The usual use of value stream mapping is studying to improve production lines that are already running. In this study, we used value stream mapping and the PDCA cycle on a production line that is still being finished and not yet operational. This work is important and unique because it uses a proactive approach to improve processes. The used method aims to create a waste-free production chain from the start. This is a big plus because it means avoiding losses with high costs and getting a very efficient production line from the start. The findings demonstrate that lean manufacturing tool (VSM) can be used on current and future production lines, and this strategy enhances production line efficiency from the outset by minimising non-value-added activities and maximising value-added activities.

The usual use of value stream mapping is studying to improve production lines that are already running. In this study, we used value stream mapping and the PDCA cycle on a production line that is still being finished and not yet operational. This work is important and unique because it uses a proactive approach to improve processes. The used method aims to create a waste-free production chain from the start. This is a big plus because it means avoiding losses with high costs and getting a very efficient production line from the start. The findings demonstrate that lean manufacturing tool (VSM) can be used on current and future production lines, and this strategy enhances production line efficiency from the outset by minimising non-value-added activities and maximising value-added activities.

The undifferentiated nasopharyngeal cancer (NPC) is a multifactorial disease mainly due to Epstein-Barr Virus (EBV) infection. The transmembrane tyrosine kinase 'EphA2' and the protease 'Furin' are implicated in the EBV entry into epithelial cells and other physiological processes. To gain insights into the association of single-nucleotide polymorphisms (SNPs) rs4702 and rs6603883 (FURIN and EPHA2 genes, respectively) with the risk and prognosis of the NPC, the genotypes of 471 individuals (228 cases and 243 controls) were assessed alongside risk cofactors (sex, tobacco, alcohol, occupation, and recurrent Ear, Nose and Throat infections) and prognosis cofactors (Tumor stage, local invasion, lymph node involvement, and metastasis) using multivariable logistic regression. We found that only the rs4702 AG/GG genotypes were statistically significantly associated with a reduced risk of cancer, both in the overall population and in men (approximately 50% reduction). The rs4702 GG genotype was also associated with a low frequency of local tumor invasion in the whole population (OR = 0.382, p = 0.017, co-dominant model, and OR = 0.409, p = 0.02, recessive model), but heterozygous women were associated with a higher lymph node involvement (OR = 3.53, p = 0.031, co-dominant model, and OR = 3.62, p = 0.02, overdominant model). The rs6603883 GG genotype was associated, in the dominant model, with distant metastasis in the whole population (OR = 2.5, p = 0.024), with advanced clinical stage in men (OR = 2.22, p = 0.034), and with advanced clinical stage and distant metastasis in patients under 49 years (OR = 3.13, p = 0.009, and OR = 5.15, p = 0.011, respectively). Additionally, men having the rs6603883 GA genotype were associated with lymph node invasion (OR = 2.22, p = 0.027, overdominant model). Our study is the first to demonstrate that FURIN and EPHA2 germline gene polymorphisms are associated with NPC risk (for rs4702) and prognosis (for both rs4702 and rs6603883), with sex-specific differences. These results need to be replicated and further investigated in other populations.

The undifferentiated nasopharyngeal cancer (NPC) is a multifactorial disease mainly due to Epstein-Barr Virus (EBV) infection. The transmembrane tyrosine kinase 'EphA2' and the protease 'Furin' are implicated in the EBV entry into epithelial cells and other physiological processes. To gain insights into the association of single-nucleotide polymorphisms (SNPs) rs4702 and rs6603883 (FURIN and EPHA2 genes, respectively) with the risk and prognosis of the NPC, the genotypes of 471 individuals (228 cases and 243 controls) were assessed alongside risk cofactors (sex, tobacco, alcohol, occupation, and recurrent Ear, Nose and Throat infections) and prognosis cofactors (Tumor stage, local invasion, lymph node involvement, and metastasis) using multivariable logistic regression. We found that only the rs4702 AG/GG genotypes were statistically significantly associated with a reduced risk of cancer, both in the overall population and in men (approximately 50% reduction). The rs4702 GG genotype was also associated with a low frequency of local tumor invasion in the whole population (OR = 0.382, p = 0.017, co-dominant model, and OR = 0.409, p = 0.02, recessive model), but heterozygous women were associated with a higher lymph node involvement (OR = 3.53, p = 0.031, co-dominant model, and OR = 3.62, p = 0.02, overdominant model). The rs6603883 GG genotype was associated, in the dominant model, with distant metastasis in the whole population (OR = 2.5, p = 0.024), with advanced clinical stage in men (OR = 2.22, p = 0.034), and with advanced clinical stage and distant metastasis in patients under 49 years (OR = 3.13, p = 0.009, and OR = 5.15, p = 0.011, respectively). Additionally, men having the rs6603883 GA genotype were associated with lymph node invasion (OR = 2.22, p = 0.027, overdominant model). Our study is the first to demonstrate that FURIN and EPHA2 germline gene polymorphisms are associated with NPC risk (for rs4702) and prognosis (for both rs4702 and rs6603883), with sex-specific differences. These results need to be replicated and further investigated in other populations.

