{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T12:20:03Z","timestamp":1791807603958,"version":"4.3.4"},"reference-count":29,"publisher":"American Society for Microbiology","issue":"11","license":[{"start":{"date-parts":[[2024,11,6]],"date-time":"2024-11-06T00:00:00Z","timestamp":1730851200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2024,11,6]],"date-time":"2024-11-06T00:00:00Z","timestamp":1730851200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["Antimicrob Agents Chemother"],"published-print":{"date-parts":[[2024,11,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title\/>\n                    <jats:p>\n                      Carbapenemase-producing\n                      <jats:italic>Klebsiella pneumoniae<\/jats:italic>\n                      (CP-Kp) isolates are a public health concern as they can cause severe hospital-acquired infections that are difficult to treat. It has recently been shown that CP-Kp can take up virulence factors from hypervirulent\n                      <jats:italic>K. pneumoniae<\/jats:italic>\n                      lineages. In this study, 109 clinical CP-Kp isolates from the University Hospital Cologne were examined for the presence of acquired virulence factors using whole-genome sequencing and phenotypic tests, and results were linked to clinical data. The virulence factor\n                      <jats:italic>iuc<\/jats:italic>\n                      was present in 18\/109 of the CP-Kp isolates. Other acquired virulence factors, such as\n                      <jats:italic>ybt<\/jats:italic>\n                      ,\n                      <jats:italic>cbt<\/jats:italic>\n                      ,\n                      <jats:italic>iro<\/jats:italic>\n                      ,\n                      <jats:italic>rmpA\/rmpA2<\/jats:italic>\n                      ,\n                      <jats:italic>peg-344<\/jats:italic>\n                      , and hypervirulence-associated capsule types were detected in various combinations among these isolates. The\n                      <jats:italic>iuc<\/jats:italic>\n                      -positive isolates produced OXA-232 (\n                      <jats:italic>n<\/jats:italic>\n                      = 7), OXA-48 (\n                      <jats:italic>n<\/jats:italic>\n                      = 6), OXA-48+NDM (\n                      <jats:italic>n<\/jats:italic>\n                      = 3), NDM, and KPC (each\n                      <jats:italic>n<\/jats:italic>\n                      = 1), and 7\/18 isolates were resistant to ceftazidime-avibactam, colistin, and\/or cefiderocol. Four isolates carried hybrid plasmids that harbored acquired virulence factors alongside the carbapenemase genes\n                      <jats:italic>bla<\/jats:italic>\n                      <jats:sub>NDM-1\/5<\/jats:sub>\n                      or\n                      <jats:italic>bla<\/jats:italic>\n                      <jats:sub>OXA-48<\/jats:sub>\n                      . In 15\/18 patients,\n                      <jats:italic>iuc<\/jats:italic>\n                      -positive CP-Kp were isolated from a clinically manifest infection site. Among these, four patients had osteomyelitis, and four patients died from pneumonia with OXA-232-producing ST231 isolates, three of them as part of an outbreak. In conclusion, acquired virulence factors are frequently detected in various combinations in carbapenemase-producing\n                      <jats:italic>K. pneumoniae<\/jats:italic>\n                      isolates in Germany, warranting continuous monitoring of infections caused by these strains.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1128\/aac.00602-24","type":"journal-article","created":{"date-parts":[[2024,10,4]],"date-time":"2024-10-04T09:00:19Z","timestamp":1728032419000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":17,"title":["High frequency of acquired virulence factors in carbapenemase-producing\n                    <i>Klebsiella pneumoniae<\/i>\n                    isolates from a large German university hospital, 2013\u20132021"],"prefix":"10.1128","volume":"68","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1415-4169","authenticated-orcid":false,"given":"Janko","family":"Sattler","sequence":"first","affiliation":[{"name":"Institute for Medical Microbiology, Immunology and Hygiene, University Hospital Cologne and Faculty of Medicine, University of Cologne, Cologne, Germany"},{"name":"Institute of Medical Microbiology and Virology, University of Oldenburg, Oldenburg, Germany"},{"name":"German Center for Infection Research (DZIF), Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5575-1325","authenticated-orcid":false,"given":"Christoph M.","family":"Ernst","sequence":"additional","affiliation":[{"name":"Institute for Medical Microbiology, Immunology and Hygiene, University Hospital Cologne and Faculty of Medicine, University of Cologne, Cologne, Germany"},{"name":"German Center for Infection Research (DZIF), Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janine","family":"Zweigner","sequence":"additional","affiliation":[{"name":"Department of Infection Control and Hospital Hygiene, University Hospital Cologne and Faculty of Medicine, University of Cologne, Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Axel","family":"Hamprecht","sequence":"additional","affiliation":[{"name":"Institute of Medical Microbiology and Virology, University of Oldenburg, Oldenburg, Germany"},{"name":"German Center for Infection Research (DZIF), Cologne, 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