{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T17:02:22Z","timestamp":1779814942997,"version":"3.53.1"},"reference-count":25,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,4,12]],"date-time":"2026-04-12T00:00:00Z","timestamp":1775952000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,4,12]],"date-time":"2026-04-12T00:00:00Z","timestamp":1775952000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100012166","name":"National Key Research and Development Program of China","doi-asserted-by":"publisher","award":["2021YFC2701800"],"award-info":[{"award-number":["2021YFC2701800"]}],"id":[{"id":"10.13039\/501100012166","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100012166","name":"National Key Research and Development Program of China","doi-asserted-by":"publisher","award":["2021YFC2701801"],"award-info":[{"award-number":["2021YFC2701801"]}],"id":[{"id":"10.13039\/501100012166","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Laboratory Analysis"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>\n                      Bloodstream infections (BSIs) caused by\n                      <jats:styled-content style=\"fixed-case\">\n                        <jats:italic>Klebsiella pneumoniae<\/jats:italic>\n                      <\/jats:styled-content>\n                      are associated with a significant risk of mortality. While the majority of existing research has concentrated on adult populations, there is a paucity of studies addressing pediatric cases. This study aims to elucidate the mechanisms underlying carbapenem resistance in\n                      <jats:styled-content style=\"fixed-case\">\n                        <jats:italic>K. pneumoniae<\/jats:italic>\n                      <\/jats:styled-content>\n                      strains responsible for bloodstream infections in children.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A retrospective study was conducted at Children's Hospital, Zhejiang University School of Medicine, focusing on patients diagnosed with bloodstream infections due to carbapenem\u2010resistant\n                      <jats:styled-content style=\"fixed-case\">\n                        <jats:italic>K. pneumoniae<\/jats:italic>\n                      <\/jats:styled-content>\n                      (CRKP). Antimicrobial susceptibility testing and whole\u2010genome sequencing were subsequently performed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In this study, all the CRKP\u2010BSI strains were detected during the COVID\u201019 pandemic. The predominant mechanism of carbapenem resistance among the 10 CRKP\u2010BSI strains was the production of class B metallo\u2010beta\u2010lactamases, with\n                      <jats:italic>bla<\/jats:italic>\n                      <jats:sub>NDM\u20101<\/jats:sub>\n                      present in 50% of the strains, followed by\n                      <jats:italic>bla<\/jats:italic>\n                      <jats:sub>NDM\u20105<\/jats:sub>\n                      (30%) and\n                      <jats:italic>bla<\/jats:italic>\n                      <jats:sub>IMP\u20104<\/jats:sub>\n                      (20%). The ST25\u2010KL2 lineage was the most prevalent strain, with all isolates originating from the neonatal intensive care unit (NICU). In strain 22WJ8105, hypervirulence\u2010associated genes, including\n                      <jats:italic>iucABC<\/jats:italic>\n                      and\n                      <jats:italic>iutA<\/jats:italic>\n                      , were identified. Additionally, a strain of ST17\u2010type\n                      <jats:styled-content style=\"fixed-case\">\n                        <jats:italic>K. pneumoniae<\/jats:italic>\n                      <\/jats:styled-content>\n                      harboring the\n                      <jats:italic>bla<\/jats:italic>\n                      <jats:sub>NDM\u20105<\/jats:sub>\n                      gene was identified.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study determined that the production of class B metalloenzymes is the primary mechanism of carbapenem resistance in pediatric bloodstream infections caused by CRKP. Importantly, the ST25\u2010KL2 lineage emerged as the dominant clone, highlighting its potential for nosocomial transmission.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jcla.70232","type":"journal-article","created":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T04:51:20Z","timestamp":1776055880000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Genomic Insights Into Carbapenem\u2010Resistant\n                    <scp>\n                      <i>Klebsiella pneumoniae<\/i>\n                    <\/scp>\n                    in Pediatric Bloodstream Infections in Zhejiang, China (2019\u20132024)"],"prefix":"10.1002","volume":"40","author":[{"given":"Mingming","family":"Zhou","sequence":"first","affiliation":[{"name":"Department of Clinical Laboratory, Children's Hospital Zhejiang University School of Medicine, National Clinical Research Center for Children and Adolescents' Health and Diseases  Hangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiucai","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, Children's Hospital Zhejiang University School of Medicine, National Clinical Research Center for Children and Adolescents' Health and Diseases  Hangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhenjie","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Pediatric Intensive Care Unit, Children's Hospital Zhejiang University School of Medicine, National Clinical Research Center for Children and Adolescents' Health and Diseases  Hangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3903-9303","authenticated-orcid":false,"given":"Chao","family":"Fang","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, Children's Hospital Zhejiang University School of Medicine, 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