{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T10:38:24Z","timestamp":1791887904133,"version":"4.3.4"},"reference-count":20,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2020,1,18]],"date-time":"2020-01-18T00:00:00Z","timestamp":1579305600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/100008535","name":"Calgary Laboratory Services","doi-asserted-by":"publisher","award":["10015169"],"award-info":[{"award-number":["10015169"]}],"id":[{"id":"10.13039\/100008535","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01AI090155"],"award-info":[{"award-number":["R01AI090155"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"name":"NHLS Research Trust"},{"name":"RESCOM"},{"DOI":"10.13039\/501100001343","name":"University of Pretoria","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001343","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,4,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Klebsiella pneumoniae with OXA-48-like enzymes were introduced into Tshwane Tertiary Hospital (TTH) (Pretoria, South Africa) during September 2015, causing nosocomial outbreaks.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>PCR methodologies and WGS were used to characterize K. pneumoniae with carbapenemases (n\u2009=\u2009124) from TTH (July 2015\u2013December 2016).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>PCR was used to track K. pneumoniae ST307 with OXA-181 among 60% of carbapenemase-positive isolates in different wards\/units over time and showed the transmission of IncX3 plasmids to other K. pneumoniae clones. WGS identified different ST307 clades: 307_OXA181 (consisting of two lineages, A and B) with OXA-181 on IncX3 plasmids (named p72_X3_OXA181) and clade 307_VIM with VIM-1 on IncFII plasmids. Clade 307_OXA181 lineage B was responsible for the rapid increase and transmission of OXA-181 K. pneumoniae in various wards\/units throughout TTH, while the numbers of clade 307_OXA181 lineage A and clade 307_VIM remained low. Separate outbreaks were due to K. pneumoniae ST17 and ST29 with p72_X3_OXA181 plasmids.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The high-risk clone K. pneumoniae ST307 with OXA-181 rapidly spread to different wards\/units despite infection and prevention measures. ST307 clades and lineages seemingly acted differently in outbreak situations. This study also highlighted the threat of promiscuous plasmids such as p72_X3_OXA181.<\/jats:p><\/jats:sec>","DOI":"10.1093\/jac\/dkz550","type":"journal-article","created":{"date-parts":[[2020,1,13]],"date-time":"2020-01-13T20:12:15Z","timestamp":1578946335000},"page":"896-902","source":"Crossref","is-referenced-by-count":45,"title":["Klebsiella pneumoniae ST307 with OXA-181: threat of a high-risk clone and promiscuous plasmid in a resource-constrained healthcare setting"],"prefix":"10.1093","volume":"75","author":[{"given":"K A","family":"Strydom","sequence":"first","affiliation":[{"name":"University of Pretoria, Pretoria, Gauteng, South Africa"},{"name":"National Health Laboratory Service, Pretoria, Gauteng, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L","family":"Chen","sequence":"first","affiliation":[{"name":"Hackensack Meridian Health, Nutley, NJ, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M 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