{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T19:31:56Z","timestamp":1777923116652,"version":"3.51.4"},"reference-count":44,"publisher":"SAGE Publications","issue":"10","license":[{"start":{"date-parts":[[2021,10,1]],"date-time":"2021-10-01T00:00:00Z","timestamp":1633046400000},"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":[[2021,10]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>\n                      The emergence and wide global spread of carbapenem-resistant\n                      <jats:italic toggle=\"yes\">Klebsiella pneumoniae<\/jats:italic>\n                      (CRKP) isolates are of great concern, and the aim of this study was to investigate drug resistance, molecular epidemiology, and genetic relationship of CRKP isolates from patients in Shanghai, China.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A retrospective study was conducted from April 2018 to July 2019, and a total of 133 CRKP isolates were collected. Antimicrobial susceptibility was determined by VITEK-2 automated microbiology analyzer platform (bioM\u00e9rieux, France) and the broth microdilution method. Polymerase chain reaction assays were used to investigate the presence of drug resistance genes. A modified carbapenem inactivation method was performed to detect carbapenemases. Multilocus sequence typing and pulsed-field gel electrophoresis (PFGE) were conducted for genetic relatedness of 50 CRKP isolates selected.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Among 670 isolates of\n                      <jats:italic toggle=\"yes\">K. pneumoniae<\/jats:italic>\n                      , 133 (19.9%) strains were identified as CRKP, of which, 76.7% (102\/133) strains were isolated from intensive care units (ICUs). All the 133 CRKP isolates were found to be carbapenemase-producers and harbor bla\n                      <jats:italic toggle=\"yes\">KPC-2<\/jats:italic>\n                      gene. No other carbapenemase genes of\n                      <jats:italic toggle=\"yes\">blaNDM<\/jats:italic>\n                      ,\n                      <jats:italic toggle=\"yes\">blaOXA-48<\/jats:italic>\n                      ,\n                      <jats:italic toggle=\"yes\">blaVIM<\/jats:italic>\n                      , and\n                      <jats:italic toggle=\"yes\">blaIMP<\/jats:italic>\n                      were detected. Furthermore, \u03b2-lactamase genes of\n                      <jats:italic toggle=\"yes\">blaSHV<\/jats:italic>\n                      ,\n                      <jats:italic toggle=\"yes\">blaCTX<\/jats:italic>\n                      , and\n                      <jats:italic toggle=\"yes\">blaTEM<\/jats:italic>\n                      were the most common resistance-associated genes among these\n                      <jats:italic toggle=\"yes\">KPC-2<\/jats:italic>\n                      producing isolates. All the 133 CRKP strains displayed &gt;95% of resistance to cephalosporins and carbapenems, except for gentamicin, trimethoprim-sulfamethoxazole, amikacin, tigecycline and colistin, and ceftazidime-avibactam. The most common sequence type was ST11, accounting for 90.0% of the 50 CRKP selected, followed by ST15 (10.0%). PFGE analysis clustered the 50\n                      <jats:italic toggle=\"yes\">KPC-2-<\/jats:italic>\n                      producing isolates into seven (A\u2013G) distinct clonal clusters at 85% cutoff. Of which, A and G were the two major clusters, accounting for the majority of the strains collected in emergency ICU and neurosurgical ICU. And all the strains of clusters D and E were collected in cardiothoracic surgery ICU, except for one strain collected in one outpatient.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>\n                      The\n                      <jats:italic toggle=\"yes\">KPC-2<\/jats:italic>\n                      -producing\n                      <jats:italic toggle=\"yes\">K. pneumoniae<\/jats:italic>\n                      belonged to ST11 was widely disseminated in ICUs, and active and effective surveillance of infection control strategies was initiated to limit the spread of CRKP strains.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/mdr.2020.0390","type":"journal-article","created":{"date-parts":[[2021,7,23]],"date-time":"2021-07-23T16:58:05Z","timestamp":1627059485000},"page":"1312-1318","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":21,"title":["Resistance Phenotype and Molecular Epidemiology of Carbapenem-Resistant\n                    <i>Klebsiella pneumoniae<\/i>\n                    Isolates in Shanghai"],"prefix":"10.1177","volume":"27","author":[{"given":"Wen-Xia","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Clinical Laboratory, Shanghai Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hong-You","family":"Chen","sequence":"additional","affiliation":[{"name":"Laboratory of Bacterial, Shanghai Center for Disease Control and Prevention, Shanghai, China."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chen","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, Shanghai Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jun-Hao","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, Shanghai Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fa-Sheng","family":"Wan","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, Shanghai Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ling-Xia","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, Shanghai Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Min","family":"Chen","sequence":"additional","affiliation":[{"name":"Laboratory of Bacterial, Shanghai Center for Disease Control and Prevention, Shanghai, China."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jue","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, Shanghai Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2021,10,14]]},"reference":[{"key":"e_1_3_7_2_2","doi-asserted-by":"crossref","first-page":"311","DOI":"10.1016\/j.ijid.2020.02.009","article-title":"Molecular epidemiology of carbapenem-resistant Klebsiella pneumoniae in a paediatric hospital in China","volume":"93","author":"Wang B.","year":"2020","unstructured":"Wang B., , Pan F., , Wang C., , Zhao W., , Sun Y., , Zhang T., , Shi Y., , and Zhang H.. 2020. 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