{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T02:50:37Z","timestamp":1792637437985,"version":"4.5.0"},"reference-count":20,"publisher":"Oxford University Press (OUP)","issue":"12","license":[{"start":{"date-parts":[[2024,9,23]],"date-time":"2024-09-23T00:00:00Z","timestamp":1727049600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/501100010253","name":"UBACYT","doi-asserted-by":"publisher","award":["20020220300060BA"],"award-info":[{"award-number":["20020220300060BA"]}],"id":[{"id":"10.13039\/501100010253","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,12,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>A drastic increase in carbapenem resistance among Klebsiella pneumoniae isolates occurred during the period 2019\u201322. Three epidemiological changes could be evidenced: (i) NDM became the predominant carbapenemase; (ii) NDM-5 replaced NDM-1; and (iii) the emergence of NDM-producing K. pneumoniae ST258 (NDM-KpST258).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Materials and methods<\/jats:title>\n                  <jats:p>Carbapenem-resistant K. pneumoniae isolates from patients on the ICU of a university hospital of Buenos Aires were studied during the period 2019\u201322. Identification was performed by MS and susceptibility by the Phoenix system (broth microdilution for colistin). Carbapenemase production was detected phenotypically. Molecular studies included PCR with specific primers and WGS (in some isolates).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>NDM-producing K. pneumoniae was statistically associated with the use of ceftazidime\/avibactam between 2019 and April 2021, whereas in the period from May 2021 to December 2022, it seemed to be related to the presence of NDM-5-KpST258. A gradual increase in the number of urease-negative NDM-Kp-ST258 during 2019\u201322 was observed. The plasmid origin of NDM-5 was supported by its presence on the IncFII incompatibility group plasmid.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Our study describes the first outbreak of NDM5-KpST258 at an ICU in Argentina, remarkably associated with considerable changes in the carbapenemase epidemiology. The intrinsic characteristics of ST258 may contribute to increased spread of NDM in hospital settings, resembling KPC-2 dissemination.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jac\/dkae337","type":"journal-article","created":{"date-parts":[[2024,9,23]],"date-time":"2024-09-23T09:38:46Z","timestamp":1727084326000},"page":"3174-3177","source":"Crossref","is-referenced-by-count":7,"title":["NDM-5-producing <i>Klebsiella pneumoniae<\/i> ST258 in a university hospital in Argentina"],"prefix":"10.1093","volume":"79","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0614-3056","authenticated-orcid":false,"given":"Carla","family":"Alvarez","sequence":"first","affiliation":[{"name":"Universidad de Buenos Aires , Departamento de Bioqu\u00edmica Cl\u00ednica, Avenida C\u00f3rdoba 2351, Buenos Aires City 1120 ,","place":["Argentina"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcela","family":"Nastro","sequence":"additional","affiliation":[{"name":"Universidad 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Bioqu\u00edmica Cl\u00ednica, Avenida C\u00f3rdoba 2351, Buenos Aires City 1120 ,","place":["Argentina"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos","family":"Vay","sequence":"additional","affiliation":[{"name":"Universidad de Buenos Aires , Departamento de Bioqu\u00edmica Cl\u00ednica, Avenida C\u00f3rdoba 2351, Buenos Aires City 1120 ,","place":["Argentina"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9937-9572","authenticated-orcid":false,"given":"Thierry","family":"Naas","sequence":"additional","affiliation":[{"name":"Team ReSIST, UMR1184, INSERM, Universit\u00e9 Paris-Saclay, CEA, School of Medicine , LabEx LERMIT, Le Kremlin-Bic\u00eatre ,","place":["France"]},{"name":"Bacteriology-Hygiene unit, Bic\u00eatre Hospital, APHP Paris-Saclay , Le Kremlin-Bic\u00eatre ,","place":["France"]},{"name":"French National Reference Center for Antibiotic Resistance: Carbapenemase-producing Enterobacterales , Le 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