{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T12:45:23Z","timestamp":1787316323290,"version":"build-2736575974"},"reference-count":54,"publisher":"American Society for Microbiology","issue":"8","license":[{"start":{"date-parts":[[2025,8,5]],"date-time":"2025-08-05T00:00:00Z","timestamp":1754352000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,8,5]],"date-time":"2025-08-05T00:00:00Z","timestamp":1754352000000},"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":["Microbiol Spectr"],"published-print":{"date-parts":[[2025,8,5]]},"abstract":"ABSTRACT<\/jats:title>\n \n \n \n In view of insufficient data on the epidemiology and genomics of\n bla<\/jats:italic>\n KPC-2<\/jats:sub>\n producing\n Klebsiella pneumoniae<\/jats:italic>\n subsp.\n pneumoniae<\/jats:italic>\n (KPC-2\n Kpn<\/jats:italic>\n ) from India, this study, first of its kind, was conducted to characterize blood-borne KPC-2\n Kpn<\/jats:italic>\n isolates according to their resistome, plasmid types, and genotypes. This study included 45 blood-borne KPC-2\n Kpn<\/jats:italic>\n isolates from ICU-admitted sepsis patients in Kolkata from 2015 to 2024. These isolates were tested for antibiotic susceptibility against \u226510 antimicrobial classes. Antimicrobial resistance gene profiles, genetic environment of\n bla<\/jats:italic>\n KPC-2<\/jats:sub>\n , plasmid types, MLST genotypes, and virulence genes were determined by whole-genome shotgun sequencing (WGS). The transmissibility of\n bla<\/jats:italic>\n KPC-2<\/jats:sub>\n genes was evaluated by conjugation experiment. Pulsed-field gel electrophoresis (PFGE) was conducted to confirm their clonality. SNP-based phylogenomic analysis was performed to compare the study isolates with global KPC-2\n Kpn<\/jats:italic>\n isolates. All 45 (100%) KPC-2\n Kpn<\/jats:italic>\n isolates showed resistance to 21 antimicrobials. In addition, 55.55% and 33.33% isolates were resistant to colistin and ceftazidime-avibactam, respectively. Presence of triple carbapenemase (\n bla<\/jats:italic>\n KPC-2<\/jats:sub>\n ,\n bla<\/jats:italic>\n NDM-1\/5<\/jats:sub>\n and\n bla<\/jats:italic>\n OXA-181\/232<\/jats:sub>\n ) was observed in six isolates.\n bla<\/jats:italic>\n KPC-2<\/jats:sub>\n transferable by IncFII\/IncFII(pBK30683)\/ColRNAI conjugative plasmids. WGS identified two distinct genetic environments of\n bla<\/jats:italic>\n KPC-2<\/jats:sub>\n among the isolates based on presence or absence of Tn\n 4401<\/jats:italic>\n . PFGE identified 45 pulsotypes with a 39.3% similarity coefficient, indicating a variety of infection sources. Of the 16 MLST genotypes found in circulation, ST15 was predominant and ST7485 was novel. Hypervirulent genetic markers (\n iucA<\/jats:italic>\n ,\n iutA<\/jats:italic>\n , and\n rmpA2<\/jats:italic>\n ) were identified in four isolates. Hospital infection control and surveillance programs should be strengthened to detect and combat\n K. pneumoniae<\/jats:italic>\n co-harboring\n bla<\/jats:italic>\n KPC-2<\/jats:sub>\n and\/or\n bla<\/jats:italic>\n NDM<\/jats:sub>\n and\/or\n bla<\/jats:italic>\n OXA-48-like<\/jats:sub>\n carbapenemase.\n <\/jats:p>\n \n IMPORTANCE<\/jats:title>\n \n Klebsiella pneumoniae<\/jats:italic>\n (\n Kpn<\/jats:italic>\n ) is the primary etiology of ICU-related bloodstream infections in India. Multi-drug resistance, including resistance to carbapenems and colistin, along with myriad virulence factors, makes this bacterium really troublesome with respect to effective treatment. In India,\n bla<\/jats:italic>\n NDM<\/jats:sub>\n and\n bla<\/jats:italic>\n OXA-48-like<\/jats:sub>\n carbapenemases are the most prevalent types with only sporadic reports of\n bla<\/jats:italic>\n KPC<\/jats:sub>\n in\n Kpn<\/jats:italic>\n . This study focuses on the emergence of\n bla<\/jats:italic>\n KPC-2<\/jats:sub>\n in\n Kpn<\/jats:italic>\n along with other carbapenemases in Kolkata, India. This study is also the first of its kind to describe the presence of triple carbapenemase (\n bla<\/jats:italic>\n KPC-2<\/jats:sub>\n ,\n bla<\/jats:italic>\n NDM-1\/5<\/jats:sub>\n and\n bla<\/jats:italic>\n OXA-181\/232<\/jats:sub>\n ) and concurrent resistance to carbapenems, colistin, and ceftazidime-avibactam antimicrobials in\n Kpn.<\/jats:italic>\n In addition, this study also highlights the diverse genotypes (sequence types) identified in KPC-2\n Kpn,<\/jats:italic>\n including the novel ST7485 identified in this study. Routine monitoring of antimicrobial resistance genes in\n Kpn<\/jats:italic>\n should be encouraged to identify the emerging resistome, which will aid in determining the most effective treatment.