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To elucidate these mechanisms, we analyzed\n                      <jats:italic toggle=\"yes\">K. pneumoniae<\/jats:italic>\n                      clinical isolates resistant to TZP but susceptible to cefotaxime and cefepime. Among 53 isolates, 14 were further studied by MIC testing for TZP, amoxicillin-clavulanic acid (AMC), and ceftazidime (CAZ). Short-read sequencing was performed for all 14 isolates and long-read sequencing for two. Core-genome MLST showed that all were unrelated. Two had a\n                      <jats:italic toggle=\"yes\">bla<\/jats:italic>\n                      <jats:sub>OXA-1<\/jats:sub>\n                      gene, one also carrying an\n                      <jats:italic toggle=\"yes\">ompK35<\/jats:italic>\n                      porin gene mutation; two others had the same mutation in the promoter of the chromosomal copy of\n                      <jats:italic toggle=\"yes\">bla<\/jats:italic>\n                      <jats:sub>SHV<\/jats:sub>\n                      usually associated with overexpression. In the remaining 10, resistance correlated with plasmid-borne\n                      <jats:italic toggle=\"yes\">bla<\/jats:italic>\n                      <jats:sub>SHV-1<\/jats:sub>\n                      copies. Nine isolates carried\n                      <jats:italic toggle=\"yes\">bla<\/jats:italic>\n                      <jats:sub>SHV-1v1<\/jats:sub>\n                      in the same IS\n                      <jats:italic toggle=\"yes\">26<\/jats:italic>\n                      pseudocompound transposon (PTn), corresponding to PTnSHV-L and located on a conserved IncFIB(K)_1_Kpn3 plasmid in eight. The tenth isolate carried PTnSHV-L with a distinct\n                      <jats:italic toggle=\"yes\">bla<\/jats:italic>\n                      <jats:sub>SHV-1<\/jats:sub>\n                      variant on both an IncHI1B_1_pNDM-MAR plasmid and a high-copy-number Col-type plasmid. Read depth analysis confirmed that\n                      <jats:italic toggle=\"yes\">bla<\/jats:italic>\n                      <jats:sub>SHV<\/jats:sub>\n                      copy number correlated with TZP, AMC, and CAZ MICs. Large-scale database screening identified related IncFIB(K)_1_Kpn3 plasmids, strongly associated with\n                      <jats:italic toggle=\"yes\">K. pneumoniae<\/jats:italic>\n                      and frequently carrying a PTnSHV-L marker. Analysis of a\n                      <jats:italic toggle=\"yes\">K. pneumoniae<\/jats:italic>\n                      genome data set confirmed the frequent co-occurrence of this plasmid and the PTnSHV-L marker in strains with multiple\n                      <jats:italic toggle=\"yes\">bla<\/jats:italic>\n                      <jats:sub>SHV<\/jats:sub>\n                      copies. These findings suggest the emergence of an epidemic plasmid adapted to\n                      <jats:italic toggle=\"yes\">K. pneumoniae<\/jats:italic>\n                      and driving TZP resistance through\n                      <jats:italic toggle=\"yes\">bla<\/jats:italic>\n                      <jats:sub>SHV-1<\/jats:sub>\n                      amplification, underscoring the need for genomic surveillance to detect amplification-based resistance overlooked by standard phenotypic or PCR assays.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1128\/aac.01682-25","type":"journal-article","created":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T14:26:22Z","timestamp":1774362382000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":0,"title":["Piperacillin-tazobactam resistance in\n                    <i>Klebsiella pneumoniae<\/i>\n                    is often associated with IS\n                    <i>26-<\/i>\n                    mediated\n                    <i>bla<\/i>\n                    <sub>SHV-1<\/sub>\n                    amplification in a widespread\n                    <i>Klebsiella<\/i>\n                    -adapted plasmid"],"prefix":"10.1128","volume":"70","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9092-8336","authenticated-orcid":true,"given":"Guilhem","family":"Royer","sequence":"first","affiliation":[{"name":"Unit\u00e9 de Bact\u00e9riologie, D\u00e9partement de Pr\u00e9vention, Diagnostic et Traitement des Infections, H\u00f4pital Henri Mondor, APHP","place":["Cr\u00e9teil, France"]},{"id":[{"id":"https:\/\/ror.org\/04qe59j94","id-type":"ROR","asserted-by":"publisher"}],"name":"INSERM U955, Institut Mondor de Recherche Biom\u00e9dicale","place":["Cr\u00e9teil, 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