{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T13:50:44Z","timestamp":1791726644027,"version":"4.3.4"},"reference-count":62,"publisher":"American Society for Microbiology","issue":"1","license":[{"start":{"date-parts":[[2025,1,31]],"date-time":"2025-01-31T00:00:00Z","timestamp":1738281600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,1,31]],"date-time":"2025-01-31T00:00:00Z","timestamp":1738281600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"funder":[{"name":"ANID | Fondo Nacional de Desarrollo Cient\u00edfico y Tecnol\u00f3gico","award":["1211947"],"award-info":[{"award-number":["1211947"]}]},{"name":"ANID | Fondo Nacional de Desarrollo Cient\u00edfico y Tecnol\u00f3gico","award":["1221209"],"award-info":[{"award-number":["1221209"]}]},{"DOI":"10.13039\/501100020884","name":"Agencia Nacional de Investigaci\u00f3n y Desarrollo","doi-asserted-by":"crossref","award":["3220577"],"award-info":[{"award-number":["3220577"]}],"id":[{"id":"10.13039\/501100020884","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100020884","name":"Agencia Nacional de Investigaci\u00f3n y Desarrollo","doi-asserted-by":"crossref","award":["3201034"],"award-info":[{"award-number":["3201034"]}],"id":[{"id":"10.13039\/501100020884","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100020884","name":"Agencia Nacional de Investigaci\u00f3n y Desarrollo","doi-asserted-by":"crossref","award":["21231099"],"award-info":[{"award-number":["21231099"]}],"id":[{"id":"10.13039\/501100020884","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100020884","name":"Agencia Nacional de Investigaci\u00f3n y Desarrollo","doi-asserted-by":"crossref","award":["220061"],"award-info":[{"award-number":["220061"]}],"id":[{"id":"10.13039\/501100020884","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["Antimicrob Agents Chemother"],"published-print":{"date-parts":[[2025,1,31]]},"abstract":"ABSTRACT<\/jats:title>\n \n \n \n Carbapenemase-producing carbapenem-resistant Enterobacterales (CP-CRE) represent a significant global threat. The emergence of dual CP-CRE is particularly alarming, as they can potentially compromise the efficacy of newer antibiotics, further decreasing therapeutic alternatives. Herein, we report the emergence of multiple species of CP-CRE recovered from invasive infections in Chile that simultaneously harbor\n bla<\/jats:italic>\n KPC<\/jats:sub>\n and\n bla<\/jats:italic>\n NDM<\/jats:sub>\n and provide an in-depth genomic characterization of these worrisome pathogens. We collected carbapenem-resistant Enterobacterales (CRE) isolates from invasive infections over a 4-year period, across 11 healthcare centers in Chile. Bacterial species and the presence of carbapenemase genes were confirmed using MALDI-TOF and PCR assays, respectively. Antimicrobial susceptibility testing was conducted through disk diffusion and broth microdilution methods. Dual CP-CRE isolates were subjected to short- and long-read whole genome sequencing to perform a detailed genomic characterization of the isolates and of the mobile genetic elements harboring the enzymes. From a total of 1,335 CRE isolates, we observed an increase in the prevalence of CP-CRE, from 11% in 2019 to 38% in 2022. A total of 11 dual CP-CRE isolates were recovered, all of them harboring\n bla<\/jats:italic>\n KPC<\/jats:sub>\n and\n bla<\/jats:italic>\n NDM<\/jats:sub>\n . Species corresponded to\n Escherichia coli<\/jats:italic>\n (\n n<\/jats:italic>\n = 6),\n Klebsiella pneumoniae<\/jats:italic>\n (\n n<\/jats:italic>\n = 2),\n Klebsiella oxytoca<\/jats:italic>\n (\n n<\/jats:italic>\n = 2), and\n Citrobacter freundii<\/jats:italic>\n (\n n<\/jats:italic>\n = 1). Dual CP-CRE isolates exhibited resistance to all tested \u03b2-lactams except for cefiderocol. The\n bla<\/jats:italic>\n KPC<\/jats:sub>\n and\n bla<\/jats:italic>\n NDM<\/jats:sub>\n encoding genes were located on independent plasmids. Platforms harboring\n bla<\/jats:italic>\n KPC<\/jats:sub>\n were diverse and included IncN, IncF, and IncFIB plasmids. In contrast,\n bla<\/jats:italic>\n NDM-7<\/jats:sub>\n was only found on fairly conserved IncX3 plasmids. We report that a rapid increase of CP-CRE in Chile, alongside with the emergence of multiple bacterial species of CP-CRE co-harboring\n bla<\/jats:italic>\n KPC-2\/3<\/jats:sub>\n and\n bla<\/jats:italic>\n NDM-7<\/jats:sub>\n , underscores a critical public health challenge. Our data suggest that the dissemination of\n bla<\/jats:italic>\n NDM-7<\/jats:sub>\n was predominantly facilitated by IncX3 plasmids, whereas the spread of\n bla<\/jats:italic>\n KPC<\/jats:sub>\n involved multiple plasmid backbones. Active surveillance and genomic monitoring are critical to inform public policy and curtail the spread of these highly resistant pathogens.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1128\/aac.01205-24","type":"journal-article","created":{"date-parts":[[2024,12,5]],"date-time":"2024-12-05T14:00:43Z","timestamp":1733407243000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":17,"title":["Multispecies emergence of dual\n bla<\/i>\n KPC\/NDM<\/sub>\n carbapenemase-producing Enterobacterales recovered from invasive infections in Chile"],"prefix":"10.1128","volume":"69","author":[{"given":"Ana M.","family":"Quesille-Villalobos","sequence":"first","affiliation":[{"name":"Genomics & Resistant Microbes group (GeRM), Instituto de Ciencias e Innovaci\u00f3n en Medicina (ICIM), Facultad de Medicina, Cl\u00ednica Alemana, Universidad del Desarrollo","place":["Santiago, Chile"]},{"name":"Multidisciplinary Initiative for Collaborative Research on Bacterial Resistance (MICROB-R)","place":["Santiago, Chile"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Camila","family":"Solar","sequence":"additional","affiliation":[{"name":"Genomics & Resistant Microbes group (GeRM), Instituto de Ciencias e Innovaci\u00f3n en Medicina (ICIM), Facultad de Medicina, Cl\u00ednica Alemana, Universidad del Desarrollo","place":["Santiago, Chile"]},{"name":"Multidisciplinary Initiative for Collaborative Research on Bacterial Resistance (MICROB-R)","place":["Santiago, Chile"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jose R. W.","family":"Mart\u00ednez","sequence":"additional","affiliation":[{"name":"Genomics & Resistant Microbes group (GeRM), Instituto de Ciencias e Innovaci\u00f3n en Medicina (ICIM), Facultad de Medicina, Cl\u00ednica Alemana, Universidad del Desarrollo","place":["Santiago, Chile"]},{"name":"Multidisciplinary Initiative for Collaborative Research on Bacterial Resistance (MICROB-R)","place":["Santiago, Chile"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lina","family":"Rivas","sequence":"additional","affiliation":[{"name":"Genomics & Resistant Microbes group (GeRM), Instituto de Ciencias e Innovaci\u00f3n en Medicina (ICIM), Facultad de Medicina, Cl\u00ednica Alemana, Universidad del Desarrollo","place":["Santiago, Chile"]},{"name":"Multidisciplinary Initiative for Collaborative Research on Bacterial Resistance (MICROB-R)","place":["Santiago, 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