The undifferentiated nasopharyngeal cancer (NPC) is a multifactorial disease mainly due to Epstein-Barr Virus (EBV) infection. The transmembrane tyrosine kinase 'EphA2' and the protease 'Furin' are implicated in the EBV entry into epithelial cells and other physiological processes. To gain insights into the association of single-nucleotide polymorphisms (SNPs) rs4702 and rs6603883 (FURIN and EPHA2 genes, respectively) with the risk and prognosis of the NPC, the genotypes of 471 individuals (228 cases and 243 controls) were assessed alongside risk cofactors (sex, tobacco, alcohol, occupation, and recurrent Ear, Nose and Throat infections) and prognosis cofactors (Tumor stage, local invasion, lymph node involvement, and metastasis) using multivariable logistic regression. We found that only the rs4702 AG/GG genotypes were statistically significantly associated with a reduced risk of cancer, both in the overall population and in men (approximately 50% reduction). The rs4702 GG genotype was also associated with a low frequency of local tumor invasion in the whole population (OR = 0.382, p = 0.017, co-dominant model, and OR = 0.409, p = 0.02, recessive model), but heterozygous women were associated with a higher lymph node involvement (OR = 3.53, p = 0.031, co-dominant model, and OR = 3.62, p = 0.02, overdominant model). The rs6603883 GG genotype was associated, in the dominant model, with distant metastasis in the whole population (OR = 2.5, p = 0.024), with advanced clinical stage in men (OR = 2.22, p = 0.034), and with advanced clinical stage and distant metastasis in patients under 49 years (OR = 3.13, p = 0.009, and OR = 5.15, p = 0.011, respectively). Additionally, men having the rs6603883 GA genotype were associated with lymph node invasion (OR = 2.22, p = 0.027, overdominant model). Our study is the first to demonstrate that FURIN and EPHA2 germline gene polymorphisms are associated with NPC risk (for rs4702) and prognosis (for both rs4702 and rs6603883), with sex-specific differences. These results need to be replicated and further investigated in other populations.

The undifferentiated nasopharyngeal cancer (NPC) is a multifactorial disease mainly due to Epstein-Barr Virus (EBV) infection. The transmembrane tyrosine kinase 'EphA2' and the protease 'Furin' are implicated in the EBV entry into epithelial cells and other physiological processes. To gain insights into the association of single-nucleotide polymorphisms (SNPs) rs4702 and rs6603883 (FURIN and EPHA2 genes, respectively) with the risk and prognosis of the NPC, the genotypes of 471 individuals (228 cases and 243 controls) were assessed alongside risk cofactors (sex, tobacco, alcohol, occupation, and recurrent Ear, Nose and Throat infections) and prognosis cofactors (Tumor stage, local invasion, lymph node involvement, and metastasis) using multivariable logistic regression. We found that only the rs4702 AG/GG genotypes were statistically significantly associated with a reduced risk of cancer, both in the overall population and in men (approximately 50% reduction). The rs4702 GG genotype was also associated with a low frequency of local tumor invasion in the whole population (OR = 0.382, p = 0.017, co-dominant model, and OR = 0.409, p = 0.02, recessive model), but heterozygous women were associated with a higher lymph node involvement (OR = 3.53, p = 0.031, co-dominant model, and OR = 3.62, p = 0.02, overdominant model). The rs6603883 GG genotype was associated, in the dominant model, with distant metastasis in the whole population (OR = 2.5, p = 0.024), with advanced clinical stage in men (OR = 2.22, p = 0.034), and with advanced clinical stage and distant metastasis in patients under 49 years (OR = 3.13, p = 0.009, and OR = 5.15, p = 0.011, respectively). Additionally, men having the rs6603883 GA genotype were associated with lymph node invasion (OR = 2.22, p = 0.027, overdominant model). Our study is the first to demonstrate that FURIN and EPHA2 germline gene polymorphisms are associated with NPC risk (for rs4702) and prognosis (for both rs4702 and rs6603883), with sex-specific differences. These results need to be replicated and further investigated in other populations.

