{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T06:42:13Z","timestamp":1789195333179,"version":"build-2803163510"},"reference-count":43,"publisher":"American Society for Microbiology","issue":"9","license":[{"start":{"date-parts":[[2015,9,1]],"date-time":"2015-09-01T00:00:00Z","timestamp":1441065600000},"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":["J Clin Microbiol"],"published-print":{"date-parts":[[2015,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n          <jats:p>\n            Multidrug-resistant (MDR)\n            <jats:named-content content-type=\"genus-species\">Klebsiella pneumoniae<\/jats:named-content>\n            is one of the most important causes of nosocomial infections worldwide. After the spread of strains resistant to beta-lactams at the end of the previous century, the diffusion of isolates resistant to carbapenems and colistin is now reducing treatment options and the containment of infections. Carbapenem-resistant\n            <jats:named-content content-type=\"genus-species\">K. pneumoniae<\/jats:named-content>\n            strains have spread rapidly among Italian hospitals, with four subclades of pandemic clonal group 258 (CG258). Here we show that a single Italian hospital has been invaded by three of these subclades within 27 months, thus replicating on a small scale the \u201cItalian scenario.\u201d We identified a single clone responsible for an epidemic outbreak involving seven patients, and we reconstructed its star-like pattern of diffusion within the intensive care unit. This epidemiological picture was obtained through phylogenomic analysis of 16 carbapenem-resistant\n            <jats:named-content content-type=\"genus-species\">K. pneumoniae<\/jats:named-content>\n            isolates collected in the hospital during a 27-month period, which were added to a database of 319 genomes representing the available global diversity of\n            <jats:named-content content-type=\"genus-species\">K. pneumoniae<\/jats:named-content>\n            strains. Phenotypic and molecular assays did not reveal virulence or resistance determinants specific for the outbreak isolates. Other factors, rather than selective advantages, might have caused the outbreak. Finally, analyses allowed us to identify a major subclade of CG258 composed of strains bearing the yersiniabactin virulence factor. Our work demonstrates how the use of combined phenotypic, molecular, and whole-genome sequencing techniques can help to identify quickly and to characterize accurately the spread of MDR pathogens.\n          <\/jats:p>","DOI":"10.1128\/jcm.00545-15","type":"journal-article","created":{"date-parts":[[2015,7,2]],"date-time":"2015-07-02T03:40:15Z","timestamp":1435808415000},"page":"2861-2868","update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":63,"title":["Tracking Nosocomial Klebsiella pneumoniae Infections and Outbreaks by Whole-Genome Analysis: Small-Scale Italian Scenario within a Single Hospital"],"prefix":"10.1128","volume":"53","author":[{"given":"Raffaella","family":"Onori","sequence":"first","affiliation":[{"name":"University of Insubria and Ospedale di Circolo e Fondazione Macchi, Varese, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefano","family":"Gaiarsa","sequence":"additional","affiliation":[{"name":"Fondazione IRCCS Policlinico S. 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