc/3.0/"
    "subdocumento" => "fla"
    "cita" => "Clinics. 2011;66:1523-9"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:1 [
      "total" => 0
    ]
    "en" => array:12 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">CLINICAL SCIENCE</span>"
      "titulo" => "Impaired hemodynamic response to mental stress in subjects with prehypertension is improved after a single bout of maximal dynamic exercise"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => "en"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "1523"
          "paginaFinal" => "1529"
        ]
      ]
      "contieneResumen" => array:1 [
        "en" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig1"
          "etiqueta" => "Figure 1"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr1.jpeg"
              "Alto" => 382
              "Ancho" => 662
              "Tamanyo" => 38655
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spara10" class="elsevierStyleSimplePara elsevierViewall">Absolute hemodynamic responses to mental stress&#44; adjusted for gender&#44; before and after an exercise bout in subjects with prehypertension or normotension&#46; Values are the mean &#177; SEM&#46; &#8727;&#44; <span class="elsevierStyleItalic">p</span>&#60;0&#46;05 <span class="elsevierStyleItalic">vs&#46;</span> within-group baseline&#59; &#8224;&#44; <span class="elsevierStyleItalic">p</span>&#60;0&#46;05 <span class="elsevierStyleItalic">vs&#46;</span> same condition between groups&#59; &#8225;&#44; <span class="elsevierStyleItalic">p</span>&#60;0&#46;05 <span class="elsevierStyleItalic">vs&#46;</span> before-exercise within group&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Renata Frauches Medeiros, Bruno Moreira Silva, Fabricia Junqueira Neves, Natalia Galito Rocha, Allan Robson Kluser Sales, Antonio Claudio Nobrega"
          "autores" => array:6 [
            0 => array:2 [
              "nombre" => "Renata Frauches"
              "apellidos" => "Medeiros"
            ]
            1 => array:2 [
              "nombre" => "Bruno Moreira"
              "apellidos" => "Silva"
            ]
            2 => array:2 [
              "nombre" => "Fabricia Junqueira"
              "apellidos" => "Neves"
            ]
            3 => array:2 [
              "nombre" => "Natalia Galito"
              "apellidos" => "Rocha"
            ]
            4 => array:2 [
              "nombre" => "Allan Robson Kluser"
              "apellidos" => "Sales"
            ]
            5 => array:2 [
              "nombre" => "Antonio Claudio"
              "apellidos" => "Nobrega"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1807593222019378?idApp=UINPBA00004N"
    "url" => "/18075932/0000006600000009/v1_202212011637/S1807593222019378/v1_202212011637/en/main.assets"
  ]
  "itemAnterior" => array:19 [
    "pii" => "S1807593222019354"
    "issn" => "18075932"
    "doi" => "10.1590/S1807-59322011000900001"
    "estado" => "S300"
    "fechaPublicacion" => "2011-09-01"
    "aid" => "1935"
    "copyright" => "CLINICS"
    "documento" => "article"
    "crossmark" => 0
    "licencia" => "https://creativecommons.org/licenses/by-nc/3.0/"
    "subdocumento" => "fla"
    "cita" => "Clinics. 2011;66:1513-8"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:1 [
      "total" => 0
    ]
    "en" => array:11 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">CLINICAL SCIENCE</span>"
      "titulo" => "Adiposity and postural balance control&#58; Correlations between bioelectrical impedance and stabilometric signals in elderly Brazilian women"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => "en"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "1513"
          "paginaFinal" => "1518"
        ]
      ]
      "contieneResumen" => array:1 [
        "en" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "M&#237;riam Raquel Meira Mainenti, &#201;rika de Carvalho Rodrigues, Juliana Fl&#225;via de Oliveira, Arthur de S&#225; Ferreira, Cristina M&#225;rcia Dias, Andr&#233; Lu&#237;s dos Santos Silva"
          "autores" => array:6 [
            0 => array:2 [
              "nombre" => "M&#237;riam Raquel Meira"
              "apellidos" => "Mainenti"
            ]
            1 => array:2 [
              "nombre" => "&#201;rika"
              "apellidos" => "de Carvalho Rodrigues"
            ]
            2 => array:2 [
              "nombre" => "Juliana Fl&#225;via"
              "apellidos" => "de Oliveira"
            ]
            3 => array:2 [
              "nombre" => "Arthur"
              "apellidos" => "de S&#225; Ferreira"
            ]
            4 => array:2 [
              "nombre" => "Cristina M&#225;rcia"
              "apellidos" => "Dias"
            ]
            5 => array:2 [
              "nombre" => "Andr&#233; Lu&#237;s"
              "apellidos" => "dos Santos Silva"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1807593222019354?idApp=UINPBA00004N"
    "url" => "/18075932/0000006600000009/v1_202212011637/S1807593222019354/v1_202212011637/en/main.assets"
  ]
  "en" => array:19 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">CLINICAL SCIENCE</span>"
    "titulo" => "The prevalence of aminoglycoside-modifying enzyme genes <span class="elsevierStyleItalic">&#40;aac &#40;6&#8242;&#41;-I&#44; aac &#40;6&#8242;&#41;-II&#44; ant &#40;2&#8243;&#41;-I&#44; aph &#40;3&#8242;&#41;-VI&#41;</span> in <span class="elsevierStyleItalic">Pseudomonas aeruginosa</span>"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "1519"
        "paginaFinal" => "1522"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "Farzam Vaziri, Shahin Najar Peerayeh, Qorban Behzadian Nejad, Abbas Farhadian"
        "autores" => array:4 [
          0 => array:3 [
            "nombre" => "Farzam"
            "apellidos" => "Vaziri"
            "email" => array:1 [
              0 => "vaziri@modares.ac.ir"
            ]
          ]
          1 => array:4 [
            "nombre" => "Shahin Najar"
            "apellidos" => "Peerayeh"
            "email" => array:1 [
              0 => "najarp_s@modares.ac.ir"
            ]
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "&#42;"
                "identificador" => "cor1"
              ]
            ]
          ]
          2 => array:2 [
            "nombre" => "Qorban Behzadian"
            "apellidos" => "Nejad"
          ]
          3 => array:2 [
            "nombre" => "Abbas"
            "apellidos" => "Farhadian"
          ]
        ]
        "afiliaciones" => array:1 [
          0 => array:2 [
            "entidad" => "Department of Bacteriology&#44; School of Medical Sciences&#44; Tarbiat Modares University&#44; Tehran&#44; Iran&#46;"
            "identificador" => "aff1"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor1"
            "etiqueta" => "&#42;"
            "correspondencia" => "&#47; Tel&#46;&#58; 00 98 021 82883870"
          ]
        ]
      ]
    ]
    "resumenGrafico" => array:2 [
      "original" => 0
      "multimedia" => array:7 [
        "identificador" => "fig2"
        "etiqueta" => "Figure 2"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr2.jpeg"
            "Alto" => 483
            "Ancho" => 415
            "Tamanyo" => 11318
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spara20" class="elsevierStyleSimplePara elsevierViewall">Lane 1&#44; 1000 bp DNA size marker&#59; Lane 2&#44; <span class="elsevierStyleItalic">aac</span>&#40;6&#8242;&#41;-II &#40;125 bp&#41;&#59; Lane 5&#44; <span class="elsevierStyleItalic">aph</span>&#40;3&#8242;&#41;-VI &#40;800 bp&#41;&#59; Lane 7&#44; <span class="elsevierStyleItalic">ant</span>&#40;2<span class="elsevierStyleItalic">&#8243;</span>&#41;-I &#40;524 bp&#41;&#59; Lanes 8 and 9&#44; <span class="elsevierStyleItalic">aac</span>&#40;6&#8242;&#41;-I &#40;392 bp&#41;&#46;</p>"
        ]
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><span id="cesec10" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle70">INTRODUCTION</span><p id="para10" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Pseudomonas aeruginosa</span> &#40;<span class="elsevierStyleItalic">P&#46; aeruginosa</span>&#41; is one of the primary opportunistic pathogens responsible for nosocomial infections&#46; The most important problem in the eradication of <span class="elsevierStyleItalic">P&#46; aeruginosa</span> is the frequently observed multi-drug resistance of the species&#46;<a class="elsevierStyleCrossRef" href="#bib1">1</a> In addition&#44; <span class="elsevierStyleItalic">P&#46; aeruginosa</span> can also acquire resistance to various antimicrobial agents&#44; such as aminoglycosides&#44; &#946;-lactams<a class="elsevierStyleCrossRef" href="#bib2">2</a> and fluoroquinolones&#46;<a class="elsevierStyleCrossRef" href="#bib3">3</a> Aminoglycosides are an important component of antipseudomonal chemotherapy&#44;<a class="elsevierStyleCrossRef" href="#bib4">4</a> and they exhibit synergy with &#946;-lactams&#46;<a class="elsevierStyleCrossRef" href="#bib5">5</a> Resistance to aminoglycosides occurs via enzymatic modification&#44; impermeability&#44; the activity of efflux pumps &#40;MexXY-OprM&#41;&#44;<a class="elsevierStyleCrossRef" href="#bib6">6</a> the PhoP-PhoQ system&#44;<a class="elsevierStyleCrossRef" href="#bib7">7</a> ndvB-dependent biofilm formation&#44;<a class="elsevierStyleCrossRef" href="#bib8">8</a> and the activity of 16s rRNA methylases&#46;<a class="elsevierStyleCrossRef" href="#bib9">9</a> Among these mechanisms&#44; the inactivation of drugs by plasmid- or chromosome-encoded modifying enzymes is the most common&#46; These modifying enzymes include aminoglycoside phosphoryl transferase &#40;<span class="elsevierStyleItalic">aph</span>&#41;&#44; aminoglycoside acetyltransferase &#40;<span class="elsevierStyleItalic">aac</span>&#41;&#44; and