{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T17:30:54Z","timestamp":1786987854392,"version":"build-2736575974"},"reference-count":39,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T00:00:00Z","timestamp":1761955200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T00:00:00Z","timestamp":1761955200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2025,10,4]],"date-time":"2025-10-04T00:00:00Z","timestamp":1759536000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100012166","name":"National Key Research and Development Program of China","doi-asserted-by":"publisher","award":["2023YFC2308400"],"award-info":[{"award-number":["2023YFC2308400"]}],"id":[{"id":"10.13039\/501100012166","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100012226","name":"Fundamental Research Funds for the Central Universities","doi-asserted-by":"publisher","award":["2022ZFJH003"],"award-info":[{"award-number":["2022ZFJH003"]}],"id":[{"id":"10.13039\/501100012226","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100017594","name":"Medical Science and Technology Project of Zhejiang Province","doi-asserted-by":"publisher","award":["2022KY355"],"award-info":[{"award-number":["2022KY355"]}],"id":[{"id":"10.13039\/501100017594","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100017594","name":"Medical Science and Technology Project of Zhejiang Province","doi-asserted-by":"publisher","award":["2024KY402"],"award-info":[{"award-number":["2024KY402"]}],"id":[{"id":"10.13039\/501100017594","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82072314"],"award-info":[{"award-number":["82072314"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["thelancet.com","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["eBioMedicine"],"published-print":{"date-parts":[[2025,11]]},"DOI":"10.1016\/j.ebiom.2025.105979","type":"journal-article","created":{"date-parts":[[2025,10,23]],"date-time":"2025-10-23T16:30:43Z","timestamp":1761237043000},"page":"105979","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":3,"special_numbering":"C","title":["Unravelling tandem repeat-mediated mutagenesis drive rapid diversification of KPC enzymes: emergence of blaKPC-263 and enhanced resistance to ceftazidime-avibactam"],"prefix":"10.1016","volume":"121","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-3032-1989","authenticated-orcid":false,"given":"Haowei","family":"Ye","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruishan","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie","family":"Shen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tongxi","family":"Hu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaojing","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kun","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lu","family":"Gong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hao","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junfei","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhencang","family":"Zheng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7690-372X","authenticated-orcid":false,"given":"Beiwen","family":"Zheng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.ebiom.2025.105979_bib1","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1016\/S1473-3099(17)30489-9","article-title":"A fatal outbreak of ST11 carbapenem-resistant hypervirulent Klebsiella pneumoniae in a Chinese hospital: a molecular epidemiological study","volume":"18","author":"Gu","year":"2018","journal-title":"Lancet Infect Dis"},{"key":"10.1016\/j.ebiom.2025.105979_bib2","doi-asserted-by":"crossref","first-page":"574","DOI":"10.1016\/S1473-3099(24)00648-0","article-title":"Effectiveness of ceftazidime\u2013avibactam versus ceftolozane\u2013tazobactam for multidrug-resistant Pseudomonas aeruginosa infections in the USA (CACTUS): a multicentre, retrospective, observational study","volume":"25","author":"Shields","year":"2025","journal-title":"Lancet Infect Dis"},{"key":"10.1016\/j.ebiom.2025.105979_bib3","doi-asserted-by":"crossref","first-page":"124.e1","DOI":"10.1016\/j.cmi.2019.08.020","article-title":"Emergence of ceftazidime\/avibactam resistance in