{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T00:48:25Z","timestamp":1791852505310,"version":"4.3.4"},"reference-count":42,"publisher":"American Society for Microbiology","issue":"10","license":[{"start":{"date-parts":[[2010,10,1]],"date-time":"2010-10-01T00:00:00Z","timestamp":1285891200000},"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":[[2010,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n          <jats:p>\n            Carbapenem-resistant\n            <jats:italic>Klebsiella pneumoniae<\/jats:italic>\n            caused an outbreak in a hospital in Rome, Italy. The clinical isolates were tested by antimicrobial susceptibility testing, pulsed-field gel electrophoresis, multilocus sequence typing, plasmid typing, and \u03b2-lactamase identification. The OmpK35 and OmpK36 porins were analyzed by SDS-PAGE, and their genes were amplified and sequenced. Complementation experiments were performed using a recombinant unrelated\n            <jats:italic>ompK36<\/jats:italic>\n            gene. An ertapenem-resistant and imipenem- and meropenem-susceptible clone was identified and assigned to the sequence type 37 lineage by MLST; it carried SHV-12 and CTX-M-15 ESBLs, did not produce the OmpK35 due to a nonsense mutation, and expressed a novel OmpK36 variant (OmpK36V). This variant showed two additional amino acids located within the L3 internal loop, one of the highly conserved domains of the protein. Two isolates of the same clone also exhibited resistance to imipenem and meropenem, due to the loss of OmpK36 expression by a nonsense mutation occurring in the\n            <jats:italic>ompK36V<\/jats:italic>\n            variant gene. These were the first carbapenem-resistant\n            <jats:italic>K. pneumoniae<\/jats:italic>\n            isolates identified within the hospital. Screening for the\n            <jats:italic>ompK36V<\/jats:italic>\n            gene of unrelated\n            <jats:italic>K. pneumoniae<\/jats:italic>\n            isolates derived from patients from 2006 to 2009 demonstrated the high frequency of this gene variant as well as its association with ertapenem resistance, reduced susceptibility to meropenem, and susceptibility to imipenem.\n          <\/jats:p>","DOI":"10.1128\/aac.01301-09","type":"journal-article","created":{"date-parts":[[2010,7,27]],"date-time":"2010-07-27T00:51:41Z","timestamp":1280191901000},"page":"4178-4184","update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":129,"title":["An Ertapenem-Resistant Extended-Spectrum-\u03b2-Lactamase-Producing\n            <i>Klebsiella pneumoniae<\/i>\n            Clone Carries a Novel OmpK36 Porin Variant"],"prefix":"10.1128","volume":"54","author":[{"given":"Aurora","family":"Garci\u0301a-Ferna\u0301ndez","sequence":"first","affiliation":[{"name":"Department of Infectious, Parasitic and Immune-Mediated Diseases, Istituto Superiore di Sanita\u0300, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vivi","family":"Miriagou","sequence":"additional","affiliation":[{"name":"Laboratory of Bacteriology, Hellenic Pasteur Institute, Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Costas C.","family":"Papagiannitsis","sequence":"additional","affiliation":[{"name":"Laboratory of Bacteriology, Hellenic Pasteur Institute, Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandra","family":"Giordano","sequence":"additional","affiliation":[{"name":"Department of Science and Public Health-Microbiology, University of Rome La Sapienza, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario","family":"Venditti","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases and Tropical Medicine, University of Rome La Sapienza, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlo","family":"Mancini","sequence":"additional","affiliation":[{"name":"Department of Science and Public Health-Microbiology, University of Rome La Sapienza, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandra","family":"Carattoli","sequence":"additional","affiliation":[{"name":"Department of Infectious, Parasitic and Immune-Mediated Diseases, Istituto Superiore di Sanita\u0300, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1128\/iai.63.3.903-910.1995"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0378-1097(97)00196-1"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1042\/bj3630521"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.01707-08"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.mimet.2005.03.018"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.01542-07"},{"key":"e_1_3_2_8_2","unstructured":"Methods for dilution antimicrobial susceptibility tests for bacteria that grow aerobically; 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