aminoglycoside nucleotidyl transferase &#40;<span class="elsevierStyleItalic">ant</span>&#41;&#46;<a class="elsevierStyleCrossRefs" href="#bib10">10&#8211;12</a> Four of these enzymes&#44; encoded by <span class="elsevierStyleItalic">aac &#40;6&#8242;&#41;-I&#44; aac &#40;6&#8242;&#41;-II&#44; ant &#40;2&#8243;&#41;-I&#44;</span> and <span class="elsevierStyleItalic">aph &#40;3&#8242;&#41;-VI</span>&#44; are of particular significance because they are among the most common modifying enzymes present in <span class="elsevierStyleItalic">P&#46; aeruginosa&#44;</span> and their substrates are the most important antipseudomonal aminoglycosides&#46; <span class="elsevierStyleItalic">aac</span> &#40;6&#8242;&#41;-I confers resistance to tobramycin and amikacin&#44; <span class="elsevierStyleItalic">aac</span> &#40;6&#8242;&#41;-II and <span class="elsevierStyleItalic">ant</span> &#40;2<span class="elsevierStyleItalic">&#8243;</span>&#41;-I inactivate tobramycin and gentamicin&#44; and amikacin is the substrate of <span class="elsevierStyleItalic">aph</span> &#40;3&#8242;&#41;-VI&#46;<a class="elsevierStyleCrossRefs" href="#bib13">13&#44;14</a></p><p id="para20" class="elsevierStylePara elsevierViewall">The aim of the present nationwide study was to investigate the occurrence of aminoglycoside resistance and the prevalence of the resistance-modifying enzyme genes&#44; <span class="elsevierStyleItalic">aac &#40;6&#8242;&#41;-I&#44; aac &#40;6&#8242;&#41;-II&#44; ant &#40;2&#8243;&#41;-I</span> and <span class="elsevierStyleItalic">aph &#40;3&#8242;&#41;-VI&#44;</span> in <span class="elsevierStyleItalic">P&#46; aeruginosa</span> isolated from several hospitals in seven Iranian cities&#46;</p></span><span id="cesec20" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle80">METHODS AND MATERIALS</span><span id="cesec30" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle90">Collection of bacterial isolates</span><p id="para30" class="elsevierStylePara elsevierViewall">A total of 250 non-duplicate&#44; clinical isolates of <span class="elsevierStyleItalic">P&#46; aeruginosa</span> were collected from a nationwide distribution of several hospitals in seven cities in Iran &#40;Tehran&#44; Shiraz&#44; Zahedan&#44; Tabriz&#44; Sannandaj&#44; Sari&#44; and Ahvaz&#41; between May 2007 and January 2008&#46; Strain data and the demographic and clinical data for each patient were regularly forwarded to our laboratory&#46; The study population was 62&#37; male and 38&#37; female&#46; The specimens were isolated from urine &#40;38&#37;&#41;&#44; wounds &#40;18&#37;&#41;&#44; the trachea &#40;18&#37;&#41;&#44; blood &#40;10&#37;&#41;&#44; sputum &#40;9&#37;&#41;&#44; and other sources &#40;7&#37;&#41;&#46; Isolate confirmations were conducted using conventional biochemical tests&#44; and then the isolates were stored at &#8211;76&#176;C in glycerol skim milk broth&#46;</p></span><span id="cesec40" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle100">Antimicrobial susceptibility testing</span><p id="para40" class="elsevierStylePara elsevierViewall">Antimicrobial susceptibility tests were performed using the disk diffusion method according to Clinical and Laboratory Standards Institute &#40;CLSI&#41; guidelines<a class="elsevierStyleCrossRef" href="#bib15">15</a> for three aminoglycosides &#91;gentamicin &#40;10 &#956;g&#41;&#44; amikacin &#40;30 &#956;g&#41;&#44; and tobramycin &#40;10 &#956;g&#41;&#93; and for five other antibiotics &#91;imipenem &#40;10 &#956;g&#41;&#44; piperacillin &#40;100 &#956;g&#41;&#44; ticarcillin &#40;75 &#956;g&#41;&#44; ceftazidime &#40;30 &#956;g&#41;&#44; and ciprofloxacin &#40;5 &#956;g&#41;&#93;&#46; All drugs were obtained from Mast laboratories &#40;Merseyside&#44; United Kingdom&#41;&#46; For all 250 isolates&#44; the minimum inhibitory concentrations &#40;MIC&#41; of amikacin&#44; gentamicin&#44; and tobramycin were determined using the E-test &#40;Biodisk&#44; Dalvagen&#44; Sweden&#41; according to CLSI guidelines&#46; <span class="elsevierStyleItalic">P&#46; aeruginosa</span> &#40;ATCC 27853&#41; served as a control for the disk diffusion and E-tests&#46;</p></span><span id="cesec50" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle110">Polymerase chain reaction amplification</span><p id="para50" class="elsevierStylePara elsevierViewall">Polymerase chain reaction &#40;PCR&#41; was used to screen all 250 isolates for the presence of the modifying enzyme genes&#44; <span class="elsevierStyleItalic">aac &#40;6&#8242;&#41;-I&#44; aac &#40;6&#8242;&#41;-II&#44; ant &#40;2&#8243;&#41;-I</span> and <span class="elsevierStyleItalic">aph &#40;3&#8242;&#41;-VI</span>&#46; The total template DNA for the PCR amplification was extracted from the supernatant of a mixture of <span class="elsevierStyleItalic">P&#46; aeruginosa</span> cells produced by the boiling method&#46; PCR amplification was performed using 2&#46;5 &#956;L of the template DNA&#44; 1 &#956;L of each primer&#44;<a class="elsevierStyleCrossRef" href="#bib16">16</a> 19&#46;5 &#956;L master mix&#44; and 1 &#956;L of Taq DNA polymerase &#40;CinnaGen&#41; in a total volume of 25 &#956;L&#46; A thermocycler &#40;Mastercycler gradient&#59; Eppendorf&#44; Hamburg&#44; Germany&#41; was programmed with the appropriate conditions&#46; Then&#44; 5 &#956;l of each PCR product was analyzed by electrophoresis on a 1&#37; &#40;w&#47;v&#41; TAE agarose gel &#40;Fermentas UAB&#44; Vilnius&#44; Lithuania&#41; containing 0&#46;1 &#956;l&#47;ml ethidium bromide&#46; The amplicons were then visualized on a UV transilluminator and photographed &#40;BioDoc-Analyse&#59; Biometra&#44; Goettingen&#44; Germany&#41;&#46;</p></span><span id="cesec60" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle120">Statistical analysis</span><p id="para60" class="elsevierStylePara elsevierViewall">All statistical analyses were performed using Statistical Package for Social Sciences &#40;SPSS&#41; software &#40;version 11&#46;5&#41; for Windows &#40;&#967;<span class="elsevierStyleSup">2</span>-test and Fisher&#39;s exact test&#41;&#46; <span class="elsevierStyleItalic">P-</span>values of &#60;0&#46;05 were considered significant&#46;</p></span></span><span id="cesec70" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle130">RESULTS AND DISCUSSION</span><p id="para70" class="elsevierStylePara elsevierViewall">The resistance rates as determined using the disk diffusion method are presented in <a class="elsevierStyleCrossRef" href="#fig1">Figure 1</a>&#46; According to the disk diffusion method&#44; 135 isolates were resistant to aminoglycosides&#46; The resistance rates according to the E-test &#40;base on MICs&#41; were as follows&#58; gentamicin 40&#37;&#44; tobramycin 36&#37;&#44; and amikacin 21&#37;&#46; The aminoglycoside susceptibility profiles according to the disk diffusion and E-test results for the 250 isolates are listed in <a class="elsevierStyleCrossRef" href="#tbl1">Table 1</a>&#46;</p><elsevierMultimedia ident="fig1"></elsevierMultimedia><elsevierMultimedia ident="tbl1"></elsevierMultimedia><p id="para80" class="elsevierStylePara elsevierViewall">PCR analysis revealed the absence of resistance genes in susceptible isolates&#46; The prevalence of aminoglycoside resistance genes in the 135 resistant isolates &#40;as determined by the disk diffusion method&#41; was as follows&#58; <span class="elsevierStyleItalic">aac &#40;6&#8242;&#41;-II</span> was detected in 36&#37; of the resistant isolates&#44; <span class="elsevierStyleItalic">ant &#40;2&#8243;&#41;-I</span> was detected in 28&#37;&#44; <span class="elsevierStyleItalic">aph &#40;3&#8242;&#41;-VI</span> in 11&#37;&#44; and <span class="elsevierStyleItalic">aac &#40;6&#8242;&#41;-I</span> was found in 7&#37; of the resistant isolates &#40;<a class="elsevierStyleCrossRef" href="#fig2">Figure 2</a>&#41;&#46; Interestingly&#44; individual aminoglycoside-resistant isolates carried multiple &#40;two to four&#41; modifying enzyme genes&#46; Six isolates harbored <span class="elsevierStyleItalic">ant&#40;2&#8243;&#41;-I</span> and <span class="elsevierStyleItalic">aac</span>&#40;6&#8242;&#41;-II&#59; three harbored <span class="elsevierStyleItalic">aph&#40;3&#8242;&#41;-VI</span> and <span class="elsevierStyleItalic">ant&#40;2&#8243;&#41;-I</span>&#59; two harbored <span class="elsevierStyleItalic">ant&#40;2&#8243;&#41;-I</span> and <span class="elsevierStyleItalic">aac&#40;6&#8242;&#41;-I&#59;</span> and three isolates harbored <span class="elsevierStyleItalic">ant&#40;2&#8243;&#41;-I</span>&#44; <span class="elsevierStyleItalic">aac&#40;6&#8242;&#41;-II</span> and <span class="elsevierStyleItalic">aph&#40;3&#8242;&#41;-VI&#46;</span> Only one isolate harbored all four genes&#46;</p><elsevierMultimedia ident="fig2"></elsevierMultimedia><p id="para90" class="elsevierStylePara elsevierViewall">Several previous studies have examined the occurrence of aminoglycoside resistance mechanisms in <span class="elsevierStyleItalic">P&#46; aeruginosa</span> isolated from different countries&#46; The overall incidence of aminoglycoside resistance found in our study &#40;according to the disk diffusion test and the E-test&#41; was much higher than the incidence that has been reported previously in different countries worldwide&#46;<a class="elsevierStyleCrossRefs" href="#bib14">14&#44;16&#44;17</a> However&#44; Estahbanati and co-workers reported that 53&#46;3&#37; of clinical isolates from Iranian burn patients were resistant to amikacin&#44; and 90&#46;7&#37; were resistant to gentamicin&#44; a result that reveals a high level of aminoglycoside resistance in their study&#46;<a class="elsevierStyleCrossRef" href="#bib18">18</a></p><p id="para100" class="elsevierStylePara elsevierViewall">The