carbapenem-resistant Klebsiella pneumoniae in China","volume":"26","author":"Zhang","year":"2020","journal-title":"Clin Microbiol Infect"},{"key":"10.1016\/j.ebiom.2025.105979_bib4","doi-asserted-by":"crossref","DOI":"10.1128\/cmr.00008-23","article-title":"Klebsiella pneumoniae carbapenemase variants: the new threat to global public health","volume":"36","author":"Ding","year":"2023","journal-title":"Clin Microbiol Rev"},{"key":"10.1016\/j.ebiom.2025.105979_bib5","doi-asserted-by":"crossref","first-page":"871","DOI":"10.1093\/jac\/dkad049","article-title":"The primary pharmacology of ceftazidime\/avibactam: microbiology from clinical studies, and development of resistance during treatment","volume":"78","author":"Nichols","year":"2023","journal-title":"J Antimicrob Chemother"},{"key":"10.1016\/j.ebiom.2025.105979_bib6","doi-asserted-by":"crossref","DOI":"10.1128\/aac.00447-22","article-title":"Klebsiella pneumoniae carbapenemase variants resistant to ceftazidime-avibactam: an evolutionary overview","volume":"66","author":"Hobson","year":"2022","journal-title":"Antimicrob Agents Chemother"},{"key":"10.1016\/j.ebiom.2025.105979_bib7","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pcbi.1005595","article-title":"Unicycler: resolving bacterial genome assemblies from short and long sequencing reads","volume":"13","author":"Wick","year":"2017","journal-title":"PLOS Comput Biol"},{"key":"10.1016\/j.ebiom.2025.105979_bib8","doi-asserted-by":"crossref","first-page":"2068","DOI":"10.1093\/bioinformatics\/btu153","article-title":"Prokka: rapid prokaryotic genome annotation","volume":"30","author":"Seemann","year":"2014","journal-title":"Bioinformatics"},{"key":"10.1016\/j.ebiom.2025.105979_bib9","doi-asserted-by":"crossref","first-page":"2640","DOI":"10.1093\/jac\/dks261","article-title":"Identification of acquired antimicrobial resistance genes","volume":"67","author":"Zankari","year":"2012","journal-title":"J Antimicrob Chemother"},{"key":"10.1016\/j.ebiom.2025.105979_bib10","doi-asserted-by":"crossref","first-page":"W78","DOI":"10.1093\/nar\/gkae268","article-title":"Interactive tree of life (iTOL) v6: recent updates to the phylogenetic tree display and annotation tool","volume":"52","author":"Letunic","year":"2024","journal-title":"Nucleic Acids Res"},{"key":"10.1016\/j.ebiom.2025.105979_bib11","doi-asserted-by":"crossref","DOI":"10.1016\/j.drup.2024.101139","article-title":"Fusion event mediated by IS903B between chromosome and plasmid in two MCR-9- and KPC-2-co-producing Klebsiella pneumoniae isolates","volume":"77","author":"Liu","year":"2024","journal-title":"Drug Resist Updat"},{"key":"10.1016\/j.ebiom.2025.105979_bib12","doi-asserted-by":"crossref","first-page":"506","DOI":"10.1186\/s12866-024-03637-2","article-title":"Genomic and phenotypic characterization of ST2012 clinical Klebsiella quasipneumoniae subsp. similipneumoniae harboring blaNDM\u22121 in China","volume":"24","author":"Liu","year":"2024","journal-title":"BMC Microbiol"},{"key":"10.1016\/j.ebiom.2025.105979_bib13","doi-asserted-by":"crossref","first-page":"W296","DOI":"10.1093\/nar\/gky427","article-title":"SWISS-MODEL: homology modelling of protein structures and complexes","volume":"46","author":"Waterhouse","year":"2018","journal-title":"Nucleic Acids Res"},{"key":"10.1016\/j.ebiom.2025.105979_bib14","doi-asserted-by":"crossref","first-page":"1701","DOI":"10.1002\/jcc.20291","article-title":"GROMACS: fast, flexible, and free","volume":"26","author":"Van Der Spoel","year":"2005","journal-title":"J Comput Chem"},{"key":"10.1016\/j.ebiom.2025.105979_bib15","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1002\/jcc.21334","article-title":"AutoDock vina: improving the speed and accuracy of docking with a new scoring function, efficient optimization, and multithreading","volume":"31","author":"Trott","year":"2010","journal-title":"J Comput Chem"},{"key":"10.1016\/j.ebiom.2025.105979_bib16","doi-asserted-by":"crossref","DOI":"10.1128\/msystems.00722-24","article-title":"Evolution of ceftazidime\u2013avibactam resistance driven by mutations in double-copy blaKPC-2 to blaKPC-189 during treatment of ST11 carbapenem-resistant