The undifferentiated nasopharyngeal cancer (NPC) is a multifactorial disease mainly due to Epstein-Barr Virus (EBV) infection. The transmembrane tyrosine kinase 'EphA2' and the protease 'Furin' are implicated in the EBV entry into epithelial cells and other physiological processes. To gain insights into the association of single-nucleotide polymorphisms (SNPs) rs4702 and rs6603883 (FURIN and EPHA2 genes, respectively) with the risk and prognosis of the NPC, the genotypes of 471 individuals (228 cases and 243 controls) were assessed alongside risk cofactors (sex, tobacco, alcohol, occupation, and recurrent Ear, Nose and Throat infections) and prognosis cofactors (Tumor stage, local invasion, lymph node involvement, and metastasis) using multivariable logistic regression. We found that only the rs4702 AG/GG genotypes were statistically significantly associated with a reduced risk of cancer, both in the overall population and in men (approximately 50% reduction). The rs4702 GG genotype was also associated with a low frequency of local tumor invasion in the whole population (OR = 0.382, p = 0.017, co-dominant model, and OR = 0.409, p = 0.02, recessive model), but heterozygous women were associated with a higher lymph node involvement (OR = 3.53, p = 0.031, co-dominant model, and OR = 3.62, p = 0.02, overdominant model). The rs6603883 GG genotype was associated, in the dominant model, with distant metastasis in the whole population (OR = 2.5, p = 0.024), with advanced clinical stage in men (OR = 2.22, p = 0.034), and with advanced clinical stage and distant metastasis in patients under 49 years (OR = 3.13, p = 0.009, and OR = 5.15, p = 0.011, respectively). Additionally, men having the rs6603883 GA genotype were associated with lymph node invasion (OR = 2.22, p = 0.027, overdominant model). Our study is the first to demonstrate that FURIN and EPHA2 germline gene polymorphisms are associated with NPC risk (for rs4702) and prognosis (for both rs4702 and rs6603883), with sex-specific differences. These results need to be replicated and further investigated in other populations.

The undifferentiated nasopharyngeal cancer (NPC) is a multifactorial disease mainly due to Epstein-Barr Virus (EBV) infection. The transmembrane tyrosine kinase 'EphA2' and the protease 'Furin' are implicated in the EBV entry into epithelial cells and other physiological processes. To gain insights into the association of single-nucleotide polymorphisms (SNPs) rs4702 and rs6603883 (FURIN and EPHA2 genes, respectively) with the risk and prognosis of the NPC, the genotypes of 471 individuals (228 cases and 243 controls) were assessed alongside risk cofactors (sex, tobacco, alcohol, occupation, and recurrent Ear, Nose and Throat infections) and prognosis cofactors (Tumor stage, local invasion, lymph node involvement, and metastasis) using multivariable logistic regression. We found that only the rs4702 AG/GG genotypes were statistically significantly associated with a reduced risk of cancer, both in the overall population and in men (approximately 50% reduction). The rs4702 GG genotype was also associated with a low frequency of local tumor invasion in the whole population (OR = 0.382, p = 0.017, co-dominant model, and OR = 0.409, p = 0.02, recessive model), but heterozygous women were associated with a higher lymph node involvement (OR = 3.53, p = 0.031, co-dominant model, and OR = 3.62, p = 0.02, overdominant model). The rs6603883 GG genotype was associated, in the dominant model, with distant metastasis in the whole population (OR = 2.5, p = 0.024), with advanced clinical stage in men (OR = 2.22, p = 0.034), and with advanced clinical stage and distant metastasis in patients under 49 years (OR = 3.13, p = 0.009, and OR = 5.15, p = 0.011, respectively). Additionally, men having the rs6603883 GA genotype were associated with lymph node invasion (OR = 2.22, p = 0.027, overdominant model). Our study is the first to demonstrate that FURIN and EPHA2 germline gene polymorphisms are associated with NPC risk (for rs4702) and prognosis (for both rs4702 and rs6603883), with sex-specific differences. These results need to be replicated and further investigated in other populations.