aminoglycoside resistance rate was almost as high in our isolates&#44; and most of the resistant isolates harbored modifying enzyme genes&#46; In addition&#44; none of the susceptible isolates harbored these resistance genes&#46; These results highlight the importance of aminoglycoside-modification-related mechanisms in aminoglycoside resistance in <span class="elsevierStyleItalic">P&#46; aeruginosa</span>&#46; Two genes&#44; <span class="elsevierStyleItalic">aac &#40;6&#8242;&#41;-II</span> and <span class="elsevierStyleItalic">ant &#40;2&#8243;&#41;-I&#44;</span> were the most frequent resistance genes observed in these isolates&#46; These results are similar to what has been observed in different studies in other countries&#46;<a class="elsevierStyleCrossRefs" href="#bib19">19&#8211;21</a> All isolates harboring the <span class="elsevierStyleItalic">aac &#40;6&#8242;&#41;-II</span> gene were resistant to gentamicin and tobramycin &#40;100&#37; concordance&#41;&#44; which indicates that <span class="elsevierStyleItalic">aac</span> &#40;6&#8242;&#41;-II is a significant determinant of gentamicin and tobramycin resistance in <span class="elsevierStyleItalic">P&#46; aeruginosa</span>&#46; It is important to mention that we encountered an unexpected phenotype in some isolates &#40;<a class="elsevierStyleCrossRef" href="#tbl2">Table 2</a>&#41;&#46; For example&#44; when an isolate harbored only the <span class="elsevierStyleItalic">aph &#40;3&#8242;&#41;-VI</span> gene&#44; which has amikacin as a substrate&#44; resistance to gentamicin&#44; tobramycin&#44; and amikacin was observed&#46; We presume that the reason for this phenomenon might be the action of other resistance mechanisms&#44; such as impermeability&#44; efflux pumps&#44; or other types of modifying enzymes&#46; On the other hand&#44; we detected 15 isolates which co-harbored two&#44; three&#44; or four aminoglycoside-modifying enzyme genes simultaneously&#44; which is in contrast to several studies conducted in the USA and Europe&#44; which reported that the majority of isolates exhibit only a single aminoglycoside modifying gene&#46;<a class="elsevierStyleCrossRef" href="#bib22">22</a></p><elsevierMultimedia ident="tbl2"></elsevierMultimedia><p id="para110" class="elsevierStylePara elsevierViewall">Miller et al&#46; brought together the results of several studies of aminoglycoside resistance in <span class="elsevierStyleItalic">P&#46; aeruginosa</span> carried out worldwide&#46;<a class="elsevierStyleCrossRef" href="#bib22">22</a> Their results indicated that in Europe&#44; <span class="elsevierStyleItalic">aac&#40;6&#8242;&#41;-II</span> was the most prevalent resistance gene &#40;32&#46;5&#37;&#41;&#44; followed by <span class="elsevierStyleItalic">ant&#40;2&#8243;&#41;-I</span> &#40;16&#46;9&#37;&#41;&#46; These results are in concordance with our study&#46; In contrast to our results&#44; a Korean nationwide study of 250 isolates of <span class="elsevierStyleItalic">P&#46; aeruginosa</span> reported that <span class="elsevierStyleItalic">aph&#40;3&#8242;&#41;-VI</span>&#44; <span class="elsevierStyleItalic">ant&#40;2&#8243;&#41;-I</span>&#44; and <span class="elsevierStyleItalic">aac&#40;6&#8242;&#41;-I</span> were all prevalent&#44; but none harbored <span class="elsevierStyleItalic">aac&#40;6&#8242;&#41;-II</span>&#46;<a class="elsevierStyleCrossRef" href="#bib16">16</a> The difference in the distribution of modifying enzymes may derive from differences in aminoglycoside prescription patterns&#44; the selection of bacterial population or geographical differences in the occurrence of aminoglycoside resistance genes&#46;</p></span><span id="cesec80" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle140">CONCLUSIONS</span><p id="para120" class="elsevierStylePara elsevierViewall">In conclusion&#44; although aminoglycosides remain useful antipseudomonal agents&#44; resistance to these drugs continues to be a major issue&#44; especially in Iran&#46; Because these aminoglycoside resistance genes are usually located on mobile genetic elements &#40;i&#46;e&#46;&#44; plasmid&#44; transposon&#44; or integrons&#41;&#44;<a class="elsevierStyleCrossRefs" href="#bib23">23&#44;24</a> there is a growing concern that they could easily spread and be disseminated among other bacteria&#46; Integrons that carry gene cassettes encoding both <span class="elsevierStyleItalic">aac</span>s and carbapenemases will only exacerbate this problem&#46;<a class="elsevierStyleCrossRef" href="#bib25">25</a> The design of novel aminoglycosides with stronger affinity for their targets and resistance to these modifying enzymes is inevitable&#44;<a class="elsevierStyleCrossRef" href="#bib26">26</a> and the new generation of anti-<span class="elsevierStyleItalic">Pseudomonas</span> therapy is forthcoming&#46;<a class="elsevierStyleCrossRef" href="#bib27">27</a> Aminoglycoside resistance among clinical isolates of <span class="elsevierStyleItalic">P&#46; aeruginosa</span> promises to become a major clinical concern in the future&#44; and continuous local surveillance of aminoglycoside resistance is crucial&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:7 [
        0 => array:2 [
          "identificador" => "xpalclavsec1582733"
          "titulo" => "KEYWORDS"
        ]
        1 => array:2 [
          "identificador" => "cesec10"
          "titulo" => "INTRODUCTION"
        ]
        2 => array:3 [
          "identificador" => "cesec20"
          "titulo" => "METHODS AND MATERIALS"
          "secciones" => array:4 [
            0 => array:2 [
              "identificador" => "cesec30"
              "titulo" => "Collection of bacterial isolates"
            ]
            1 => array:2 [
              "identificador" => "cesec40"
              "titulo" => "Antimicrobial susceptibility testing"
            ]
            2 => array:2 [
              "identificador" => "cesec50"
              "titulo" => "Polymerase chain reaction amplification"
            ]
            3 => array:2 [
              "identificador" => "cesec60"
              "titulo" => "Statistical analysis"
            ]
          ]
        ]
        3 => array:2 [
          "identificador" => "cesec70"
          "titulo" => "RESULTS AND DISCUSSION"
        ]
        4 => array:2 [
          "identificador" => "cesec80"
          "titulo" => "CONCLUSIONS"
        ]
        5 => array:2 [
          "identificador" => "xack639490"
          "titulo" => "ACKNOWLEDGEMENTS"
        ]
        6 => array:1 [
          "titulo" => "REFERENCES"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2011-02-01"
    "fechaAceptado" => "2011-05-16"
    "PalabrasClave" => array:1 [
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "KEYWORDS"
          "identificador" => "xpalclavsec1582733"
          "palabras" => array:5 [
            0 => "<span class="elsevierStyleItalic">Pseudomonas aeruginosa</span>"
            1 => "Antibiotic"
            2 => "Resistance"
            3 => "<span class="elsevierStyleItalic">aac &#40;6&#8242;&#41;-II</span>"
            4 => "<span class="elsevierStyleItalic">ant &#40;2&#8243;&#41;-I</span>"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:1 [
      "en" => array:2 [
        "resumen" => "<span id="ceabs10" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle10">INTRODUCTION&#58;</span><p id="spara50" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">Pseudomonas aeruginosa</span> &#40;<span class="elsevierStyleItalic">P&#46; aeruginosa</span>&#41; is one of the primary opportunistic pathogens responsible for nosocomial infections&#46; Aminoglycosides are an important component of antipseudomonal chemotherapy&#46; The inactivation of drugs by modifying enzymes is the most common mechanism of aminoglycoside resistance&#46;</p></span> <span id="ceabs20" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle20">OBJECTIVES&#58;</span><p id="spara60" class="elsevierStyleSimplePara elsevierViewall">The inactivation of aminoglycosides by modifying enzymes is the primary resistance mechanism employed by <span class="elsevierStyleItalic">P&#46; aeruginosa</span>&#46; The aim of the present study was to investigate the occurrence of aminoglycoside resistance and the prevalence of four important modifying enzyme genes &#40;<span class="elsevierStyleItalic">aac &#40;6&#8242;&#41;-I&#44; aac &#40;6&#8242;&#41;-II&#44; ant &#40;2&#8243;&#41;-I&#44; aph &#40;3&#8242;&#41;-VI</span>&#41; in <span class="elsevierStyleItalic">P&#46; aeruginosa</span> in Iran&#46;</p></span> <span id="ceabs30" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle30">METHODS&#58;</span><p id="spara70" class="elsevierStyleSimplePara elsevierViewall">A total of 250 clinical isolates of <span class="elsevierStyleItalic">P&#46; aeruginosa</span> were collected from several hospitals in seven cities in Iran&#46; Antimicrobial susceptibility tests &#40;using the disk diffusion method and E-tests&#41; were performed for all 250 isolates&#46; In addition&#44; all isolates were screened for the presence of modifying enzyme genes by polymerase chain reaction&#46;</p></span> <span id="ceabs40" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle40">RESULTS&#58;</span><p id="spara80" class="elsevierStyleSimplePara elsevierViewall">The resistance rates&#44; as determined by the disk diffusion method&#44; were as follows&#58; gentamicin 43&#37;&#44; tobramycin 38&#37;&#44; and amikacin 24&#37;&#46; Of the genes examined&#44; <span class="elsevierStyleItalic">aac &#40;6&#8242;&#41;-II</span> &#40;36&#37;&#41; was the most frequently identified gene in phenotypic resistant isolates&#44; followed by <span class="elsevierStyleItalic">ant &#40;2&#8243;&#41;-I&#44; aph &#40;3&#8242;&#41;-VI&#44;</span> and <span class="elsevierStyleItalic">aac &#40;6&#8242;&#41;-I</span>&#46;</p></span> <span id="ceabs50" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle50">CONCLUSIONS&#58;</span><p id="spara90" class="elsevierStyleSimplePara elsevierViewall">Aminoglycoside resistance in <span class="elsevierStyleItalic">P&#46; aeruginosa</span> remains a significant problem in Iran&#46; Therefore&#44; there is considerable local surveillance of aminoglycoside resistance&#46;</p></span>"