Klebsiella pneumoniae","volume":"9","author":"Zhang","year":"2024","journal-title":"mSystems"},{"key":"10.1016\/j.ebiom.2025.105979_bib17","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1111\/1574-6976.12036","article-title":"The role of variable DNA tandem repeats in bacterial adaptation","volume":"38","author":"Zhou","year":"2014","journal-title":"FEMS Microbiol Rev"},{"key":"10.1016\/j.ebiom.2025.105979_bib18","doi-asserted-by":"crossref","first-page":"5370","DOI":"10.1128\/AAC.05202-11","article-title":"Functional characterization of Tn4401, a Tn3-Based transposon involved in blaKPC gene mobilization","volume":"55","author":"Cuzon","year":"2011","journal-title":"Antimicrob Agents Chemother"},{"key":"10.1016\/j.ebiom.2025.105979_bib19","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1016\/j.tim.2020.05.011","article-title":"The role of integrative and conjugative elements in antibiotic resistance evolution","volume":"29","author":"Botelho","year":"2021","journal-title":"Trends Microbiol"},{"key":"10.1016\/j.ebiom.2025.105979_bib20","doi-asserted-by":"crossref","first-page":"W229","DOI":"10.1093\/nar\/gky352","article-title":"oriTfinder: a web-based tool for the identification of origin of transfers in DNA sequences of bacterial mobile genetic elements","volume":"46","author":"Li","year":"2018","journal-title":"Nucleic Acids Res"},{"key":"10.1016\/j.ebiom.2025.105979_bib21","doi-asserted-by":"crossref","first-page":"3891","DOI":"10.1021\/acs.jcim.1c00203","article-title":"AutoDock vina 1.2.0: new docking methods, expanded force field, and python bindings","volume":"61","author":"Eberhardt","year":"2021","journal-title":"J Chem Inf Model"},{"key":"10.1016\/j.ebiom.2025.105979_bib22","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1080\/14787210.2024.2303028","article-title":"Reviewing novel treatment options for carbapenem-resistant Enterobacterales","volume":"22","author":"Mackow","year":"2024","journal-title":"Expert Rev Anti Infect Ther"},{"key":"10.1016\/j.ebiom.2025.105979_bib23","doi-asserted-by":"crossref","DOI":"10.1371\/journal.ppat.1010334","article-title":"Widespread emergence of OmpK36 loop 3 insertions among multidrug-resistant clones of Klebsiella pneumoniae","volume":"18","author":"David","year":"2022","journal-title":"PLOS Pathog"},{"key":"10.1016\/j.ebiom.2025.105979_bib24","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1128\/MMBR.62.2.275-293.1998","article-title":"Short-sequence DNA repeats in prokaryotic genomes","volume":"62","author":"van Belkum","year":"1998","journal-title":"Microbiol Mol Biol Rev"},{"key":"10.1016\/j.ebiom.2025.105979_bib25","first-page":"203","article-title":"Slipped-strand mispairing: a major mechanism for DNA sequence evolution","volume":"4","author":"Levinson","year":"1987","journal-title":"Mol Biol Evol"},{"key":"10.1016\/j.ebiom.2025.105979_bib26","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1038\/nrclinonc.2009.237","article-title":"Microsatellite instability in colorectal cancer\u2014the stable evidence","volume":"7","author":"Vilar","year":"2010","journal-title":"Nat Rev Clin Oncol"},{"key":"10.1016\/j.ebiom.2025.105979_bib27","doi-asserted-by":"crossref","first-page":"5808","DOI":"10.1038\/s41467-022-33479-3","article-title":"MutS functions as a clamp loader by positioning MutL on the DNA during mismatch repair","volume":"13","author":"Yang","year":"2022","journal-title":"Nat Commun"},{"key":"10.1016\/j.ebiom.2025.105979_bib28","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pgen.1000327","article-title":"A microhomology-mediated break-induced replication model for the origin of human copy number variation","volume":"5","author":"Hastings","year":"2009","journal-title":"PLoS Genet"},{"key":"10.1016\/j.ebiom.2025.105979_bib29","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1016\/j.tig.2014.01.001","article-title":"The role of microhomology in genomic structural variation","volume":"30","author":"Ottaviani","year":"2014","journal-title":"Trends Genet"},{"key":"10.1016\/j.ebiom.2025.105979_bib30","doi-asserted-by":"crossref","first-page":"860","DOI":"10.1016\/j.molcel.2015.10.041","article-title":"Translesion