{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T23:11:05Z","timestamp":1787008265452,"version":"build-2736575974"},"reference-count":30,"publisher":"SAGE Publications","issue":"8","license":[{"start":{"date-parts":[[2021,8,1]],"date-time":"2021-08-01T00:00:00Z","timestamp":1627776000000},"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":[[2021,8]]},"abstract":"<jats:p>\n                    The emerging epidemic of carbapenem-resistant\n                    <jats:italic toggle=\"yes\">Klebsiella pneumoniae<\/jats:italic>\n                    (CRKP) is a global public health crisis. However, the phylogenetic affiliation and pathotypic status of CRKP strains in the host colonization period under consistent antibiotic treatments are not well characterized. In this study, a 5-year tracking study was performed, in which a patient admitted to an intensive care unit was recruited and then screened for the carriage of CRKP based on microbiological culture. Nine isolates from the sputum or stool samples were acquired and subjected to real-time whole-genome sequencing, antimicrobial susceptibility testing,\n                    <jats:italic toggle=\"yes\">Galleria mellonella<\/jats:italic>\n                    larval infection, and epithelial cell invasion assay. All nine isolates showed phenotypic resistance to carbapenems, quinolones, and aminoglycosides. Altogether,\n                    <jats:italic toggle=\"yes\">bla<\/jats:italic>\n                    <jats:sub>KPC-2<\/jats:sub>\n                    and 10 other antibiotic resistance genes were identified and all nine CRKP isolates exhibited low virulence with more than 38 virulence factors. All but one variant belonged to ST11 with a novel sequence type, differing at the\n                    <jats:italic toggle=\"yes\">phoE<\/jats:italic>\n                    locus. The isolates shared the same plasmid replicon type, prophages, and capsular serotype (K47) with few single-nucleotide polymorphism variations, consistent with epidemiological clones. Furthermore, these CRKP isolates displayed the ability of moderate invasion of lung epithelial cells. Meanwhile, a deficiency of chromosomal type IV secretion system-related gene cluster was detected after 2 years of carriage. Our findings demonstrated that low-virulence CRKP clones could colonize in the gut and respiratory tract under multiple antibiotic stresses, suggesting the strong colonization adaptability of CRKP to the host. Ethical approval was given by The Second Affiliated Hospital of Zhejiang University, School of Medicine, (2018-039).\n                  <\/jats:p>","DOI":"10.1089\/mdr.2020.0225","type":"journal-article","created":{"date-parts":[[2020,12,28]],"date-time":"2020-12-28T16:49:48Z","timestamp":1609174188000},"page":"1117-1125","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["Genomic and Phenotypic Analysis of Persistent Carbapenem-Resistant\n                    <i>Klebsiella pneumoniae<\/i>\n                    Isolates from a 5-Year Hospitalized Patient"],"prefix":"10.1177","volume":"27","author":[{"given":"Zhiqiang","family":"Yang","sequence":"first","affiliation":[{"name":"National Center for Veterinary Drug Safety Evaluation, College of Veterinary Medicine, China Agricultural University, Beijing, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiaoling","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, The Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shang","family":"Chen","sequence":"additional","affiliation":[{"name":"National Center for Veterinary Drug Safety Evaluation, College of Veterinary Medicine, China Agricultural University, Beijing, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuangyang","family":"Ding","sequence":"additional","affiliation":[{"name":"Beijing Key Laboratory of Detection Technology for Animal-Derived Food Safety and Beijing Laboratory for Food Quality and Safety, College of Veterinary Medicine, China Agricultural University, Beijing, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rong","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, The Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kui","family":"Zhu","sequence":"additional","affiliation":[{"name":"National Center for Veterinary Drug Safety Evaluation, College of Veterinary Medicine, China Agricultural University, Beijing, China."},{"name":"Beijing Key Laboratory of Detection Technology for Animal-Derived Food Safety and Beijing Laboratory for Food Quality and Safety, College of Veterinary Medicine, China Agricultural University, Beijing, China."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2021,8,12]]},"reference":[{"key":"e_1_3_6_2_2","first-page":"and","article-title":"Klebsiella spp","author":"Podschun R.","year":"1998","unstructured":"Podschun R., , and U Ullmann. 1998. Klebsiella spp. as nosocomial pathogens: epidemiology, taxonomy, typing, methods, and pathogenicity factors. Clin. Microbiol. Rev. 11:589\u2013603.","journal-title":"as nosocomial pathogens: epidemiology, taxonomy, typing"},{"key":"e_1_3_6_3_2","doi-asserted-by":"publisher","DOI":"10.2147\/IDR.S229085"},{"key":"e_1_3_6_4_2","doi-asserted-by":"publisher","DOI":"10.1586\/eri.13.12"},{"key":"e_1_3_6_5_2","doi-asserted-by":"publisher","DOI":"10.1093\/femsre\/fux013"},{"key":"e_1_3_6_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(15)00424-7"},{"key":"e_1_3_6_7_2","doi-asserted-by":"publisher","DOI":"10.2147\/IDR.S199844"},{"key":"e_1_3_6_8_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cix270"},{"key":"e_1_3_6_9_2","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1038\/s41426-018-0129-7","article-title":"Evolution of tigecycline- and colistin-resistant CRKP (carbapenem-resistant Klebsiella pneumoniae) in vivo and its persistence in the GI tract","volume":"7","author":"Zhang R.","year":"2018","unstructured":"Zhang R., , Dong N., , Huang Y., , Zhou H., , Xie M., , Chan E.W, , Hu Y., , Cai J., , and Chen S.. 2018. 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