        "secciones" => array:5 [
          0 => array:2 [
            "identificador" => "ceabs10"
            "titulo" => "INTRODUCTION&#58;"
          ]
          1 => array:2 [
            "identificador" => "ceabs20"
            "titulo" => "OBJECTIVES&#58;"
          ]
          2 => array:2 [
            "identificador" => "ceabs30"
            "titulo" => "METHODS&#58;"
          ]
          3 => array:2 [
            "identificador" => "ceabs40"
            "titulo" => "RESULTS&#58;"
          ]
          4 => array:2 [
            "identificador" => "ceabs50"
            "titulo" => "CONCLUSIONS&#58;"
          ]
        ]
      ]
    ]
    "multimedia" => array:4 [
      0 => array:7 [
        "identificador" => "fig1"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 235
            "Ancho" => 558
            "Tamanyo" => 13358
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spara10" class="elsevierStyleSimplePara elsevierViewall">The antimicrobial resistance rate of 250 <span class="elsevierStyleItalic">P&#46; aeruginosa</span> isolates as determined by the disk diffusion method AMI&#58; amikacin&#44; GEN&#58; gentamicin&#44; TOB&#58; tobramycin&#44; IMI&#58; imipenem&#44; PIP&#58; piperacillin&#44; TIC&#58; ticarcillin&#44; CAZ&#58; ceftazidime&#44; CIP&#58; ciprofloxacin&#46;</p>"
        ]
      ]
      1 => array:7 [
        "identificador" => "fig2"
        "etiqueta" => "Figure 2"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr2.jpeg"
            "Alto" => 483
            "Ancho" => 415
            "Tamanyo" => 11318
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spara20" class="elsevierStyleSimplePara elsevierViewall">Lane 1&#44; 1000 bp DNA size marker&#59; Lane 2&#44; <span class="elsevierStyleItalic">aac</span>&#40;6&#8242;&#41;-II &#40;125 bp&#41;&#59; Lane 5&#44; <span class="elsevierStyleItalic">aph</span>&#40;3&#8242;&#41;-VI &#40;800 bp&#41;&#59; Lane 7&#44; <span class="elsevierStyleItalic">ant</span>&#40;2<span class="elsevierStyleItalic">&#8243;</span>&#41;-I &#40;524 bp&#41;&#59; Lanes 8 and 9&#44; <span class="elsevierStyleItalic">aac</span>&#40;6&#8242;&#41;-I &#40;392 bp&#41;&#46;</p>"
        ]
      ]
      2 => array:7 [
        "identificador" => "tbl1"
        "etiqueta" => "Table 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "tabla" => array:2 [
          "tablatextoimagen" => array:2 [
            0 => array:1 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="3" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Disk Diffusion<a class="elsevierStyleCrossRef" href="#tfn1">1</a></th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="6" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">E-test<a class="elsevierStyleCrossRef" href="#tfn2">2</a></th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="top" scope="col">MIC 50&#37; &#40;ug&#47;mL&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="top" scope="col">MIC 90&#37; &#40;ug&#47;mL&#41;&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="3" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Resistant</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Intermediate&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Susceptible</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="3" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">No&#46; &#40;&#37;&#41; of isolates</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="3" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">MIC&#40;&#956;g&#47;ml&#41;</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">MIC&#40;&#956;g&#47;ml&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">MIC&#40;&#956;g&#47;ml&#41;</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="top" scope="col">Resistant&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="top" scope="col">Intermediate&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="top" scope="col">Susceptible&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="top" scope="col">&#8211;1024128&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="top" scope="col">64&#8211;128&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="top" scope="col">16&#8211;64&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="top" scope="col">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="top" scope="col">2&#8211;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="top" scope="col">&#60;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="top">Gentamicin&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">108&#40;43&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">8&#40;3&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">134&#40;53&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">41&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">49&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">98&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">44&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">64&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="top">Tobramycin&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">95&#40;38&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">7&#40;2&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">148&#40;59&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">45&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">37&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">103&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">52&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">64&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
            ]
            1 => array:1 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="3" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">MIC&#40;&#956;g&#47;ml&#41;</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">MIC&#40;&#956;g&#47;ml&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">MIC&#40;&#956;g&#47;ml&#41;</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="top" scope="col">MIC 50&#37; &#40;ug&#47;mL&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="top" scope="col">MIC 90&#37; &#40;ug&#47;mL&#41;&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="top" scope="col">&#62;256&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="top" scope="col">&#8211;256128&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="top" scope="col">64&#8211;128&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="top" scope="col">32&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="top" scope="col">4&#8211;16&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="top" scope="col">&#60;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="top" style="border-bottom: 2px solid black">Amikacin&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top" style="border-bottom: 2px solid black">59&#40;23&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top" style="border-bottom: 2px solid black">7&#40;2&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top" style="border-bottom: 2px solid black">184&#40;73&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top" style="border-bottom: 2px solid black">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top" style="border-bottom: 2px solid black">17&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top" style="border-bottom: 2px solid black">32&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top" style="border-bottom: 2px solid black">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top" style="border-bottom: 2px solid black">134&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top" style="border-bottom: 2px solid black">57&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top" style="border-bottom: 2px solid black">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top" style="border-bottom: 2px solid black">128&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
            ]
          ]
          "notaPie" => array:2 [
            0 => array:3 [
              "identificador" => "tfn1"
              "etiqueta" => "1&#46;"
              "nota" => "<p class="elsevierStyleNotepara" id="cenpara10">Zone diameter &#40;mm&#41; for gentamicin and tobramycin&#44; R&#58;&#60;12&#44; I&#58;13-14&#44; S&#58;&#62;15&#59; for amikacin&#44; R&#58;&#60;14&#44; I&#58;15-16&#44; S&#58;&#62;17&#46;</p>"
            ]
            1 => array:3 [
              "identificador" => "tfn2"
              "etiqueta" => "2&#46;"
              "nota" => "<p class="elsevierStyleNotepara" id="cenpara20">MIC breakpoint&#40;&#956;g&#47;ml&#41; for gentamicin and tobramycin&#44; R&#58;&#62;16&#44; I&#58;8&#59; S&#58;&#60;4&#59; for amikacin&#44; R&#58;&#62;64&#44; I&#58;32&#44; S&#58;&#60;16&#46;</p>"
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spara30" class="elsevierStyleSimplePara elsevierViewall">Aminoglycoside susceptibility profiles according to the disk diffusion method and MIC results &#40;E-test&#41; for 250 <span class="elsevierStyleItalic">P&#46; aeruginosa</span> isolates &#40;according to CLSI guidelines&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib15">15</a></p>"
        ]
      ]
      3 => array:7 [
        "identificador" => "tbl2"
        "etiqueta" => "Table 2"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "tabla" => array:2 [
          "tablatextoimagen" => array:1 [