polymerases drive microhomology-mediated break-induced replication leading to complex chromosomal rearrangements","volume":"60","author":"Sakofsky","year":"2015","journal-title":"Mol Cell"},{"key":"10.1016\/j.ebiom.2025.105979_bib31","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1021\/cb3005066","article-title":"Chemically modified tandem repeats in proteins: natural combinatorial peptide libraries","volume":"8","author":"Fuchs","year":"2013","journal-title":"ACS Chem Biol"},{"key":"10.1016\/j.ebiom.2025.105979_bib32","doi-asserted-by":"crossref","first-page":"1763","DOI":"10.1093\/jac\/dkt115","article-title":"Diversity of \u03b2-lactam resistance mechanisms in cystic fibrosis isolates of Pseudomonas aeruginosa: a French multicentre study","volume":"68","author":"Llanes","year":"2013","journal-title":"J Antimicrob Chemother"},{"key":"10.1016\/j.ebiom.2025.105979_bib33","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1186\/s13756-021-00890-2","article-title":"Candida tropicalis distribution and drug resistance is correlated with ERG11 and UPC2 expression","volume":"10","author":"Wang","year":"2021","journal-title":"Antimicrob Resist Infect Control"},{"key":"10.1016\/j.ebiom.2025.105979_bib34","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1016\/j.tim.2020.04.012","article-title":"Carbapenem resistance-encoding and virulence-encoding conjugative plasmids in Klebsiella pneumoniae","volume":"29","author":"Yang","year":"2021","journal-title":"Trends Microbiol"},{"key":"10.1016\/j.ebiom.2025.105979_bib35","article-title":"A clinical KPC-producing Klebsiella michiganensis strain carrying IncFII\/IncFIA (HI1)\/IncFIB (K) multiple replicon plasmid","volume":"13","author":"Zhang","year":"2022","journal-title":"Front Microbiol"},{"key":"10.1016\/j.ebiom.2025.105979_bib36","doi-asserted-by":"crossref","first-page":"603","DOI":"10.1146\/annurev-micro-032521-022006","article-title":"Mobile genetic element flexibility as an underlying principle to bacterial evolution","volume":"77","author":"Weisberg","year":"2023","journal-title":"Annu Rev Microbiol"},{"key":"10.1016\/j.ebiom.2025.105979_bib37","doi-asserted-by":"crossref","DOI":"10.1128\/mSystems.00783-20","article-title":"Emerging transcriptional and genomic mechanisms mediating carbapenem and polymyxin resistance in Enterobacteriaceae : a systematic review of current reports","volume":"5","author":"Mmatli","year":"2020","journal-title":"mSystems"},{"key":"10.1016\/j.ebiom.2025.105979_bib38","first-page":"81","article-title":"Towards an integrated model of bacterial conjugation","volume":"39","author":"Cabez\u00f3n","year":"2014","journal-title":"FEMS Microbiol Rev"},{"key":"10.1016\/j.ebiom.2025.105979_bib39","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1016\/j.jmii.2017.10.006","article-title":"Update on fosfomycin-modified genes in Enterobacteriaceae","volume":"52","author":"Yang","year":"2019","journal-title":"J Microbiol Immunol Infect"}],"container-title":["eBioMedicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2352396425004232?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2352396425004232?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T15:49:54Z","timestamp":1773244194000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S2352396425004232"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11]]},"references-count":39,"alternative-id":["S2352396425004232"],"URL":"https:\/\/doi.org\/10.1016\/j.ebiom.2025.105979","relation":{},"ISSN":["2352-3964"],"issn-type":[{"value":"2352-3964","type":"print"}],"subject":[],"published":{"date-parts":[[2025,11]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Unravelling tandem repeat-mediated mutagenesis drive rapid diversification of KPC enzymes: emergence of blaKPC-263 and enhanced resistance to ceftazidime-avibactam","name":"articletitle","label":"Article Title"},{"value":"eBioMedicine","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.ebiom.2025.105979","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2025 The Author(s). Published by Elsevier B.V.","name":"copyright","label":"Copyright"}],"article-number":"105979"}}