{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T13:52:11Z","timestamp":1792677131319,"version":"4.5.0"},"reference-count":41,"publisher":"American Society for Microbiology","issue":"12","license":[{"start":{"date-parts":[[2009,12,1]],"date-time":"2009-12-01T00:00:00Z","timestamp":1259625600000},"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":[[2009,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    A Swedish patient of Indian origin traveled to New Delhi, India, and acquired a urinary tract infection caused by a carbapenem-resistant\n                    <jats:italic>Klebsiella pneumoniae<\/jats:italic>\n                    strain that typed to the sequence type 14 complex. The isolate,\n                    <jats:italic>Klebsiella pneumoniae<\/jats:italic>\n                    05-506, was shown to possess a metallo-\u03b2-lactamase (MBL) but was negative for previously known MBL genes. Gene libraries and amplification of class 1 integrons revealed three resistance-conferring regions; the first contained\n                    <jats:italic>bla<\/jats:italic>\n                    <jats:sub>CMY-4<\/jats:sub>\n                    flanked by IS\n                    <jats:italic>EcP1<\/jats:italic>\n                    and\n                    <jats:italic>blc<\/jats:italic>\n                    . The second region of 4.8 kb contained a complex class 1 integron with the gene cassettes\n                    <jats:italic>arr<\/jats:italic>\n                    -\n                    <jats:italic>2<\/jats:italic>\n                    , a new erythromycin esterase gene;\n                    <jats:italic>ereC<\/jats:italic>\n                    ;\n                    <jats:italic>aadA1<\/jats:italic>\n                    ; and\n                    <jats:italic>cmlA7<\/jats:italic>\n                    . An intact IS\n                    <jats:italic>CR1<\/jats:italic>\n                    element was shown to be downstream from the\n                    <jats:italic>qac<\/jats:italic>\n                    \/\n                    <jats:italic>sul<\/jats:italic>\n                    genes. The third region consisted of a new MBL gene, designated\n                    <jats:italic>bla<\/jats:italic>\n                    <jats:sub>NDM-1<\/jats:sub>\n                    , flanked on one side by\n                    <jats:italic>K. pneumoniae<\/jats:italic>\n                    DNA and a truncated IS\n                    <jats:italic>26<\/jats:italic>\n                    element on its other side. The last two regions lie adjacent to one another, and all three regions are found on a 180-kb region that is easily transferable to recipient strains and that confers resistance to all antibiotics except fluoroquinolones and colistin. NDM-1 shares very little identity with other MBLs, with the most similar MBLs being VIM-1\/VIM-2, with which it has only 32.4% identity. As well as possessing unique residues near the active site, NDM-1 also has an additional insert between positions 162 and 166 not present in other MBLs. NDM-1 has a molecular mass of 28 kDa, is monomeric, and can hydrolyze all \u03b2-lactams except aztreonam. Compared to VIM-2, NDM-1 displays tighter binding to most cephalosporins, in particular, cefuroxime, cefotaxime, and cephalothin (cefalotin), and also to the penicillins. NDM-1 does not bind to the carbapenems as tightly as IMP-1 or VIM-2 and turns over the carbapenems at a rate similar to that of VIM-2. In addition to\n                    <jats:italic>K. pneumoniae<\/jats:italic>\n                    05-506,\n                    <jats:italic>bla<\/jats:italic>\n                    <jats:sub>NDM-1<\/jats:sub>\n                    was found on a 140-kb plasmid in an\n                    <jats:italic>Escherichia coli<\/jats:italic>\n                    strain isolated from the patient's feces, inferring the possibility of in vivo conjugation. The broad resistance carried on these plasmids is a further worrying development for India, which already has high levels of antibiotic resistance.\n                  <\/jats:p>","DOI":"10.1128\/aac.00774-09","type":"journal-article","created":{"date-parts":[[2009,9,21]],"date-time":"2009-09-21T22:19:59Z","timestamp":1253571599000},"page":"5046-5054","update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":2190,"title":["Characterization of a New Metallo-\u03b2-Lactamase Gene,\n                    <i>bla<\/i>\n                    <sub>NDM-1<\/sub>\n                    , and a Novel Erythromycin Esterase Gene Carried on a Unique Genetic Structure in\n                    <i>Klebsiella pneumoniae<\/i>\n                    Sequence Type 14 from India"],"prefix":"10.1128","volume":"53","author":[{"given":"Dongeun","family":"Yong","sequence":"first","affiliation":[{"name":"Yonsei University College of Medicine, Research Institute of Antimicrobial Resistance, Seoul, Republic of Korea"},{"name":"Department of Medical Microbiology, Cardiff University, Cardiff, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark A.","family":"Toleman","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, Cardiff University, Cardiff, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian G.","family":"Giske","sequence":"additional","affiliation":[{"name":"Clinical