The undifferentiated nasopharyngeal cancer (NPC) is a multifactorial disease mainly due to Epstein-Barr Virus (EBV) infection. The transmembrane tyrosine kinase 'EphA2' and the protease 'Furin' are implicated in the EBV entry into epithelial cells and other physiological processes. To gain insights into the association of single-nucleotide polymorphisms (SNPs) rs4702 and rs6603883 (FURIN and EPHA2 genes, respectively) with the risk and prognosis of the NPC, the genotypes of 471 individuals (228 cases and 243 controls) were assessed alongside risk cofactors (sex, tobacco, alcohol, occupation, and recurrent Ear, Nose and Throat infections) and prognosis cofactors (Tumor stage, local invasion, lymph node involvement, and metastasis) using multivariable logistic regression. We found that only the rs4702 AG/GG genotypes were statistically significantly associated with a reduced risk of cancer, both in the overall population and in men (approximately 50% reduction). The rs4702 GG genotype was also associated with a low frequency of local tumor invasion in the whole population (OR = 0.382, p = 0.017, co-dominant model, and OR = 0.409, p = 0.02, recessive model), but heterozygous women were associated with a higher lymph node involvement (OR = 3.53, p = 0.031, co-dominant model, and OR = 3.62, p = 0.02, overdominant model). The rs6603883 GG genotype was associated, in the dominant model, with distant metastasis in the whole population (OR = 2.5, p = 0.024), with advanced clinical stage in men (OR = 2.22, p = 0.034), and with advanced clinical stage and distant metastasis in patients under 49 years (OR = 3.13, p = 0.009, and OR = 5.15, p = 0.011, respectively). Additionally, men having the rs6603883 GA genotype were associated with lymph node invasion (OR = 2.22, p = 0.027, overdominant model). Our study is the first to demonstrate that FURIN and EPHA2 germline gene polymorphisms are associated with NPC risk (for rs4702) and prognosis (for both rs4702 and rs6603883), with sex-specific differences. These results need to be replicated and further investigated in other populations.

The undifferentiated nasopharyngeal cancer (NPC) is a multifactorial disease mainly due to Epstein-Barr Virus (EBV) infection. The transmembrane tyrosine kinase 'EphA2' and the protease 'Furin' are implicated in the EBV entry into epithelial cells and other physiological processes. To gain insights into the association of single-nucleotide polymorphisms (SNPs) rs4702 and rs6603883 (FURIN and EPHA2 genes, respectively) with the risk and prognosis of the NPC, the genotypes of 471 individuals (228 cases and 243 controls) were assessed alongside risk cofactors (sex, tobacco, alcohol, occupation, and recurrent Ear, Nose and Throat infections) and prognosis cofactors (Tumor stage, local invasion, lymph node involvement, and metastasis) using multivariable logistic regression. We found that only the rs4702 AG/GG genotypes were statistically significantly associated with a reduced risk of cancer, both in the overall population and in men (approximately 50% reduction). The rs4702 GG genotype was also associated with a low frequency of local tumor invasion in the whole population (OR = 0.382, p = 0.017, co-dominant model, and OR = 0.409, p = 0.02, recessive model), but heterozygous women were associated with a higher lymph node involvement (OR = 3.53, p = 0.031, co-dominant model, and OR = 3.62, p = 0.02, overdominant model). The rs6603883 GG genotype was associated, in the dominant model, with distant metastasis in the whole population (OR = 2.5, p = 0.024), with advanced clinical stage in men (OR = 2.22, p = 0.034), and with advanced clinical stage and distant metastasis in patients under 49 years (OR = 3.13, p = 0.009, and OR = 5.15, p = 0.011, respectively). Additionally, men having the rs6603883 GA genotype were associated with lymph node invasion (OR = 2.22, p = 0.027, overdominant model). Our study is the first to demonstrate that FURIN and EPHA2 germline gene polymorphisms are associated with NPC risk (for rs4702) and prognosis (for both rs4702 and rs6603883), with sex-specific differences. These results need to be replicated and further investigated in other populations.

