{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T19:30:43Z","timestamp":1777923043767,"version":"3.51.4"},"reference-count":42,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2021,3,1]],"date-time":"2021-03-01T00:00:00Z","timestamp":1614556800000},"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":[[2021,3,1]]},"abstract":"<jats:p>\n                    The emergence and spread of carbapenem-resistant hypervirulent\n                    <jats:italic toggle=\"yes\">Klebsiella pneumoniae<\/jats:italic>\n                    (CR-hvKP) is causing worldwide concern. Sequence type (ST) 86\n                    <jats:italic toggle=\"yes\">K. pneumoniae<\/jats:italic>\n                    , a major hvKP clone, is rarely resistant to carbapenem. In this study, we report the genomic features and virulence characteristics of a community-acquired bloodstream infection (CA-BSI)-causing CR-hvKP ST86 strain (KPN55602). This strain is resistant to carbapenem but sensitive to amikacin, gentamicin, tigecycline, and colistin. According to\n                    <jats:italic toggle=\"yes\">in vitro<\/jats:italic>\n                    and\n                    <jats:italic toggle=\"yes\">in vivo<\/jats:italic>\n                    virulence assessments, it was classified as hypervirulent. Whole-genome sequencing revealed that KPN55602 has a single 5.13 Mb chromosome and two plasmids. The chromosome of KPN55602 is phylogenetically similar to those of other sequenced ST86 strains. The incompatibility (Inc) group HI1B plasmid pK55602_1, harboring a set of virulence genes, was classified as a virulence plasmid. The IncX6 plasmid pK55602_2, carrying\n                    <jats:italic toggle=\"yes\">bla<\/jats:italic>\n                    <jats:sub>KPC-2<\/jats:sub>\n                    , was transferable through conjugation and is highly homologous to all five sequenced\n                    <jats:italic toggle=\"yes\">bla<\/jats:italic>\n                    <jats:sub>KPC<\/jats:sub>\n                    -bearing IncX6 plasmids. In conclusion, to our knowledge, this is the first report of a CA-BSI-causing CR-hvKP ST86 strain harboring an exogenous\n                    <jats:italic toggle=\"yes\">bla<\/jats:italic>\n                    <jats:sub>KPC-2<\/jats:sub>\n                    -bearing IncX6 plasmid, supplementing existing knowledge on the CR-hvKP evolutionary scenario. The IncX6 plasmid may be an important vehicle for\n                    <jats:italic toggle=\"yes\">bla<\/jats:italic>\n                    <jats:sub>KPC<\/jats:sub>\n                    , and its horizontal transfer may have led to CR-hvKP evolution in the community setting.\n                  <\/jats:p>","DOI":"10.1089\/mdr.2019.0394","type":"journal-article","created":{"date-parts":[[2020,7,27]],"date-time":"2020-07-27T11:50:51Z","timestamp":1595850651000},"page":"360-368","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":16,"title":["Genomic Features and Virulence Characteristics of a Community-Acquired Bloodstream Infection-Causing Hypervirulent\n                    <i>Klebsiella pneumoniae<\/i>\n                    ST86 Strain Harboring KPC-2-Encoding IncX6 Plasmid"],"prefix":"10.1177","volume":"27","author":[{"given":"Zhou","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Laboratory Medicine and The Second Hospital of Anhui Medical University, Hefei, China."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wenwen","family":"Chu","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine and The Second Hospital of Anhui Medical University, Hefei, China."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xin","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine and The Second Hospital of Anhui Medical University, Hefei, China."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wei","family":"Tang","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine and The Second Hospital of Anhui Medical University, Hefei, China."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jun","family":"Ye","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease, The Second Hospital of Anhui Medical University, Hefei, China."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qiang","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine and The Second Hospital of Anhui Medical University, Hefei, China."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shihe","family":"Guan","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine and The Second Hospital of Anhui Medical University, Hefei, China."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2021,3,12]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1093\/femsre\/fux013"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.1986.00360220057011"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1128\/mBio.00630-15"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.3389\/fcimb.2017.00483"},{"key":"e_1_3_4_6_2","first-page":"721","article-title":"First report of two rapid-onset fatal infections caused by a newly emerging hypervirulent K","volume":"6","author":"Zhang Y.","year":"2015","unstructured":"Zhang Y., , Sun J., , Mi C., , Li W., , Zhao S., , Wang Q., , Shi D., , Liu L., , Ding B., , Chang Y.F, , Guo H., , Guo X., , Li Q., , and Zhu Y.. 2015. First report of two rapid-onset fatal infections caused by a newly emerging hypervirulent K. pneumonia ST86 strain of serotype K2 in China. Front. Microbiol. 6:721.","journal-title":"pneumonia ST86 strain of serotype K2 in China. Front. Microbiol"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.7883\/yoken.JJID.2015.321"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jinf.2015.07.010"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.02173-15"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1590\/0074-02760150423"},{"key":"e_1_3_4_11_2","first-page":"e57","article-title":"Primary osteomyelitis caused by an NDM-1-producing K","volume":"6","author":"Compain F.","year":"2017","unstructured":"Compain F., , Vandenberghe A., , Gominet M., , Genel N., , Lebeaux D., , Ramahefasolo A., , Podglajen I., , and Decre D.. 2017. Primary osteomyelitis caused by an NDM-1-producing K. pneumoniae strain of the highly virulent sequence type 23. Emerg. Microbes Infect. 6:e57.","journal-title":"pneumoniae strain of the highly virulent sequence type 23. Emerg. Microbes Infect"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.3343\/alm.2019.39.2.167"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2334-14-176"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(17)30489-9"},{"key":"e_1_3_4_15_2","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dky164"},{"key":"e_1_3_4_16_2","doi-asserted-by":"publisher","DOI":"10.3389\/fmicb.2016.00895"},{"key":"e_1_3_4_17_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.03053-15"},{"key":"e_1_3_4_18_2","first-page":"2092","volume":"42","author":"Mazloum M.","year":"2016","unstructured":"Mazloum M., , Le Meur M., , Barnaud G., , and Messika J.. 2016. Hypermucoviscous Klebsiella pneumoniae pneumonia: follow the string! Intensive Care Med. 42:2092\u20132093.","journal-title":"Hypermucoviscous Klebsiella pneumoniae pneumonia: follow the string! Intensive Care Med"},{"key":"e_1_3_4_19_2","unstructured":"CLSI. 2018. Performance Standards for Antimicrobial Susceptibility Testing. 28th ed. CLSI Supplement M100. CLSI Wayne PA."},{"key":"e_1_3_4_20_2","unstructured":"CLSI. 2018. Methods for Dilution Antimicrobial Susceptibility Tests for Bacteria that Grow Aerobically. 11th ed. CLSI Standard M07. CLSI Wayne PA."},{"key":"e_1_3_4_21_2","unstructured":"EUCAST. 2017. Breakpoint tables for interpretation of MICs and zone diameters. Version 7.0. 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