{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T09:16:11Z","timestamp":1790241371517,"version":"4.1.0"},"reference-count":20,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2020,5,9]],"date-time":"2020-05-09T00:00:00Z","timestamp":1588982400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"University Paris-Sud"},{"DOI":"10.13039\/501100011879","name":"Laboratory of Excellence in Research on Medication and Innovative Therapeutics","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100011879","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001665","name":"French National Research Agency","doi-asserted-by":"publisher","award":["ANR-10-LABX-33"],"award-info":[{"award-number":["ANR-10-LABX-33"]}],"id":[{"id":"10.13039\/501100001665","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100013281","name":"Joint Programming Initiative on Antimicrobial Resistance","doi-asserted-by":"publisher","award":["ANR-14-JAMR-002"],"award-info":[{"award-number":["ANR-14-JAMR-002"]}],"id":[{"id":"10.13039\/100013281","id-type":"DOI","asserted-by":"publisher"}]},{"name":"European Union\u2019s Horizon 2020 Research and Innovation Program","award":["773830"],"award-info":[{"award-number":["773830"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>KPC-producing Klebsiella pneumoniae of clonal group 258 are prominent in healthcare settings in many regions of the world. The blaKPC gene is mostly carried by a multireplicon IncFIIk-IncFI plasmid suspected to be highly compatible and stable in this genetic background. Here, we analysed the genetic diversity of an ST512 K. pneumoniae population in a single patient.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Twelve K. pneumoniae isolates (n\u2009=\u20095 from urine samples and n\u2009=\u20097 from rectal swabs) were recovered from one patient over a 2\u2009month period. Antimicrobial susceptibility testing, plasmid extraction and WGS were performed on all isolates. The first K. pneumoniae isolate, D1, was used as a reference for phylogenetic analysis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Antimicrobial susceptibility testing, plasmid analysis and WGS revealed concomitant carriage of carbapenem-resistant and carbapenem-susceptible K. pneumoniae isolates of ST512, with the absence of the entire blaKPC-carrying plasmid in the susceptible population. Furthermore, 14 other genetic events occurred within the genome, including 3 chromosomal deletions (of 71\u2009kb, 33\u2009kb and 11\u2009bp), 2 different insertions of ISKpn26 and 9 SNPs. Interestingly, most of the events occurred in the same chromosomal region that has been deleted independently several times, probably after homologous recombination involving 259\u2009bp repeated sequences.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Our study revealed (to the best of our knowledge) the first case of in vivo blaKPC-carrying plasmid curing and a wide within-patient genetic diversity of a single K. pneumoniae ST512 clone over a short period of carriage. This within-patient diversity must be taken into account when characterizing transmission chains using WGS during nosocomial outbreaks.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jac\/dkaa137","type":"journal-article","created":{"date-parts":[[2020,3,19]],"date-time":"2020-03-19T12:11:38Z","timestamp":1584619898000},"source":"Crossref","is-referenced-by-count":8,"title":["Concomitant carriage of KPC-producing and non-KPC-producing Klebsiella pneumoniae ST512 within a single patient"],"prefix":"10.1093","author":[{"given":"Agn\u00e8s B","family":"Jousset","sequence":"first","affiliation":[{"name":"EA7361 \u2018Structure, Dynamic, Function and Expression of Broad Spectrum \u03b2-Lactamases\u2019, University Paris-Saclay, LabEx Lermit, Faculty of Medicine, Le Kremlin-Bic\u00eatre, France"},{"name":"Bacteriology-Hygiene Unit, Assistance Publique\/H\u00f4pitaux de Paris, Bic\u00eatre Hospital, Le Kremlin-Bic\u00eatre, France"},{"name":"Associated French National Reference Centre for Antibiotic Resistance: Carbapenemase-Producing Enterobacteriaceae, Le Kremlin-Bic\u00eatre, France"},{"name":"Evolution and Ecology of Resistance to Antibiotics Unit, Institut Pasteur\u2014Assistance Publique\/H\u00f4pitaux de Paris\u2014University Paris-Saclay, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2307-3232","authenticated-orcid":false,"given":"R\u00e9my A","family":"Bonnin","sequence":"first","affiliation":[{"name":"EA7361 \u2018Structure, Dynamic, Function and Expression of Broad Spectrum \u03b2-Lactamases\u2019, University Paris-Saclay, LabEx Lermit, Faculty of Medicine, Le Kremlin-Bic\u00eatre, France"},{"name":"Associated French National Reference Centre for Antibiotic Resistance: Carbapenemase-Producing Enterobacteriaceae, Le Kremlin-Bic\u00eatre, France"},{"name":"Evolution and Ecology of Resistance to Antibiotics Unit, Institut Pasteur\u2014Assistance Publique\/H\u00f4pitaux de Paris\u2014University Paris-Saclay, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie","family":"Takissian","sequence":"first","affiliation":[{"name":"EA7361 \u2018Structure, Dynamic, Function and Expression of Broad Spectrum \u03b2-Lactamases\u2019, University Paris-Saclay, LabEx Lermit, Faculty of Medicine, Le Kremlin-Bic\u00eatre, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Delphine","family":"Girlich","sequence":"first","affiliation":[{"name":"EA7361 \u2018Structure, Dynamic, Function and Expression of Broad Spectrum \u03b2-Lactamases\u2019, University Paris-Saclay, LabEx Lermit, Faculty of Medicine, Le Kremlin-Bic\u00eatre, France"},{"name":"Evolution and Ecology of Resistance to Antibiotics Unit, Institut Pasteur\u2014Assistance Publique\/H\u00f4pitaux de Paris\u2014University Paris-Saclay, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liliana","family":"Mihaila","sequence":"first","affiliation":[{"name":"Bacteriology-Hygiene Unit, Assistance Publique\/H\u00f4pitaux de Paris, Bic\u00eatre Hospital, Le Kremlin-Bic\u00eatre, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolas","family":"Cabanel","sequence":"first","affiliation":[{"name":"Evolution and Ecology of Resistance to Antibiotics Unit, Institut Pasteur\u2014Assistance Publique\/H\u00f4pitaux de Paris\u2014University Paris-Saclay, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurent","family":"Dortet","sequence":"first","affiliation":[{"name":"EA7361 \u2018Structure, Dynamic, Function and Expression of Broad Spectrum \u03b2-Lactamases\u2019, University Paris-Saclay, LabEx Lermit, Faculty of Medicine, Le Kremlin-Bic\u00eatre, France"},{"name":"Bacteriology-Hygiene Unit, Assistance Publique\/H\u00f4pitaux de Paris, Bic\u00eatre Hospital, Le Kremlin-Bic\u00eatre, France"},{"name":"Associated French National Reference Centre for Antibiotic Resistance: Carbapenemase-Producing Enterobacteriaceae, Le Kremlin-Bic\u00eatre, France"},{"name":"Evolution and Ecology of Resistance to Antibiotics Unit, Institut Pasteur\u2014Assistance Publique\/H\u00f4pitaux de Paris\u2014University Paris-Saclay, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philippe","family":"Glaser","sequence":"first","affiliation":[{"name":"Evolution and Ecology of Resistance to Antibiotics Unit, Institut Pasteur\u2014Assistance Publique\/H\u00f4pitaux de Paris\u2014University Paris-Saclay, Paris, France"},{"name":"CNRS UMR3525, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9937-9572","authenticated-orcid":false,"given":"Thierry","family":"Naas","sequence":"first","affiliation":[{"name":"EA7361 \u2018Structure, Dynamic, Function and Expression of Broad 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