The undifferentiated nasopharyngeal cancer (NPC) is a multifactorial disease mainly due to Epstein-Barr Virus (EBV) infection. The transmembrane tyrosine kinase 'EphA2' and the protease 'Furin' are implicated in the EBV entry into epithelial cells and other physiological processes. To gain insights into the association of single-nucleotide polymorphisms (SNPs) rs4702 and rs6603883 (FURIN and EPHA2 genes, respectively) with the risk and prognosis of the NPC, the genotypes of 471 individuals (228 cases and 243 controls) were assessed alongside risk cofactors (sex, tobacco, alcohol, occupation, and recurrent Ear, Nose and Throat infections) and prognosis cofactors (Tumor stage, local invasion, lymph node involvement, and metastasis) using multivariable logistic regression. We found that only the rs4702 AG/GG genotypes were statistically significantly associated with a reduced risk of cancer, both in the overall population and in men (approximately 50% reduction). The rs4702 GG genotype was also associated with a low frequency of local tumor invasion in the whole population (OR = 0.382, p = 0.017, co-dominant model, and OR = 0.409, p = 0.02, recessive model), but heterozygous women were associated with a higher lymph node involvement (OR = 3.53, p = 0.031, co-dominant model, and OR = 3.62, p = 0.02, overdominant model). The rs6603883 GG genotype was associated, in the dominant model, with distant metastasis in the whole population (OR = 2.5, p = 0.024), with advanced clinical stage in men (OR = 2.22, p = 0.034), and with advanced clinical stage and distant metastasis in patients under 49 years (OR = 3.13, p = 0.009, and OR = 5.15, p = 0.011, respectively). Additionally, men having the rs6603883 GA genotype were associated with lymph node invasion (OR = 2.22, p = 0.027, overdominant model). Our study is the first to demonstrate that FURIN and EPHA2 germline gene polymorphisms are associated with NPC risk (for rs4702) and prognosis (for both rs4702 and rs6603883), with sex-specific differences. These results need to be replicated and further investigated in other populations.

Let T ∈ B(H) be a bounded linear operator on a Hilbert space H with the polar decomposition T =U|T|. The(f,g)-Aluthge transform of the operator T, denoted by ∆f,g(T), is defined as ∆f,g(T) = f(|T|)Ug(|T|), wheref andg botharenon-negativecontinuousfunctionson[0,∞[suchthatf(x)g(x) = x, for all x ≥ 0. In this paper, firstly, we investigate the relationship between this transform and several classes of operators as quasi-normal, normal, positive, nilpotent and closed range operators. Secondly, we show that under some conditions the (f,g)-Aluthge transform possesses the polar decomposition. Lastly, we provide a characterization of binormal operators from the viewpoint of the polar decomposition and the (f, g)-Aluthge transform. 2020 Mathematics Subject Classification. 47A05; 47B49. Key words and phrases. (f,g)-Aluthge transform; quasinormal operato; Polar decomposition; binormal operators.

Let T ∈ B(H) be a bounded linear operator on a Hilbert space H with the polar decomposition T =U|T|. The(f,g)-Aluthge transform of the operator T, denoted by ∆f,g(T), is defined as ∆f,g(T) = f(|T|)Ug(|T|), wheref andg botharenon-negativecontinuousfunctionson[0,∞[suchthatf(x)g(x) = x, for all x ≥ 0. In this paper, firstly, we investigate the relationship between this transform and several classes of operators as quasi-normal, normal, positive, nilpotent and closed range operators. Secondly, we show that under some conditions the (f,g)-Aluthge transform possesses the polar decomposition. Lastly, we provide a characterization of binormal operators from the viewpoint of the polar decomposition and the (f, g)-Aluthge transform. 2020 Mathematics Subject Classification. 47A05; 47B49. Key words and phrases. (f,g)-Aluthge transform; quasinormal operato; Polar decomposition; binormal operators.