\n <\/jats:p>\n <\/jats:sec>\n <\/jats:sec>","DOI":"10.1128\/spectrum.00126-25","type":"journal-article","created":{"date-parts":[[2025,6,12]],"date-time":"2025-06-12T08:27:18Z","timestamp":1749716838000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":7,"title":["Antimicrobial resistance and phylogenetic lineages of KPC-2-producing blood-borne\n Klebsiella pneumoniae<\/i>\n subsp.\n pneumoniae<\/i>\n from Kolkata, India during 2015\u20132024: Emergence of\n Klebsiella pneumoniae<\/i>\n subsp.\n pneumoniae<\/i>\n with\n bla<\/i>\n KPC-2<\/sub>\n ,\n bla<\/i>\n NDM<\/sub>\n , and\n bla<\/i>\n OXA-48-like<\/sub>\n triple carbapenemases"],"prefix":"10.1128","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3873-3280","authenticated-orcid":false,"given":"Gourab","family":"Halder","sequence":"first","affiliation":[{"name":"Division of Bacteriology, ICMR-National Institute for Research in Bacterial Infections, Formerly ICMR-NICED","place":["Kolkata, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bhaskar Narayan","family":"Chaudhuri","sequence":"additional","affiliation":[{"name":"Division of Microbiology, Peerless Hospitex Hospital","place":["Kolkata, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8662-4257","authenticated-orcid":false,"given":"Balaji","family":"Veeraraghavan","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/01vj9qy35","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Clinical Microbiology, Christian Medical College","place":["Vellore, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Priyanka","family":"Denny","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/0492wrx28","id-type":"ROR","asserted-by":"publisher"}],"name":"Collaborative Research Centre of Okayama University for Infectious Diseases in India at ICMR-NIRBI","place":["Kolkata, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-3123-1446","authenticated-orcid":false,"given":"Paulami","family":"Dutta","sequence":"additional","affiliation":[{"name":"Division of Bacteriology, ICMR-National Institute for Research in Bacterial Infections, Formerly ICMR-NICED","place":["Kolkata, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mandira","family":"Chakraborty","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/021nb2v44","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Microbiology, Calcutta Medical College","place":["Kolkata, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ujjwayini Ray","family":"Khan","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/0176wfg98","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Microbiology, Apollo Gleneagles Hospital","place":["Kolkata, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shelley Sharma","family":"Ganguly","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/05mryn396","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Microbiology, Manipal Hospital, Formerly AMRI Hospital Saltake","place":["Kolkata, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Subhranshu","family":"Mandal","sequence":"additional","affiliation":[{"name":"Department of Microbiology, CNCI","place":["Kolkata, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yesha Parasmani","family":"Upadhyaya","sequence":"additional","affiliation":[{"name":"Division of Bacteriology, ICMR-National Institute for Research in Bacterial Infections, Formerly ICMR-NICED","place":["Kolkata, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bedobroto","family":"Biswas","sequence":"additional","affiliation":[{"name":"Division of Microbiology, Desun Hospital","place":["Kolkata, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arindam","family":"Chakraborty","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/02vxh6479","id-type":"ROR","asserted-by":"publisher"}],"name":"Division of Microbiology, Fortis Hospital","place":["Anandapur, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sourav","family":"Maiti","sequence":"additional","affiliation":[{"name":"Division of Microbiology, Ruby General Hospital","place":["Kolkata, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Himadri","family":"Mondal","sequence":"additional","affiliation":[{"name":"Division of Microbiology, Manipal Hospital, Formerly Columbia Asia Hospital","place":["Kolkata, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saikat","family":"Pal","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Calcutta Medical Research