{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T12:19:52Z","timestamp":1791807592794,"version":"4.3.4"},"reference-count":32,"publisher":"SAGE Publications","issue":"10","license":[{"start":{"date-parts":[[2022,10,1]],"date-time":"2022-10-01T00:00:00Z","timestamp":1664582400000},"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":[[2022,10]]},"abstract":"\n Background:<\/jats:title>\n \n Recently, the emergence of carbapenem-resistant hypermucoviscous\n Klebsiella pneumoniae<\/jats:italic>\n has aroused increasing attention in China. We investigated the characteristics of a\n Klebsiella pneumoniae<\/jats:italic>\n carbapenemase-2 (KPC-2) and New Delhi metallo-\u03b2-lactamase-5 (NDM-5) coproducing hypermucoviscous\n K. pneumoniae<\/jats:italic>\n strain, named RJ-8061, which was isolated from the urine of an 86-year-old female patient with pneumonia.\n <\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n \n The RJ-8061 strain was investigated by string test, antimicrobial susceptibility testing, polymerase chain reaction for carbapenemase genes detection, capsular genotyping, multilocus sequence typing, whole-genome sequencing, and phylogenetics. A serum killing assay and a\n Galleria mellonella<\/jats:italic>\n infection model were used to evaluate the virulence of RJ-8061\n in vitro<\/jats:italic>\n and\n in vivo<\/jats:italic>\n .\n <\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n RJ-8061 belonged to the sequence type 11 K64 serotype and showed high-level resistance to almost all frequently used antibiotics, only remaining susceptible to amikacin, colistin, and tigecycline. The complete genome size of RJ-8061 was 6,106,028\u2009bp, including a 5,394,921\u2009bp chromosome and seven circular plasmids. Plasmid pRJ-8061-hybrid is a 294,249\u2009bp hybrid plasmid that co-harbored resistance genes [\n bla<\/jats:italic>\n TEM-1B<\/jats:sub>\n ,\n mph(A)<\/jats:italic>\n ,\n aac(3)-IId<\/jats:italic>\n ] and virulence genes (\n iucABCDiutA<\/jats:italic>\n ,\n rmpA2<\/jats:italic>\n ), whereas\n rmpA2<\/jats:italic>\n is a truncated version. In addition,\n bla<\/jats:italic>\n KPC-2<\/jats:sub>\n and\n bla<\/jats:italic>\n NDM-5<\/jats:sub>\n were located on plasmids 171,321\u2009bp pRJ-8061-KPC-2 (IncFII\/IncR) and 46,161\u2009bp pRJ-8061-NDM-5 (IncX3), respectively. K-mer-based phylogenetic analysis grouped RJ-8061 into a carbapenem-resistant\n Klebsiella pneumoniae<\/jats:italic>\n cluster. The\n G. mellonella<\/jats:italic>\n infection model revealed that RJ-8061 showed relatively low virulence, with a 50% lethal dose of 10\n 6<\/jats:sup>\n cfu.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions:<\/jats:title>\n \n To the best of our knowledge, this is the first report of a hypermucoviscous\n K. pneumoniae<\/jats:italic>\n coproducing KPC-2 and NDM-5 carbapenemases.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1089\/mdr.2021.0342","type":"journal-article","created":{"date-parts":[[2022,9,29]],"date-time":"2022-09-29T13:20:16Z","timestamp":1664457616000},"page":"980-987","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":7,"title":["Emergence of a Hypermucoviscous\n Klebsiella pneumoniae<\/i>\n Strain Coproducing\n K. pneumoniae<\/i>\n Carbapenemase-2 and New Delhi Metallo-\u03b2-Lactamase-5 Carbapenemases in Shanghai, China"],"prefix":"10.1177","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9904-6126","authenticated-orcid":false,"given":"Xuemei","family":"Jiang","sequence":"first","affiliation":[{"name":"Department of Laboratory Medicine, Urumqi Maternal and Child Health Care Hospital, Urumqi, Xinjiang, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lina","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhen","family":"Shen","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junying","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2022,10,14]]},"reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.micpath.2018.01.030"},{"key":"e_1_3_5_3_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41579-019-0315-1"},{"key":"e_1_3_5_4_2","doi-asserted-by":"crossref","first-page":"7","DOI":"10.7196\/SAMJ.2018.v109i1.13696","article-title":"Genomic characterisation of Klebsiella michiganensis co-producing OXA-181 and NDM-1 carbapenemases isolated from a cancer patient in uMgungundlovu District, KwaZulu-Natal Province, South Africa","volume":"109","author":"Founou R.C.","year":"2018","unstructured":"Founou R.C., , Founou L.L, , Allam M., , Ismail A., , and Essack S.Y.. 2018. Genomic characterisation of Klebsiella michiganensis co-producing OXA-181 and NDM-1 carbapenemases isolated from a cancer patient in uMgungundlovu District, KwaZulu-Natal Province, South Africa. S. Afr. Med. J., 109:7\u20138.","journal-title":"S. Afr. Med. J."},{"key":"e_1_3_5_5_2","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1016\/j.ijantimicag.2017.03.012","article-title":"Carbapenem-resistant Enterobacteriaceae in the community: a scoping review","volume":"50","author":"Kelly A.M.","year":"2017","unstructured":"Kelly A.M., , Mathema B., , and Larson E.L.. 2017. Carbapenem-resistant Enterobacteriaceae in the community: a scoping review. Int. J. Antimicrob. Agents., 50:127\u2013134.","journal-title":"Int. J. Antimicrob. 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