Objective The aim of this study was to investigate the distribution and genetic determinants of carbapenemase production and colistin resistance among Acinetobacter baumannii isolates recovered from three health care facilities in the city of Batna, Algeria.

Methods A prospective study was conducted between 2021 and 2022 on 46 Acinetobacter baumannii clinical isolates, which were collected and identified using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. Antibiotic susceptibility testing was performed using the disk diffusion method and colistin minimum inhibitory concentrations (MICs) were determined by broth microdilution method. Carbapenemase and colistin resist ance determinants were detected by qPCR.

Results The 46 clinical isolates were mainly from the intensive care unit (52.17%) and the burns unit (17.39%). The strains were collected primarily from pus samples (34.78%) and blood samples (17.39%). Eleven strains were classified as colistin-resistant, with MICs ranging from 4 to 128 μg/mL. The blaOXA-24 gene was detected in 63.04% of the isolates, followed by the blaOXA-23 gene (43.47%). Nine strains were positive for both blaOXA-23-like and blaOXA-24-like genes. The blaNDM gene was detected in eight isolates (17.39%), including two which co-expressed a blaOXA-24 gene. In contrast, all strains were negative for the plasmid-mediated colistin resistance mcr-1 to mcr-5 and mcr-8.

Conclusion Here, we report a high prevalence of carbapenemases-producing A. baumannii isolates in Batna hospi tals. Notably, this study is the first to identify A. baumannii isolates co-producing OXA-24 and NDM carbapenemases and to report the first detection of colistin-resistant A. baumannii co-producing OXA-24 and OXA-23 carbapenemases from a patient in Algeria.

Keywords Acinetobacter baumannii, blaOXA-23, blaOXA-24, blaNDM, Algeri

Objective The aim of this study was to investigate the distribution and genetic determinants of carbapenemase production and colistin resistance among Acinetobacter baumannii isolates recovered from three health care facilities in the city of Batna, Algeria.

Methods A prospective study was conducted between 2021 and 2022 on 46 Acinetobacter baumannii clinical isolates, which were collected and identified using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. Antibiotic susceptibility testing was performed using the disk diffusion method and colistin minimum inhibitory concentrations (MICs) were determined by broth microdilution method. Carbapenemase and colistin resist ance determinants were detected by qPCR.

Results The 46 clinical isolates were mainly from the intensive care unit (52.17%) and the burns unit (17.39%). The strains were collected primarily from pus samples (34.78%) and blood samples (17.39%). Eleven strains were classified as colistin-resistant, with MICs ranging from 4 to 128 μg/mL. The blaOXA-24 gene was detected in 63.04% of the isolates, followed by the blaOXA-23 gene (43.47%). Nine strains were positive for both blaOXA-23-like and blaOXA-24-like genes. The blaNDM gene was detected in eight isolates (17.39%), including two which co-expressed a blaOXA-24 gene. In contrast, all strains were negative for the plasmid-mediated colistin resistance mcr-1 to mcr-5 and mcr-8.

Conclusion Here, we report a high prevalence of carbapenemases-producing A. baumannii isolates in Batna hospi tals. Notably, this study is the first to identify A. baumannii isolates co-producing OXA-24 and NDM carbapenemases and to report the first detection of colistin-resistant A. baumannii co-producing OXA-24 and OXA-23 carbapenemases from a patient in Algeria.

Keywords Acinetobacter baumannii, blaOXA-23, blaOXA-24, blaNDM, Algeri

Objective The aim of this study was to investigate the distribution and genetic determinants of carbapenemase production and colistin resistance among Acinetobacter baumannii isolates recovered from three health care facilities in the city of Batna, Algeria.