            0 => array:1 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="top" scope="col">Gene&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="top" scope="col">no&#46; of isolates &#40;&#37;&#41;<a class="elsevierStyleCrossRef" href="#tfn3">1</a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="top" scope="col">Expected resistance<a class="elsevierStyleCrossRef" href="#tfn4">2</a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="top" scope="col">Observed resistance phenotypes &#40;no&#46; of isolates&#41;<a class="elsevierStyleCrossRef" href="#tfn5">3</a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="top"><span class="elsevierStyleItalic">aac&#40;6&#8242;&#41;-I</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">9&#40;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">TOB&#44;AMI&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">Unexpected resistance to GEN&#40;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="top"><span class="elsevierStyleItalic">aac&#40;6&#8242;&#41;-II</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">49&#40;36&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">GEN&#44;TOB&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">Unexpected resistance to AMI&#40;16&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="top"><span class="elsevierStyleItalic">ant&#40;2&#8243;&#41;-I</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">38&#40;28&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">GEN&#44;TOB&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">As expected&#40;38&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="top"><span class="elsevierStyleItalic">aph&#40;3&#8242;&#41;-VI</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">15&#40;11&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">AMI&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">Unexpected resistance to GEN and TOB&#40;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="top"><span class="elsevierStyleItalic">aac&#40;6&#8242;&#41;-II&#43; ant&#40;2&#8243;&#41;-I</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">6&#40;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">GEN&#44;TOB&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">As expected&#40;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="top"><span class="elsevierStyleItalic">ant&#40;2&#8243;&#41;-I&#43; aph&#40;3&#8242;&#41;-VI</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">3&#40;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">AMI&#44;GEN&#44;TOB&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">As expected&#40;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="top"><span class="elsevierStyleItalic">aac&#40;6&#8242;&#41;-I&#43; ant&#40;2&#8243;&#41;-I</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">2&#40;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">AMI&#44;GEN&#44;TOB&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">As expected&#40;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="top"><span class="elsevierStyleItalic">ant&#40;2&#8243;&#41;-I</span> &#43; <span class="elsevierStyleItalic">aac&#40;6&#8242;&#41;-II</span> &#43;<span class="elsevierStyleItalic">aph&#40;3&#8242;&#41;-VI</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">3&#40;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">AMI&#44;GEN&#44;TOB&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">As expected&#40;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="top" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">aac</span>&#40;6&#8242;&#41;-II <span class="elsevierStyleItalic">ant</span>&#40;2&#8243;&#41;-I&#43; &#43; <span class="elsevierStyleItalic">aph</span>&#40;3&#8242;&#41;-VI &#43; <span class="elsevierStyleItalic">aac</span>&#40;6&#8242;&#41;-I&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top" style="border-bottom: 2px solid black">1&#40;&#8764;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top" style="border-bottom: 2px solid black">AMI&#44;GEN&#44;TOB&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top" style="border-bottom: 2px solid black">As expected&#40;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
            ]
          ]
          "notaPie" => array:3 [
            0 => array:3 [
              "identificador" => "tfn3"
              "etiqueta" => "1&#46;"
              "nota" => "<p class="elsevierStyleNotepara" id="cenpara30">According to the disk diffusion method&#44; a total of 135 resistant isolates were identified&#46;</p>"
            ]
            1 => array:3 [
              "identificador" => "tfn4"
              "etiqueta" => "2&#46;"
              "nota" => "<p class="elsevierStyleNotepara" id="cenpara40">AMI&#58; amikacin&#44; GEN&#58; gentamicin&#44; TOB&#58; tobramycin&#46;</p>"
            ]
            2 => array:3 [
              "identificador" => "tfn5"
              "etiqueta" => "3&#46;"
              "nota" => "<p class="elsevierStyleNotepara" id="cenpara50">Described in greater detail in the text&#46;</p>"
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spara40" class="elsevierStyleSimplePara elsevierViewall">Prevalence of aminoglycoside modifying enzymes genes and the correlation between these genes and phenotypic patterns in aminoglycoside resistant <span class="elsevierStyleItalic">P&#46; aeruginosa</span> isolates&#46;</p>"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "REFERENCES"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "cebibsec10"
          "bibliografiaReferencia" => array:27 [
            0 => array:3 [
              "identificador" => "bib1"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Mechanisms of antibiotic resistance in Pseudomonas aeruginosa"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => """
                              PA Lambert \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:7 [
                        "tituloSerie" => "J R Soc Med"
                        "fecha" => "2002"
                        "volumen" => "95"
                        "numero" => "suppl 41"
                        "paginaInicial" => "22"
                        "paginaFinal" => "26"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12216271"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib2"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Prevalence of Ambler class A and D &#946;-lactamases among clinical isolates of Pseudomonas aeruginosa in Korea"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => """
                              YJ Park \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:2 [
                    0 => array:2 [
                      "doi" => "10.1093/jac/dki160"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Antimicrob Chemother"
                        "fecha" => "2005"
                        "volumen" => "56"
                        "paginaInicial" => "122"
                        "paginaFinal" => "127"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15890715"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                    1 => array:2 [
                      "doi" => "10.1093/jac/dki160"
                      "WWW" => array:1 [
                        "link" => "10&#46;1093&#47;jac&#47;dki160"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib3"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:1 [
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => """
                              S Jalal \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              O Ciofu \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              N H&#8856;iby \n
                              \t\t\t\t\t\t\t\t
                              """
                            3 => """
                              N Gotoh \n
                              \t\t\t\t\t\t\t\t
                              """
                            4 => """
                              patients Wretlind B&#46; Molecular mechanisms of fluoroquinolone resistance in Pseudomonas aeruginosa isolates from cystic fibrosis \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1128/AAC.44.3.710-712.2000"
                      "Revista" => array:6 [
                        "tituloSerie" => "Antimicrob Agents Chemother"
                        "fecha" => "2000"
                        "volumen" => "44"
                        "paginaInicial" => "710"
                        "paginaFinal" => "712"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10681343"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib4"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Therapeutic guidelines for Pseudomonas aeruginosa infections"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => """
                              H Giamarellou \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:2 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Int J antimicrob Agen"
                        "fecha" => "2000"
                        "volumen" => "16"
                        "paginaInicial" => "103"
                        "paginaFinal" => "106"
                      ]
                    ]
                    1 => array:1 [
                      "WWW" => array:1 [
                        "link" => "10&#46;1016&#47;S0924-8579&#40;00&#41;00212-0"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib5"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "&#946;-lactam and aminoglycoside resistance rates and mechanisms among Pseudomonas aeruginosa in French general practice &#40;community and private healthcare centres&#41;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => """
                              V Dubois \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              C Arpin \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              V Dupart \n