Microbiology, MTC\u2014Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyun S.","family":"Cho","sequence":"additional","affiliation":[{"name":"Yonsei University College of Life Science and Biotechnology, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristina","family":"Sundman","sequence":"additional","affiliation":[{"name":"Department of Clinical Microbiology, O\u0308rebro University Hospital, O\u0308rebro, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyungwon","family":"Lee","sequence":"additional","affiliation":[{"name":"Yonsei University College of Medicine, Research Institute of Antimicrobial Resistance, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy R.","family":"Walsh","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, Cardiff University, Cardiff, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.45.10.2971-2972.2001"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00931-08"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.01672-07"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1021\/ar0400241"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00543-08"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijantimicag.2006.11.006"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.43.8.4178-4182.2005"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkn453"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.chembiol.2009.04.010"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.01581-08"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkn500"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.45.3.660-663.2001"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmb.2007.11.012"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.39.1.175-182.2001"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00359-07"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.50.4.1590-1593.2006"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.3201\/eid1503.081131"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.47.2.582-587.2003"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajic.2007.10.013"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(09)70054-4"},{"key":"e_1_3_2_22_2","doi-asserted-by":"crossref","first-page":"S20","DOI":"10.1016\/j.ajic.2006.05.238","volume":"34","year":"2006","unstructured":"Paterson, D. L. 2006. Resistance in gram-negative bacteria: Enterobacteriaceae. Am. J. Infect. Control34:S20-S28.","journal-title":"Am. J. Infect. Control"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkn512"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.44.4.891-897.2000"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.2217\/17460913.2.5.501"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijantimicag.2008.07.018"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.00001-07"},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.1385\/MB:28:1:47"},{"key":"e_1_3_2_29_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1574-6968.2008.01145.x"},{"key":"e_1_3_2_30_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00166-08"},{"key":"e_1_3_2_31_2","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkp018"},{"key":"e_1_3_2_32_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.01337-07"},{"key":"e_1_3_2_33_2","doi-asserted-by":"publisher","DOI":"10.1074\/jbc.M105550200"},{"key":"e_1_3_2_34_2","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkl204"},{"key":"e_1_3_2_35_2","doi-asserted-by":"publisher","DOI":"10.1128\/MMBR.00048-05"},{"key":"e_1_3_2_36_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.48.1.329-332.2004"},{"key":"e_1_3_2_37_2","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkf210"},{"key":"e_1_3_2_38_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00479-08"},{"key":"e_1_3_2_39_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.43.4.960"},{"key":"e_1_3_2_40_2","doi-asserted-by":"crossref","unstructured":"Euro. Surveill. 2008 13","DOI":"10.2807\/ese.13.43.19012-en"},{"key":"e_1_3_2_41_2","doi-asserted-by":"publisher","DOI":"10.1097\/QCO.0b013e328303670b"},{"key":"e_1_3_2_42_2","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.18.2.306-325.2005"}],"container-title":["Antimicrobial Agents and Chemotherapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.asm.org\/doi\/pdf\/10.1128\/AAC.00774-09","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.asm.org\/doi\/pdf\/10.1128\/AAC.00774-09","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,2,21]],"date-time":"2022-02-21T14:41:47Z","timestamp":1645454507000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.asm.org\/doi\/10.1128\/AAC.00774-09"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2009,12]]},"references-count":41,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2009,12]]}},"alternative-id":["10.1128\/AAC.00774-09"],"URL":"https:\/\/doi.org\/10.1128\/aac.00774-09","relation":{"has-review":[{"id-type":"doi","id":"10.3410\/f.718490115.793497306","asserted-by":"object"}]},"ISSN":["0066-4804","1098-6596"],"issn-type":[{"value":"0066-4804","type":"print"},{"value":"1098-6596","type":"electronic"}],"subject":[],"published":{"date-parts":[[2009,12]]},"assertion":[{"value":"2009-06-10","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2009-09-10","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2009-12-01","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}