{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T00:07:46Z","timestamp":1791158866498,"version":"4.1.0"},"reference-count":30,"publisher":"American Society for Microbiology","issue":"6","license":[{"start":{"date-parts":[[2008,6,1]],"date-time":"2008-06-01T00:00:00Z","timestamp":1212278400000},"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":[[2008,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n          <jats:p>\n            Twenty-one\n            <jats:italic>Serratia marcescens<\/jats:italic>\n            , ten\n            <jats:italic>Klebsiella pneumoniae<\/jats:italic>\n            , and one\n            <jats:italic>Escherichia coli<\/jats:italic>\n            isolate with carbapenem resistance or reduced carbapenem susceptibility were recovered from intensive care units (ICUs) in our hospital. Enterobacterial repetitive intergenic consensus-PCR and pulsed-field gel electrophoresis demonstrated that all the\n            <jats:italic>S. marcescens<\/jats:italic>\n            isolates belonged to a clonal strain and the 10\n            <jats:italic>K. pneumoniae<\/jats:italic>\n            isolates were indistinguishable or closely related to each other. The MICs of imipenem, meropenem, and ertapenem for all isolates were 2 to 8 \u03bcg\/ml, except for\n            <jats:italic>K. pneumoniae<\/jats:italic>\n            K10 (MICs of 128, 256, and &gt;256 \u03bcg\/ml). Isoelectric focusing, PCRs, and DNA sequencing indicated that all\n            <jats:italic>S. marcescens<\/jats:italic>\n            isolates produced KPC-2 and a \u03b2-lactamase with a pI of 6.5. All\n            <jats:italic>K. pneumoniae<\/jats:italic>\n            isolates produced TEM-1, KPC-2, CTX-M-14, and a \u03b2-lactamase with a pI of 7.3. The\n            <jats:italic>E. coli<\/jats:italic>\n            E1 isolate produced KPC-2, CTX-M-15, and a \u03b2-lactamase with a pI of 7.3. Conjugation studies with\n            <jats:italic>E. coli<\/jats:italic>\n            (EC600) resulted in the transfer of reduced carbapenem susceptibility compared to that of the original isolates, and only the\n            <jats:italic>bla<\/jats:italic>\n            <jats:sub>KPC-2<\/jats:sub>\n            gene was detected in\n            <jats:italic>E. coli<\/jats:italic>\n            transconjugants. Plasmid restriction analysis showed identical restriction patterns among all\n            <jats:italic>E. coli<\/jats:italic>\n            transconjugants. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis and\n            <jats:italic>ompK35\/36<\/jats:italic>\n            gene sequence analysis of outer membrane proteins revealed that\n            <jats:italic>K. pneumoniae<\/jats:italic>\n            K10 failed to express OmpK36, because of insertional inactivation by an insertion sequence IS\n            <jats:italic>Ecp1<\/jats:italic>\n            . All these results indicate that KPC-2-producing\n            <jats:italic>S. marcescens<\/jats:italic>\n            ,\n            <jats:italic>K. pneumoniae<\/jats:italic>\n            , and\n            <jats:italic>E. coli<\/jats:italic>\n            isolates emerged in ICUs in our hospital. KPC-2 combined with porin deficiency results in high-level carbapenem resistance in\n            <jats:italic>K. pneumoniae<\/jats:italic>\n            . The same\n            <jats:italic>bla<\/jats:italic>\n            <jats:sub>KPC-2<\/jats:sub>\n            -encoding plasmid was spread among the three different genera.\n          <\/jats:p>","DOI":"10.1128\/aac.01539-07","type":"journal-article","created":{"date-parts":[[2008,3,11]],"date-time":"2008-03-11T00:51:03Z","timestamp":1205196663000},"page":"2014-2018","update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":166,"title":["Emergence of\n            <i>Serratia marcescens<\/i>\n            ,\n            <i>Klebsiella pneumoniae<\/i>\n            , and\n            <i>Escherichia coli<\/i>\n            Isolates Possessing the Plasmid-Mediated Carbapenem-Hydrolyzing \u03b2-Lactamase KPC-2 in Intensive Care Units of a Chinese Hospital"],"prefix":"10.1128","volume":"52","author":[{"given":"Jia Chang","family":"Cai","sequence":"first","affiliation":[{"name":"2nd Affiliated Hospital of Zhejiang University, Zhejiang University, 88 Jiefang Rd., Hangzhou, China 310009"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hong Wei","family":"Zhou","sequence":"additional","affiliation":[{"name":"2nd Affiliated Hospital of Zhejiang University, Zhejiang University, 88 Jiefang Rd., Hangzhou, China 310009"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rong","family":"Zhang","sequence":"additional","affiliation":[{"name":"2nd Affiliated Hospital of Zhejiang University, Zhejiang University, 88 Jiefang Rd., Hangzhou, China 310009"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gong-Xiang","family":"Chen","sequence":"additional","affiliation":[{"name":"2nd Affiliated Hospital of Zhejiang University, Zhejiang University, 88 Jiefang Rd., Hangzhou, China 310009"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1086\/421495"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.49.2.776-778.2005"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.49.7.3018-3020.2005"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.1086\/512370"},{"key":"e_1_3_1_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.mimet.2005.03.018"},{"key":"e_1_3_1_7_2","doi-asserted-by":"crossref","first-page":"750","DOI":"10.1093\/jac\/dkl019","volume":"57","year":"2006","unstructured":"Chen, G. 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