                              \t\t\t\t\t\t\t\t
                              """
                            3 => """
                              A Scavelli \n
                              \t\t\t\t\t\t\t\t
                              """
                            4 => """
                              L Coulange \n
                              \t\t\t\t\t\t\t\t
                              """
                            5 => """
                              C Andre \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:2 [
                    0 => array:2 [
                      "doi" => "10.1093/jac/dkn174"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Antimicrob Chemother"
                        "fecha" => "2008"
                        "volumen" => "62"
                        "paginaInicial" => "316"
                        "paginaFinal" => "323"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18467306"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                    1 => array:2 [
                      "doi" => "10.1093/jac/dkn174"
                      "WWW" => array:1 [
                        "link" => "10&#46;1093&#47;jac&#47;dkn174"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib6"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Chromosomal mechanisms of aminoglycoside resistance in Pseudomonas aeruginosa isolates from cystic fibrosis patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => """
                              S Islam \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              H Oh \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              S Jalal \n
                              \t\t\t\t\t\t\t\t
                              """
                            3 => """
                              F Karpati \n
                              \t\t\t\t\t\t\t\t
                              """
                            4 => """
                              O Ciofu \n
                              \t\t\t\t\t\t\t\t
                              """
                            5 => """
                              N H&#8856;iby \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:2 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1469-0691.2009.02999.x"
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Microbiol Infect"
                        "fecha" => "2009"
                        "volumen" => "15"
                        "paginaInicial" => "60"
                        "paginaFinal" => "66"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19754760"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                    1 => array:2 [
                      "doi" => "10.1111/j.1469-0691.2009.02999.x"
                      "WWW" => array:1 [
                        "link" => "10&#46;1111&#47;j&#46;1469-0691&#46;2008&#46;02097&#46;x"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib7"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Role of Pseudomonas aeruginosa PhoP-PhoQ in resistance to antimicrobial cationic peptides and aminoglycosides"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => """
                              E Macfarlane \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              A Kwasnicka \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              R Hancock \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Microbiol"
                        "fecha" => "2000"
                        "volumen" => "146"
                        "paginaInicial" => "2543"
                        "paginaFinal" => "2554"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib8"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "High-level antibiotic resistance in Pseudomonas aeruginosa biofilm&#58; the ndvB gene is involved in the production of highly glycerol-phosphorylated &#946;-&#40;1&#8594;3&#41;-glucans&#44; which bind aminoglycosides"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => """
                              I Sadovskaya \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              E Vinogradov \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              J Li \n
                              \t\t\t\t\t\t\t\t
                              """
                            3 => """
                              A Hachani \n
                              \t\t\t\t\t\t\t\t
                              """
                            4 => """
                              K Kowalska \n
                              \t\t\t\t\t\t\t\t
                              """
                            5 => """
                              A Filloux \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:2 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Glycobiol"
                        "fecha" => "2010"
                        "volumen" => "20"
                        "paginaInicial" => "895"
                        "paginaFinal" => "904"
                      ]
                    ]
                    1 => array:1 [
                      "WWW" => array:1 [
                        "link" => "10&#46;1093&#47;glycob&#47;cwq047"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib9"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "High prevalence of metallo- &#946;-lactamase and 16S rRNA methylase coproduction among imipenem- resistant Pseudomonas aeruginosa isolates in Brazil"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => """
                              Y Doi \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              AC Ghilardi \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              J Adams \n
                              \t\t\t\t\t\t\t\t
                              """
                            3 => """
                              GD de Oliveira \n
                              \t\t\t\t\t\t\t\t
                              """
                            4 => """
                              DL Paterson \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:2 [
                    0 => array:2 [
                      "doi" => "10.1128/AAC.00443-07"
                      "Revista" => array:6 [
                        "tituloSerie" => "Antimicrob Agents Chemother"
                        "fecha" => "2007"
                        "volumen" => "51"
                        "paginaInicial" => "3388"
                        "paginaFinal" => "3390"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17576840"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                    1 => array:2 [
                      "doi" => "10.1128/AAC.00443-07"
                      "WWW" => array:1 [
                        "link" => "10&#46;1128&#47;AAC&#46;00443-07"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib10"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Molecular genetics aminoglycoside resistance genes and familial relationship of the aminoglycoside modifying enzymes"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => """
                              KJ Shaw \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              PN Rather \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              RS Hare \n
                              \t\t\t\t\t\t\t\t
                              """
                            3 => """
                              GH Miller \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1128/mr.57.1.138-163.1993"
                      "Revista" => array:6 [
                        "tituloSerie" => "Microbiol Rev"
                        "fecha" => "1993"
                        "volumen" => "57"
                        "paginaInicial" => "138"
                        "paginaFinal" => "163"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8385262"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib11"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Aminoglycoside antibiotic resistance by enzymatic deactivation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => """
                              CA Smith \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              EN Baker \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:2 [
                    0 => array:2 [
                      "doi" => "10.2174/1568005023342533"
                      "Revista" => array:6 [
                        "tituloSerie" => "Curr Drug Targets Infect Disord"
                        "fecha" => "2002"
                        "volumen" => "2"
                        "paginaInicial" => "143"
                        "paginaFinal" => "160"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12462145"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                    1 => array:2 [
                      "doi" => "10.2174/1568005023342533"
                      "WWW" => array:1 [
                        "link" => "10&#46;2174&#47;1568005023342533"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib12"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Global spread of multiple aminoglycoside resistance genes"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => """
                              K Yamane \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              J Wachino \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              Y Doi \n
                              \t\t\t\t\t\t\t\t
                              """
                            3 => """
                              H Kurokawa \n
                              \t\t\t\t\t\t\t\t
                              """
                            4 => """
                              Y Arakawa \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3201/eid1106.040924"
                      "Revista" => array:6 [
