{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T11:23:01Z","timestamp":1779276181532,"version":"3.51.4"},"reference-count":31,"publisher":"SAGE Publications","issue":"8","license":[{"start":{"date-parts":[[2018,10,1]],"date-time":"2018-10-01T00:00:00Z","timestamp":1538352000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Microbial Drug Resistance"],"published-print":{"date-parts":[[2018,10]]},"abstract":"<jats:p>\n                    Here we report an outbreak of extended spectrum \u03b2-lactamase-producing\n                    <jats:italic toggle=\"yes\">Klebsiella pneumoniae<\/jats:italic>\n                    that occurred in a neonatal intensive care unit in Northern Italy and involved 97 patients. Progressively tightened sets of containment measures were implemented but the epidemic event was stopped only 9 months later. The final, effective, containment strategy consisted of the application of strict geographic cohorting of colonized infants and their nursing staff, the suspension of any new admission and a rigorous daily sterilization protocol for all surfaces and fomites in the ward.\n                    <jats:italic toggle=\"yes\">A posteriori<\/jats:italic>\n                    characterization of the outbreak strain was performed using both traditional microbiology and molecular biology techniques, and whole genome sequencing, allowing to compare outbreak isolates with other strains collected in the previous two years. The results allowed to determine that the outbreak strain had been circulating inside the ward since the year before. Genomic characterization revealed that the strain carried a wide array of virulence and antibiotic resistance determinants, including gene\n                    <jats:italic toggle=\"yes\">bla<\/jats:italic>\n                    <jats:sub>TEM-206<\/jats:sub>\n                    , which had never been reported in a clinical isolate of\n                    <jats:italic toggle=\"yes\">K. pneumoniae<\/jats:italic>\n                    before. The presence of such a high number of determinants for antibiotic resistance imposes significant therapeutic limitations on the treatment of infections, thus, further epidemiological investigations are needed to evaluate the prevalence of the newly described variant.\n                  <\/jats:p>","DOI":"10.1089\/mdr.2017.0270","type":"journal-article","created":{"date-parts":[[2018,1,25]],"date-time":"2018-01-25T11:50:33Z","timestamp":1516881033000},"page":"1128-1136","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":15,"title":["Characterization of an Outbreak of Extended-Spectrum \u03b2-Lactamase-Producing\n                    <i>Klebsiella pneumoniae<\/i>\n                    in a Neonatal Intensive Care Unit in Italy"],"prefix":"10.1177","volume":"24","author":[{"given":"Marta","family":"Corbella","sequence":"first","affiliation":[{"name":"Fondazione IRCCS Policlinico San Matteo","place":["Italy"]},{"name":"Fondazione IRCCS Policlinico San Matteo","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mariasofia","family":"Caltagirone","sequence":"additional","affiliation":[{"name":"Universit\u00e0 di Pavia","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefano","family":"Gaiarsa","sequence":"additional","affiliation":[{"name":"Fondazione IRCCS Policlinico San Matteo","place":["Italy"]},{"name":"Universit\u00e0 degli Studi di Milano","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bianca","family":"Mariani","sequence":"additional","affiliation":[{"name":"Fondazione IRCCS Policlinico San Matteo","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Davide","family":"Sassera","sequence":"additional","affiliation":[{"name":"Universit\u00e0 degli Studi di Pavia","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ibrahim","family":"Bitar","sequence":"additional","affiliation":[{"name":"Universit\u00e0 di Pavia","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alba","family":"Muzzi","sequence":"additional","affiliation":[{"name":"Fondazione IRCCS Policlinico San Matteo","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roberta","family":"Migliavacca","sequence":"additional","affiliation":[{"name":"Universit\u00e0 di Pavia","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luigia","family":"Scudeller","sequence":"additional","affiliation":[{"name":"Fondazione IRCCS Policlinico San Matteo","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mauro","family":"Stronati","sequence":"additional","affiliation":[{"name":"Fondazione IRCCS Policlinico San Matteo","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patrizia","family":"Cambieri","sequence":"additional","affiliation":[{"name":"Fondazione IRCCS Policlinico San Matteo","place":["Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2018,10,9]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"crossref","first-page":"942","DOI":"10.3855\/jidc.4590","article-title":"Gram-negative infections in pediatric and neonatal intensive care units of Latin America","volume":"8","author":"Berezin E.N.","year":"2014","unstructured":"Berezin E.N., , Sol\u00f3rzano F.; Latin America Working Group on Bacterial Resistance. 2014. Gram-negative infections in pediatric and neonatal intensive care units of Latin America. J. Infect. Dev. Ctries., 8:942\u2013953.","journal-title":"J. Infect. Dev. Ctries."},{"issue":"1","key":"e_1_3_3_3_2","doi-asserted-by":"crossref","first-page":"23","DOI":"10.3109\/14767058.2011.607567","article-title":"Prevention of nosocomial infections and surveillance of emerging resistances in NICU","volume":"24","author":"Cipolla D.","year":"2011","unstructured":"Cipolla D., , Giuffr\u00e8 M., , Mammina C., , and Corsello G.. 2011. Prevention of nosocomial infections and surveillance of emerging resistances in NICU. J. Matern. Fetal. Neonatal Med., 24 Suppl 1:23\u201326.","journal-title":"J. Matern. Fetal. 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