{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T18:59:54Z","timestamp":1789757994328,"version":"4.0.1"},"reference-count":37,"publisher":"American Society for Microbiology","issue":"2","license":[{"start":{"date-parts":[[2011,2,1]],"date-time":"2011-02-01T00:00:00Z","timestamp":1296518400000},"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":[[2011,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n          <jats:p>\n            Carbapenem-resistant\n            <jats:italic>Klebsiella pneumoniae<\/jats:italic>\n            has spread worldwide and throughout the United States. Colistin is used extensively to treat infections with this organism. We describe a cluster of colistin-resistant, carbapenem-resistant\n            <jats:italic>K. pneumoniae<\/jats:italic>\n            infection cases involving three institutions in Detroit, MI. A cluster of five cases of colistin-resistant, carbapenem-resistant\n            <jats:italic>K. pneumoniae<\/jats:italic>\n            was identified at Detroit Medical Center (DMC) from 27 July to 22 August 2009. Epidemiologic data were collected, and transmission opportunities were analyzed. Isolates were genotyped by using pulsed-field gel electrophoresis and repetitive extragenic palindromic PCR. Data regarding the use of colistin were obtained from pharmacy records. The index case of colistin-resistant, carbapenem-resistant\n            <jats:italic>K. pneumoniae<\/jats:italic>\n            was followed 20 days later by four additional cases occurring in a 6-day interval. All of the patients, at some point, had stayed at one particular institution. The mean number of opportunities for transmission between patients was 2.3 \u00b1 0.5, and each patient had at least one opportunity for transmission with one of the other patients. Compared to 60 colistin-susceptible, carbapenem-resistant\n            <jats:italic>K. pneumoniae<\/jats:italic>\n            controls isolated in the previous year at DMC, case patients were significantly older (\n            <jats:italic>P<\/jats:italic>\n            = 0.05) and the carbapenem-resistant\n            <jats:italic>K. pneumoniae<\/jats:italic>\n            organisms isolated from them displayed much higher MICs to imipenem (\n            <jats:italic>P<\/jats:italic>\n            &lt; 0.001). Colistin use was not enhanced in the months preceding the outbreak. Genotyping revealed two closely related clones. This report of a colistin-resistant, carbapenem-resistant\n            <jats:italic>K. pneumoniae<\/jats:italic>\n            outbreak is strongly linked to patient-to-patient transmission. Controlling the spread and novel emergence of bacteria with this phenotype is of paramount importance.\n          <\/jats:p>","DOI":"10.1128\/aac.01020-10","type":"journal-article","created":{"date-parts":[[2010,11,30]],"date-time":"2010-11-30T09:45:25Z","timestamp":1291110325000},"page":"593-599","update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":187,"title":["Outbreak of Colistin-Resistant, Carbapenem-Resistant\n            <i>Klebsiella pneumoniae<\/i>\n            in Metropolitan Detroit, Michigan"],"prefix":"10.1128","volume":"55","author":[{"given":"Dror","family":"Marchaim","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases, Detroit Medical Center, Wayne State University, Detroit, Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teena","family":"Chopra","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Detroit Medical Center, Wayne State University, Detroit, Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason M.","family":"Pogue","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Services, Detroit Medical Center, Wayne State University, Detroit, Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federico","family":"Perez","sequence":"additional","affiliation":[{"name":"Research Service, Louis Stokes Cleveland Department of Veterans Affairs Medical Center, Cleveland, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea M.","family":"Hujer","sequence":"additional","affiliation":[{"name":"Research Service, Louis Stokes Cleveland Department of Veterans Affairs Medical Center, Cleveland, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"Rudin","sequence":"additional","affiliation":[{"name":"Research Service, Louis Stokes Cleveland Department of Veterans Affairs Medical Center, Cleveland, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Endimiani","sequence":"additional","affiliation":[{"name":"Research Service, Louis Stokes Cleveland Department of Veterans Affairs Medical Center, Cleveland, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shiri","family":"Navon-Venezia","sequence":"additional","affiliation":[{"name":"Division of Epidemiology, Tel-Aviv Sourasky Medical Center, Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jatinder","family":"Hothi","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Detroit Medical Center, Wayne State University, Detroit, Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica","family":"Slim","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Detroit Medical Center, Wayne State University, Detroit, Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Blunden","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Detroit Medical Center, Wayne State University, Detroit, Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maryann","family":"Shango","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Detroit Medical Center, Wayne State University, Detroit, Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul R.","family":"Lephart","sequence":"additional","affiliation":[{"name":"Department of Clinical Microbiology, Detroit Medical Center, Wayne State University, Detroit, Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hossein","family":"Salimnia","sequence":"additional","affiliation":[{"name":"Department of Clinical Microbiology, Detroit Medical Center, Wayne State