{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,18]],"date-time":"2026-04-18T15:11:55Z","timestamp":1776525115410,"version":"3.51.2"},"reference-count":41,"publisher":"American Society for Microbiology","issue":"6","license":[{"start":{"date-parts":[[2004,6,1]],"date-time":"2004-06-01T00:00:00Z","timestamp":1086048000000},"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":[[2004,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n          <jats:p>\n            <jats:italic>Klebsiella pneumoniae<\/jats:italic>\n            strain KG525, which showed high-level resistance to broad-spectrum cephalosporins, was isolated from the neonatal intensive care unit (NICU) of a Japanese hospital in March 2002. The ceftazidime resistance of strain KG525 was transferable to\n            <jats:italic>Escherichia coli<\/jats:italic>\n            CSH-2 by conjugation. Cloning and sequence analysis revealed that production of a novel extended-spectrum class A \u03b2-lactamase (pI 7.0), designated GES-3, which had two amino acid substitutions of M62T and E104K on the basis of the sequence of GES-1, was responsible for resistance in strain KG525 and its transconjugant. The\n            <jats:italic>bla<\/jats:italic>\n            <jats:sub>GES-3<\/jats:sub>\n            gene was located as the first gene cassette in a class 1 integron that also contained an\n            <jats:italic>aacA1-orfG<\/jats:italic>\n            fused gene cassette and one unique cassette that has not been described in other class 1 integrons and ended with a truncated 3\u2032 conserved segment by insertion of IS\n            <jats:italic>26<\/jats:italic>\n            . Another five ceftazidime-resistant\n            <jats:italic>K. pneumoniae<\/jats:italic>\n            strains, strains KG914, KG1116, KG545, KG502, and KG827, which were isolated from different neonates during a 1-year period in the same NICU where strain KG525 had been isolated, were also positive for GES-type \u03b2-lactamase genes by PCR. Pulsed-field gel electrophoresis and enterobacterial repetitive intergenic consensus-PCR analyses displayed genetic relatedness among the six\n            <jats:italic>K. pneumoniae<\/jats:italic>\n            strains. Southern hybridization analysis with a GES-type \u03b2-lactamase gene-specific probe showed that the locations of\n            <jats:italic>bla<\/jats:italic>\n            <jats:sub>GES<\/jats:sub>\n            were multiple and diverse among the six strains. These findings suggest that within the NICU setting genetically related\n            <jats:italic>K. pneumoniae<\/jats:italic>\n            strains carrying the\n            <jats:italic>bla<\/jats:italic>\n            <jats:sub>GES<\/jats:sub>\n            gene were ambushed with genetic rearrangements that caused the multiplication and translocation of the\n            <jats:italic>bla<\/jats:italic>\n            <jats:sub>GES<\/jats:sub>\n            gene.\n          <\/jats:p>","DOI":"10.1128\/aac.48.6.1960-1967.2004","type":"journal-article","created":{"date-parts":[[2004,5,21]],"date-time":"2004-05-21T18:38:42Z","timestamp":1085164722000},"page":"1960-1967","update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":56,"title":["Nosocomial Spread of Ceftazidime-Resistant\n            <i>Klebsiella pneumoniae<\/i>\n            Strains Producing a Novel Class A \u03b2-Lactamase, GES-3, in a Neonatal Intensive Care Unit in Japan"],"prefix":"10.1128","volume":"48","author":[{"given":"Jun-ichi","family":"Wachino","sequence":"first","affiliation":[{"name":"Department of Bacterial Pathogenesis and Infection Control, National Institute of Infectious Diseases, Tokyo"},{"name":"Program in Radiological and Medical Laboratory Sciences, Nagoya University Graduate School of Medicine, Nagoya, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yohei","family":"Doi","sequence":"additional","affiliation":[{"name":"Department of Bacterial Pathogenesis and Infection Control, National Institute of Infectious Diseases, Tokyo"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kunikazu","family":"Yamane","sequence":"additional","affiliation":[{"name":"Department of Bacterial Pathogenesis and Infection Control, National Institute of Infectious Diseases, Tokyo"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naohiro","family":"Shibata","sequence":"additional","affiliation":[{"name":"Department of Bacterial Pathogenesis and Infection Control, National Institute of Infectious Diseases, Tokyo"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tetsuya","family":"Yagi","sequence":"additional","affiliation":[{"name":"Department of Bacterial Pathogenesis and Infection Control, National Institute of Infectious Diseases, Tokyo"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takako","family":"Kubota","sequence":"additional","affiliation":[{"name":"Central Clinical Laboratory, Kagoshima Municipal Hospital, Kagoshima"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hideo","family":"Ito","sequence":"additional","affiliation":[{"name":"Program in Radiological and Medical Laboratory Sciences, Nagoya University Graduate School of Medicine, Nagoya, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoshichika","family":"Arakawa","sequence":"additional","affiliation":[{"name":"Department of Bacterial Pathogenesis and Infection Control, National Institute of Infectious Diseases, 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