Methods A prospective study was conducted between 2021 and 2022 on 46 Acinetobacter baumannii clinical isolates, which were collected and identified using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. Antibiotic susceptibility testing was performed using the disk diffusion method and colistin minimum inhibitory concentrations (MICs) were determined by broth microdilution method. Carbapenemase and colistin resist ance determinants were detected by qPCR.

Results The 46 clinical isolates were mainly from the intensive care unit (52.17%) and the burns unit (17.39%). The strains were collected primarily from pus samples (34.78%) and blood samples (17.39%). Eleven strains were classified as colistin-resistant, with MICs ranging from 4 to 128 μg/mL. The blaOXA-24 gene was detected in 63.04% of the isolates, followed by the blaOXA-23 gene (43.47%). Nine strains were positive for both blaOXA-23-like and blaOXA-24-like genes. The blaNDM gene was detected in eight isolates (17.39%), including two which co-expressed a blaOXA-24 gene. In contrast, all strains were negative for the plasmid-mediated colistin resistance mcr-1 to mcr-5 and mcr-8.

Conclusion Here, we report a high prevalence of carbapenemases-producing A. baumannii isolates in Batna hospi tals. Notably, this study is the first to identify A. baumannii isolates co-producing OXA-24 and NDM carbapenemases and to report the first detection of colistin-resistant A. baumannii co-producing OXA-24 and OXA-23 carbapenemases from a patient in Algeria.

Keywords Acinetobacter baumannii, blaOXA-23, blaOXA-24, blaNDM, Algeri

Objective The aim of this study was to investigate the distribution and genetic determinants of carbapenemase production and colistin resistance among Acinetobacter baumannii isolates recovered from three health care facilities in the city of Batna, Algeria.

Methods A prospective study was conducted between 2021 and 2022 on 46 Acinetobacter baumannii clinical isolates, which were collected and identified using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. Antibiotic susceptibility testing was performed using the disk diffusion method and colistin minimum inhibitory concentrations (MICs) were determined by broth microdilution method. Carbapenemase and colistin resist ance determinants were detected by qPCR.

Results The 46 clinical isolates were mainly from the intensive care unit (52.17%) and the burns unit (17.39%). The strains were collected primarily from pus samples (34.78%) and blood samples (17.39%). Eleven strains were classified as colistin-resistant, with MICs ranging from 4 to 128 μg/mL. The blaOXA-24 gene was detected in 63.04% of the isolates, followed by the blaOXA-23 gene (43.47%). Nine strains were positive for both blaOXA-23-like and blaOXA-24-like genes. The blaNDM gene was detected in eight isolates (17.39%), including two which co-expressed a blaOXA-24 gene. In contrast, all strains were negative for the plasmid-mediated colistin resistance mcr-1 to mcr-5 and mcr-8.

Conclusion Here, we report a high prevalence of carbapenemases-producing A. baumannii isolates in Batna hospi tals. Notably, this study is the first to identify A. baumannii isolates co-producing OXA-24 and NDM carbapenemases and to report the first detection of colistin-resistant A. baumannii co-producing OXA-24 and OXA-23 carbapenemases from a patient in Algeria.

Keywords Acinetobacter baumannii, blaOXA-23, blaOXA-24, blaNDM, Algeri

Objective The aim of this study was to investigate the distribution and genetic determinants of carbapenemase production and colistin resistance among Acinetobacter baumannii isolates recovered from three health care facilities in the city of Batna, Algeria.

Methods A prospective study was conducted between 2021 and 2022 on 46 Acinetobacter baumannii clinical isolates, which were collected and identified using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. Antibiotic susceptibility testing was performed using the disk diffusion method and colistin minimum inhibitory concentrations (MICs) were determined by broth microdilution method. Carbapenemase and colistin resist ance determinants were detected by qPCR.

Results The 46 clinical isolates were mainly from the intensive care unit (52.17%) and the burns unit (17.39%). The strains were collected primarily from pus samples (34.78%) and blood samples (17.39%). Eleven strains were classified as colistin-resistant, with MICs ranging from 4 to 128 μg/mL. The blaOXA-24 gene was detected in 63.04% of the isolates, followed by the blaOXA-23 gene (43.47%). Nine strains were positive for both blaOXA-23-like and blaOXA-24-like genes. The blaNDM gene was detected in eight isolates (17.39%), including two which co-expressed a blaOXA-24 gene. In contrast, all strains were negative for the plasmid-mediated colistin resistance mcr-1 to mcr-5 and mcr-8.