                        "tituloSerie" => "Emerg Infect Dis"
                        "fecha" => "2005"
                        "volumen" => "11"
                        "paginaInicial" => "951"
                        "paginaFinal" => "953"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15963295"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib13"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The most frequently occurring aminoglycoside resistance mechanisms&#8212; combined results of surveys in eight regions of the world"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => """
                              GH Miller \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              FJ Sabatelli \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              L Naples \n
                              \t\t\t\t\t\t\t\t
                              """
                            3 => """
                              RS Hare \n
                              \t\t\t\t\t\t\t\t
                              """
                            4 => """
                              KJ Shaw \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:7 [
                        "tituloSerie" => "J Chemother"
                        "fecha" => "1995"
                        "volumen" => "7"
                        "numero" => "Suppl&#46; 2"
                        "paginaInicial" => "17"
                        "paginaFinal" => "30"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8622108"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib14"
              "etiqueta" => "14"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Aminoglycoside resistance in Pseudomonas aeruginosa"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => """
                              K Poole \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:2 [
                    0 => array:2 [
                      "doi" => "10.1128/AAC.49.2.479-487.2005"
                      "Revista" => array:6 [
                        "tituloSerie" => "Antimicrob Agents Chemother"
                        "fecha" => "2005"
                        "volumen" => "49"
                        "paginaInicial" => "479"
                        "paginaFinal" => "487"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15673721"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                    1 => array:2 [
                      "doi" => "10.1128/AAC.49.2.479-487.2005"
                      "WWW" => array:1 [
                        "link" => "10&#46;1128&#47;AAC&#46;49&#46;2&#46;479-487&#46;2005"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib15"
              "etiqueta" => "15"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "Clinical and Laboratory Standards Institute&#46; Performance standards for antimicrobial susceptibility testing&#59; seventeenth informational supplement&#46; CLSI document M100-S17&#46; CLSI&#44; 2007 Wayne&#44; PA"
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib16"
              "etiqueta" => "16"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Occurrence and mechanisms of amikacin resistance and its association with &#946;-lactamases in Pseudomonas aeruginosa&#58; a Korean nationwide study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => """
                              JY Kim \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              YJ Park \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              HJ Kwon \n
                              \t\t\t\t\t\t\t\t
                              """
                            3 => """
                              K Han \n
                              \t\t\t\t\t\t\t\t
                              """
                            4 => """
                              MW Kang \n
                              \t\t\t\t\t\t\t\t
                              """
                            5 => """
                              GJ Woo \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:2 [
                    0 => array:2 [
                      "doi" => "10.1093/jac/dkn244"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Antimicrob Chemother"
                        "fecha" => "2008"
                        "volumen" => "62"
                        "paginaInicial" => "479"
                        "paginaFinal" => "483"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18606785"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                    1 => array:2 [
                      "doi" => "10.1093/jac/dkn244"
                      "WWW" => array:1 [
                        "link" => "10&#46;1093&#47;jac&#47;dkn244"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib17"
              "etiqueta" => "17"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Susceptibility of Pseudomonas aeruginosa to antimicrobials&#58; a 2004 French multicentre hospital study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => """
                              J Cavallo \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              D Hocquet \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              P Plesiat \n
                              \t\t\t\t\t\t\t\t
                              """
                            3 => """
                              R Fabre \n
                              \t\t\t\t\t\t\t\t
                              """
                            4 => """
                              M Roussel-Delvallez \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:2 [
                    0 => array:2 [
                      "doi" => "10.1093/jac/dkm076"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Antimicrob Chemother"
                        "fecha" => "2007"
                        "volumen" => "59"
                        "paginaInicial" => "1021"
                        "paginaFinal" => "1024"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17412726"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                    1 => array:2 [
                      "doi" => "10.1093/jac/dkm076"
                      "WWW" => array:1 [
                        "link" => "10&#46;1093&#47;jac&#47;dkm076"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib18"
              "etiqueta" => "18"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Frequency of Pseudomonas aeruginosa serotypes in burn wound infections and their resistance to antibiotics"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => """
                              H Estahbanati \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              P Kashani \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              F Ghanaatpisheh \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:2 [
                    0 => array:2 [
                      "doi" => "10.1016/s0305-4179(02)00024-4"
                      "Revista" => array:6 [
                        "tituloSerie" => "Burns"
                        "fecha" => "2002"
                        "volumen" => "28"
                        "paginaInicial" => "340"
                        "paginaFinal" => "348"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12052372"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                    1 => array:2 [
                      "doi" => "10.1016/s0305-4179(02)00024-4"
                      "WWW" => array:1 [
                        "link" => "10&#46;1016&#47;S0305-4179&#40;02&#41;00024-4"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib19"
              "etiqueta" => "19"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Aminoglycoside resistance mechanisms in Enterobacteriaceae and Pseudomonas spp&#46; from two Danish hospitals&#58; correlation with type of aminoglycoside used"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => """
                              C Busch-Sorensen \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              M Sonmezoglu \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              N Frimodt-Moller \n
                              \t\t\t\t\t\t\t\t
                              """
                            3 => """
                              T Hojbjerg \n
                              \t\t\t\t\t\t\t\t
                              """
                            4 => """
                              GH Miller \n
                              \t\t\t\t\t\t\t\t
                              """
                            5 => """
                              F Espersen \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "APMIS"
                        "fecha" => "1996"
                        "volumen" => "104"
                        "paginaInicial" => "763"
                        "paginaFinal" => "768"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8980628"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib20"
              "etiqueta" => "20"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The changing nature of aminoglycoside resistance mechanisms and prevalence of newly recognized resistance mechanisms in Turkey"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => """
                              U Over \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              D Gur \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              S Unal \n
                              \t\t\t\t\t\t\t\t
                              """
                            3 => """
                              GH Miller \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1046/j.1198-743x.2001.00284.x"
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Microbiol Infect"
                        "fecha" => "2001"
                        "volumen" => "7"