University, Detroit, Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deborah","family":"Reid","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Detroit Medical Center, Wayne State University, Detroit, Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judy","family":"Moshos","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Detroit Medical Center, Wayne State University, Detroit, Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wasif","family":"Hafeez","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Detroit Medical Center, Wayne State University, Detroit, Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suchitha","family":"Bheemreddy","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Detroit Medical Center, Wayne State University, Detroit, Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ting-Yi","family":"Chen","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Detroit Medical Center, Wayne State University, Detroit, Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sorabh","family":"Dhar","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Detroit Medical Center, Wayne State University, Detroit, Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert A.","family":"Bonomo","sequence":"additional","affiliation":[{"name":"Research Service, Louis Stokes Cleveland Department of Veterans Affairs Medical Center, Cleveland, Ohio"},{"name":"VISN 10 Geriatric Research, Education, and Clinical Centers (GRECC) at Veterans Affairs Medical Center, Cleveland, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keith S.","family":"Kaye","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Detroit Medical Center, Wayne State University, Detroit, Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00284-09"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkl562"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkm511"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dki175"},{"key":"e_1_3_2_6_2","first-page":"256","volume":"58","year":"2009","unstructured":"Centers for Disease Control and Prevention. 2009. Guidance for control of infections with carbapenem-resistant or carbapenemase-producing Enterobacteriaceae in acute care facilities. MMWR Morb. Mortal. Wkly. Rep. 58:256-260.","journal-title":"MMWR Morb. Mortal. Wkly. Rep."},{"key":"e_1_3_2_7_2","unstructured":"Laboratory protocol for detection of carbapenem-resistant or carbapenemase-producing [sic] Klebsiella spp. and E. coli from rectal swabs. 2009"},{"key":"e_1_3_2_8_2","unstructured":"Performance standards for antimicrobial susceptibility testing. 2009"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1086\/600042"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkp327"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkn547"},{"key":"e_1_3_2_12_2","unstructured":"Clinical breakpoints. 2009"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.2165\/11315690-000000000-00000"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.2165\/00003495-200868020-00003"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.48.10.3980-3988.2004"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00126-09"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00299-07"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.02466-08"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1086\/520658"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1086\/518970"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinthera.2008.01.015"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinthera.2009.01.013"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1086\/600391"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1086\/651097"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00693-09"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.00130-09"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.00058-07"},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.01361-08"},{"key":"e_1_3_2_29_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijantimicag.2007.07.024"},{"key":"e_1_3_2_30_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2008.896"},{"key":"e_1_3_2_31_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.01020-07"},{"key":"e_1_3_2_32_2","doi-asserted-by":"publisher","DOI":"10.1086\/649865"},{"key":"e_1_3_2_33_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00762-09"},{"key":"e_1_3_2_34_2","first-page":"621","volume":"47","year":"2006","unstructured":"Tan, T. Y., and S. Y. Ng. 2006. The in-vitro activity of colistin in gram-negative bacteria. Singapore Med. J. 47:621-624.","journal-title":"Singapore Med. J."},{"key":"e_1_3_2_35_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.01101-07"},{"key":"e_1_3_2_36_2","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkn396"},{"key":"e_1_3_2_37_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jinf.2008.11.002"},{"key":"e_1_3_2_38_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.02301-09"}],"container-title":["Antimicrobial Agents and Chemotherapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.asm.org\/doi\/pdf\/10.1128\/AAC.01020-10","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.asm.org\/doi\/pdf\/10.1128\/AAC.01020-10","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,2,21]],"date-time":"2022-02-21T23:24:16Z","timestamp":1645485856000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.asm.org\/doi\/10.1128\/AAC.01020-10"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2011,2]]},"references-count":37,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2011,2]]}},"alternative-id":["10.1128\/AAC.01020-10"],"URL":"https:\/\/doi.org\/10.1128\/aac.01020-10","relation":{},"ISSN":["0066-4804","1098-6596"],"issn-type":[{"value":"0066-4804","type":"print"},{"value":"1098-6596","type":"electronic"}],"subject":[],"published":{"date-parts":[[2011,2]]},"assertion":[{"value":"2010-07-24","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2010-11-19","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2011-01-20","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}