{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T16:04:30Z","timestamp":1779984270706,"version":"3.53.1"},"reference-count":71,"publisher":"Microbiology Society","issue":"5","license":[{"start":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T00:00:00Z","timestamp":1779926400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Fund of China","doi-asserted-by":"crossref","award":["82272394"],"award-info":[{"award-number":["82272394"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,5,28]]},"abstract":"<jats:p>\n                    Carbapenem-resistant\n                    <jats:italic>Klebsiella pneumoniae<\/jats:italic>\n                    (CRKP) poses a significant threat to global public health. Identifying high-risk clones that facilitate the global dissemination of carbapenemases is essential for developing effective strategies to address this challenge. Here, we collected 29 ST307 CRKP isolates harbouring the\n                    <jats:italic>bla<\/jats:italic>\n                    <jats:sub>KPC-2<\/jats:sub>\n                    and\/or\n                    <jats:italic>bla<\/jats:italic>\n                    <jats:sub>NDM-5<\/jats:sub>\n                    genes from three hospitals.\n                    <jats:italic>bla<\/jats:italic>\n                    <jats:sub>NDM-5<\/jats:sub>\n                    was carried by the IncX3 plasmid, and\n                    <jats:italic>bla<\/jats:italic>\n                    <jats:sub>KPC-2<\/jats:sub>\n                    was located on an IncFII plasmid. All of them were horizontally transmissible as verified by plasmid conjugation assays. Phylogenetic analysis revealed a clonal outbreak involving 27 of the isolates in this study and further demonstrated an emerging trend of\n                    <jats:italic>bla<\/jats:italic>\n                    <jats:sub>KPC-2<\/jats:sub>\n                    - and\n                    <jats:italic>bla<\/jats:italic>\n                    <jats:sub>NDM-5<\/jats:sub>\n                    -positive CRKP strains within the ST307 lineages in China since 2023. Resistance to \u2018last-resort\u2019 antibiotics mediated by genetic mutations is a major contributor to treatment failure in CRKP infections. In this study, we functionally confirmed that the plasmid-borne\n                    <jats:italic>tet<\/jats:italic>\n                    (A)\n                    <jats:sup>I235F<\/jats:sup>\n                    mutation confers resistance to both tigecycline and eravacycline. The results of the murine bloodstream infection model further demonstrated that the\n                    <jats:italic>tet<\/jats:italic>\n                    (A)\n                    <jats:sup>I235F<\/jats:sup>\n                    mutation increased the treatment cost of tigecycline. Furthermore, we found colistin resistance in ST307 CRKP primarily mediated by mutations in the\n                    <jats:italic>mgrB<\/jats:italic>\n                    and\n                    <jats:italic>pmrB<\/jats:italic>\n                    genes. Specific mutation patterns, including\n                    <jats:italic>mgrB<\/jats:italic>\n                    disruption by IS\n                    <jats:italic>5D<\/jats:italic>\n                    ,\n                    <jats:italic>mgrB<\/jats:italic>\n                    W20* and\n                    <jats:italic>pmrB<\/jats:italic>\n                    S203P substitutions, were identified in nine colistin-resistant ST307 CRKP isolates in this study. These findings highlight the need for enhanced surveillance and control measures to prevent the potential widespread outbreak of extensively drug-resistant ST307 isolates in China.\n                  <\/jats:p>","DOI":"10.1099\/mgen.0.001718","type":"journal-article","created":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T15:16:34Z","timestamp":1779981394000},"source":"Crossref","is-referenced-by-count":0,"title":["Emergence and dissemination of extensively drug-resistant ST307 Klebsiella pneumoniae in China"],"prefix":"10.1099","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-3285-3905","authenticated-orcid":false,"given":"Weihua","family":"Han","sequence":"first","affiliation":[{"name":"Department of Clinical Laboratory, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, PR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinru","family":"Yuan","sequence":"additional","affiliation":[{"name":"Department of Clinical 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China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peiyao","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, PR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haojin","family":"Gao","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, PR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, PR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhixuan","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, PR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinjin","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, PR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiana","family":"Fu","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, PR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinyi","family":"Fu","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, PR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiawen","family":"Lou","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, Shanghai Pulmonary 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