                        "paginaInicial" => "470"
                        "paginaFinal" => "478"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11678929"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib21"
              "etiqueta" => "21"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Prevalence and mechanisms of aminoglycoside resistance"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => """
                              I Phillips \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              A King \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              K Shannon \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/0002-9343(86)90479-1"
                      "Revista" => array:6 [
                        "tituloSerie" => "A ten-year study&#46; Am J Med"
                        "fecha" => "1986"
                        "volumen" => "80"
                        "paginaInicial" => "48"
                        "paginaFinal" => "55"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3728534"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib22"
              "etiqueta" => "22"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The most frequent aminoglycoside resistance mechanisms changes with time and geographic area&#58; a reflection of aminoglycoside usage patterns"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => """
                              GH Miller \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              FJ Sabatelli \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              RS Hare \n
                              \t\t\t\t\t\t\t\t
                              """
                            3 => """
                              Y Glupczynski \n
                              \t\t\t\t\t\t\t\t
                              """
                            4 => """
                              P Mackey \n
                              \t\t\t\t\t\t\t\t
                              """
                            5 => """
                              D Shlaes \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:2 [
                    0 => array:2 [
                      "doi" => "10.1093/clinids/24.supplement_1.s46"
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Infect Dis"
                        "fecha" => "1997"
                        "volumen" => "24"
                        "paginaInicial" => "S46"
                        "paginaFinal" => "S62"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8994779"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                    1 => array:2 [
                      "doi" => "10.1093/clinids/24.supplement_1.s46"
                      "WWW" => array:1 [
                        "link" => "10&#46;1093&#47;clinids&#47;24&#46;Supplement&#95;1&#46;S46"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            22 => array:3 [
              "identificador" => "bib23"
              "etiqueta" => "23"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Aminoglycoside Resistance in Gram-negative Bacilli"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => """
                              YJ Park \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Korean J Clin Microbiol"
                        "fecha" => "2009"
                        "volumen" => "12"
                        "paginaInicial" => "57"
                        "paginaFinal" => "61"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            23 => array:3 [
              "identificador" => "bib24"
              "etiqueta" => "24"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Aminoglycoside modifying enzymes"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => """
                              MS Ramirez \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              ME Tolmasky \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:2 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Drug Resist"
                        "fecha" => "2010"
                        "volumen" => "13"
                        "paginaInicial" => "151"
                        "paginaFinal" => "171"
                      ]
                    ]
                    1 => array:1 [
                      "WWW" => array:1 [
                        "link" => "10&#46;1016&#47;j&#46;drup&#46;2010&#46;08&#46;003"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            24 => array:3 [
              "identificador" => "bib25"
              "etiqueta" => "25"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Pseudomonas aeruginosa &#8211; a phenomenon of bacterial resistance"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => """
                              T Strateva \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              D Yordanov \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:2 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Medic Microbiol"
                        "fecha" => "2009"
                        "volumen" => "58"
                        "paginaInicial" => "1133"
                        "paginaFinal" => "1148"
                      ]
                    ]
                    1 => array:1 [
                      "WWW" => array:1 [
                        "link" => "10&#46;1099&#47;jmm&#46;0&#46;009142-0"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            25 => array:3 [
              "identificador" => "bib26"
              "etiqueta" => "26"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Design of novel antibiotics that bind to the ribosomal acyltransfer site"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => """
                              J Haddad \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              LP Kotra \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              B Llano-Sotelo \n
                              \t\t\t\t\t\t\t\t
                              """
                            3 => """
                              C Kim \n
                              \t\t\t\t\t\t\t\t
                              """
                            4 => """
                              EF Azucena \n
                              \t\t\t\t\t\t\t\t
                              """
                            5 => """
                              M Liu \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:2 [
                    0 => array:2 [
                      "doi" => "10.1021/ja011695m"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Am Chem Soc"
                        "fecha" => "2002"
                        "volumen" => "124"
                        "paginaInicial" => "3229"
                        "paginaFinal" => "3237"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11916405"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                    1 => array:2 [
                      "doi" => "10.1021/ja011695m"
                      "WWW" => array:1 [
                        "link" => "10&#46;1021&#47;ja011695m"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            26 => array:3 [
              "identificador" => "bib27"
              "etiqueta" => "27"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Prospects for the next anti-Pseudomonas drug"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => """
                              M Page \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              J Heim \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:2 [
                    0 => array:2 [
                      "doi" => "10.1016/j.coph.2009.08.006"
                      "Revista" => array:6 [
                        "tituloSerie" => "Curr Opin Pharmacol"
                        "fecha" => "2009"
                        "volumen" => "9"
                        "paginaInicial" => "558"
                        "paginaFinal" => "565"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19748829"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                    1 => array:2 [
                      "doi" => "10.1016/j.coph.2009.08.006"
                      "WWW" => array:1 [
                        "link" => "10&#46;1016&#47;j&#46;coph&#46;2009&#46;08&#46;006"
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
    "agradecimientos" => array:1 [
      0 => array:4 [
        "identificador" => "xack639490"
        "titulo" => "ACKNOWLEDGEMENTS"
        "texto" => "<p id="para130" class="elsevierStylePara elsevierViewall">This study was funded by a M&#46;Sc&#46; grant from the Tarbiat Modares University&#44; Tehran&#44; Iran&#46;</p>"
        "vista" => "all"
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/18075932/0000006600000009/v1_202212011637/S1807593222019366/v1_202212011637/en/main.assets"
  "Apartado" => null
  "PDF" => "https://static.elsevier.es/multimedia/18075932/0000006600000009/v1_202212011637/S1807593222019366/v1_202212011637/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1807593222019366?idApp=UINPBA00004N"
]

Article information

ISSN: 18075932
Original language: English

DOI:10.1590/S1807-59322011000900002

The statistics are updated each day

Year/Month	Html	Pdf	Total

2024 November	8	1	9
2024 October	26	19	45
2024 September	36	28	64
2024 August	37	17	54
2024 July	40	28	68
2024 June	37	7	44
2024 May	28	18	46
2024 April	35	17	52
2024 March	36	26	62
2024 February	38	24	62
2024 January	44	26	70
2023 December	9	22	31
2023 November	13	29	42
2023 October	11	35	46
2023 September	17	25	42
2023 August	9	18	27
2023 July	4	12	16
2023 June	6	13	19
2023 May	2	0	2
2023 April	3	1	4
2023 March	2	7	9
2023 February	0	1	1
2023 January	3	3	6
2022 December	28	1	29

Show all

Indexed in:

Follow us:

Statistics

Indexed in:

Follow us:

Statistics

Subscribe to our newsletter