Conclusion Here, we report a high prevalence of carbapenemases-producing A. baumannii isolates in Batna hospi tals. Notably, this study is the first to identify A. baumannii isolates co-producing OXA-24 and NDM carbapenemases and to report the first detection of colistin-resistant A. baumannii co-producing OXA-24 and OXA-23 carbapenemases from a patient in Algeria.

Keywords Acinetobacter baumannii, blaOXA-23, blaOXA-24, blaNDM, Algeri

Objective The aim of this study was to investigate the distribution and genetic determinants of carbapenemase production and colistin resistance among Acinetobacter baumannii isolates recovered from three health care facilities in the city of Batna, Algeria.

Methods A prospective study was conducted between 2021 and 2022 on 46 Acinetobacter baumannii clinical isolates, which were collected and identified using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. Antibiotic susceptibility testing was performed using the disk diffusion method and colistin minimum inhibitory concentrations (MICs) were determined by broth microdilution method. Carbapenemase and colistin resist ance determinants were detected by qPCR.

Results The 46 clinical isolates were mainly from the intensive care unit (52.17%) and the burns unit (17.39%). The strains were collected primarily from pus samples (34.78%) and blood samples (17.39%). Eleven strains were classified as colistin-resistant, with MICs ranging from 4 to 128 μg/mL. The blaOXA-24 gene was detected in 63.04% of the isolates, followed by the blaOXA-23 gene (43.47%). Nine strains were positive for both blaOXA-23-like and blaOXA-24-like genes. The blaNDM gene was detected in eight isolates (17.39%), including two which co-expressed a blaOXA-24 gene. In contrast, all strains were negative for the plasmid-mediated colistin resistance mcr-1 to mcr-5 and mcr-8.

Conclusion Here, we report a high prevalence of carbapenemases-producing A. baumannii isolates in Batna hospi tals. Notably, this study is the first to identify A. baumannii isolates co-producing OXA-24 and NDM carbapenemases and to report the first detection of colistin-resistant A. baumannii co-producing OXA-24 and OXA-23 carbapenemases from a patient in Algeria.

Keywords Acinetobacter baumannii, blaOXA-23, blaOXA-24, blaNDM, Algeri

Objective The aim of this study was to investigate the distribution and genetic determinants of carbapenemase production and colistin resistance among Acinetobacter baumannii isolates recovered from three health care facilities in the city of Batna, Algeria.

Methods A prospective study was conducted between 2021 and 2022 on 46 Acinetobacter baumannii clinical isolates, which were collected and identified using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. Antibiotic susceptibility testing was performed using the disk diffusion method and colistin minimum inhibitory concentrations (MICs) were determined by broth microdilution method. Carbapenemase and colistin resist ance determinants were detected by qPCR.

Results The 46 clinical isolates were mainly from the intensive care unit (52.17%) and the burns unit (17.39%). The strains were collected primarily from pus samples (34.78%) and blood samples (17.39%). Eleven strains were classified as colistin-resistant, with MICs ranging from 4 to 128 μg/mL. The blaOXA-24 gene was detected in 63.04% of the isolates, followed by the blaOXA-23 gene (43.47%). Nine strains were positive for both blaOXA-23-like and blaOXA-24-like genes. The blaNDM gene was detected in eight isolates (17.39%), including two which co-expressed a blaOXA-24 gene. In contrast, all strains were negative for the plasmid-mediated colistin resistance mcr-1 to mcr-5 and mcr-8.

Conclusion Here, we report a high prevalence of carbapenemases-producing A. baumannii isolates in Batna hospi tals. Notably, this study is the first to identify A. baumannii isolates co-producing OXA-24 and NDM carbapenemases and to report the first detection of colistin-resistant A. baumannii co-producing OXA-24 and OXA-23 carbapenemases from a patient in Algeria.

Keywords Acinetobacter baumannii, blaOXA-23, blaOXA-24, blaNDM, Algeri