{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T13:04:19Z","timestamp":1773752659590,"version":"3.50.1"},"reference-count":17,"publisher":"Cambridge University Press (CUP)","issue":"3","license":[{"start":{"date-parts":[[2016,10,28]],"date-time":"2016-10-28T00:00:00Z","timestamp":1477612800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":["www.cambridge.org"],"crossmark-restriction":true},"short-container-title":["Epidemiol. Infect."],"published-print":{"date-parts":[[2017,2]]},"abstract":"<jats:title>SUMMARY<\/jats:title><jats:p>To date, only a few sporadic cases of infections due to<jats:italic>Klebsiella pneumoniae<\/jats:italic>carbapenemase (KPC) producers have been reported in Portugal. Here, we report for the first time an outbreak of<jats:italic>K. pneumoniae<\/jats:italic>KPC-3 producers in a tertiary-care hospital during 2013. Twenty-seven ertapenem-resistant<jats:italic>K. pneumoniae<\/jats:italic>were identified in patients at a tertiary-care hospital during 2013 isolated predominantly from urine (48\u00b71%) and blood (25\u00b79%) cultures. All isolates were highly resistant to<jats:italic>\u03b2<\/jats:italic>-lactam antibiotics and most showed intermediate resistance to imipenem. The more frequent<jats:italic>\u03b2<\/jats:italic>-lactamases were TEM- (77\u00b77%), CTX-M- (70\u00b73%) and KPC-type (66\u00b76%). KPC-3 was identified by sequencing. The<jats:italic>bla<\/jats:italic><jats:sub>KPC\u22123<\/jats:sub>gene was associated with an IncF plasmid, and efficiently transferred to<jats:italic>E. coli<\/jats:italic>J53. Pulsed-field gel electrophoresis typing revealed three clusters of isolates which were further characterized by multi-locus sequence typing as ST11, ST15 and ST348. Ertapenem-resistant ST15 was already in circulation in the hospital, related to expression of OmpK36 modified porin, but the other two sequence types had not been previously found in the hospital. We conclude that the IncF plasmid mediated transfer of KPC-3 in the outbreak and that implementation of carbapenemase gene screening in isolates from patients on admission to hospital is advisable in order to control dissemination of these antimicrobial resistance elements.<\/jats:p>","DOI":"10.1017\/s0950268816002442","type":"journal-article","created":{"date-parts":[[2016,10,28]],"date-time":"2016-10-28T07:03:32Z","timestamp":1477638212000},"page":"595-599","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":43,"title":["Outbreak of KPC-3-producing ST15 and ST348<i>Klebsiella pneumoniae<\/i>in a Portuguese hospital"],"prefix":"10.1017","volume":"145","author":[{"given":"D.","family":"VUBIL","sequence":"first","affiliation":[]},{"given":"R.","family":"FIGUEIREDO","sequence":"additional","affiliation":[]},{"given":"T.","family":"REIS","sequence":"additional","affiliation":[]},{"given":"C.","family":"CANHA","sequence":"additional","affiliation":[]},{"given":"L.","family":"BOAVENTURA","sequence":"additional","affiliation":[]},{"given":"G. 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European Committee on Antimicrobial Susceptibility Testing Breakpoint tables for interpretation of MICs and zone diameters European Committee on Antimicrobial Susceptibility Testing Breakpoint tables for interpretation of MICs and zone diameters 2014, pp. 1\u201377 (http:\/\/www.eucast.org\/clinical_breakpoints). Accessed 15 January 2015."},{"key":"S0950268816002442_ref14","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijmm.2013.02.008"},{"key":"S0950268816002442_ref6","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.01412-06"},{"key":"S0950268816002442_ref2","doi-asserted-by":"publisher","DOI":"10.1007\/s10096-012-1665-z"},{"key":"S0950268816002442_ref10","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijmm.2013.02.001"},{"key":"S0950268816002442_ref15","doi-asserted-by":"publisher","DOI":"10.1016\/j.diagmicrobio.2013.08.031"},{"key":"S0950268816002442_ref1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(13)70190-7"}],"container-title":["Epidemiology and Infection"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0950268816002442","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,9,27]],"date-time":"2020-09-27T00:49:41Z","timestamp":1601167781000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0950268816002442\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,10,28]]},"references-count":17,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2017,2]]}},"alternative-id":["S0950268816002442"],"URL":"https:\/\/doi.org\/10.1017\/s0950268816002442","relation":{},"ISSN":["0950-2688","1469-4409"],"issn-type":[{"value":"0950-2688","type":"print"},{"value":"1469-4409","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,10,28]]},"assertion":[{"value":"Copyright \u00a9 Cambridge University Press 2016\u00a0","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}}]}}