Institute","place":["Kolkata, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6897-7390","authenticated-orcid":true,"given":"Shanta","family":"Dutta","sequence":"additional","affiliation":[{"name":"Division of Bacteriology, ICMR-National Institute for Research in Bacterial Infections, Formerly ICMR-NICED","place":["Kolkata, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2021.754944"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13756-017-0222-z"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.19-0877"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1086\/500318"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.271.20.1598"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1097\/MCC.0b013e328356cefe"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1099\/jmm.0.000767"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0208442"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00355-19"},{"key":"e_1_3_4_11_2","unstructured":"ICMR annual report. 2024. AMRSN_Annual_Report_2022.pdf. https:\/\/www.icmr.gov.in\/icmrobject\/uploads\/Documents\/1725536060_annual_report_2023.pdf."},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.01019-15"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.1002\/nmi2.54"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.1097\/SMJ.0b013e3181fd7d5a"},{"key":"e_1_3_4_15_2","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkq124"},{"key":"e_1_3_4_16_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.45.4.1151-1161.2001"},{"key":"e_1_3_4_17_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.02072-13"},{"key":"e_1_3_4_18_2","doi-asserted-by":"publisher","DOI":"10.1128\/spectrum.01542-24"},{"key":"e_1_3_4_19_2","volume-title":"Performance standards for antimicrobial susceptibility testing, M100","author":"Clinical and Laboratory Standards Institute","year":"2023","unstructured":"Clinical and Laboratory Standards Institute. 2023. Performance standards for antimicrobial susceptibility testing, M100. 33rd ed. Clinical and Laboratory Standards Institute, Wayne, PA.","edition":"33"},{"key":"e_1_3_4_20_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10482-017-0844-4"},{"key":"e_1_3_4_21_2","doi-asserted-by":"publisher","DOI":"10.1128\/jb.145.3.1365-1373.1981"},{"key":"e_1_3_4_22_2","doi-asserted-by":"publisher","DOI":"10.1128\/spectrum.03529-23"},{"key":"e_1_3_4_23_2","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkt065"},{"key":"e_1_3_4_24_2","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkp498"},{"key":"e_1_3_4_25_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.01447-16"},{"key":"e_1_3_4_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.diagmicrobio.2011.08.016"},{"key":"e_1_3_4_27_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.mimet.2005.03.018"},{"key":"e_1_3_4_28_2","unstructured":"Centers for Disease Control and Prevention. 2013. Standard operating procedure for PulseNet PFGE of Escherichia coli O157:H7 Escherichia coli non-O157 (STEC) Salmonella serotypes Shigella sonnei and Shigella flexneri. Atlanta CDC"},{"key":"e_1_3_4_29_2","doi-asserted-by":"publisher","DOI":"10.1128\/jcm.33.9.2233-2239.1995"},{"key":"e_1_3_4_30_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(13)70190-7"},{"key":"e_1_3_4_31_2","doi-asserted-by":"publisher","DOI":"10.3389\/fmicb.2016.00895"},{"key":"e_1_3_4_32_2","doi-asserted-by":"publisher","DOI":"10.1186\/1757-4749-4-7"},{"key":"e_1_3_4_33_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.01666-12"},{"key":"e_1_3_4_34_2","doi-asserted-by":"publisher","DOI":"10.3389\/fmicb.2015.00519"},{"key":"e_1_3_4_35_2","doi-asserted-by":"publisher","DOI":"10.1017\/S0950268814000995"},{"key":"e_1_3_4_36_2","doi-asserted-by":"publisher","DOI":"10.1017\/S0950268813002975"},{"key":"e_1_3_4_37_2","doi-asserted-by":"publisher","DOI":"10.1179\/1973947814Y.0000000223"},{"key":"e_1_3_4_38_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00690-09"},{"key":"e_1_3_4_39_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(15)00424-7"},{"key":"e_1_3_4_40_2","doi-asserted-by":"publisher","DOI":"10.3389\/fmicb.2016.02135"},{"key":"e_1_3_4_41_2","doi-asserted-by":"publisher","DOI":"10.3389\/fmicb.2014.00643"},{"key":"e_1_3_4_42_2","doi-asserted-by":"publisher","DOI":"10.1080\/22221751.2021.1984182"},{"key":"e_1_3_4_43_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00389-17"},{"key":"e_1_3_4_44_2","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkq431"},{"key":"e_1_3_4_45_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-021-95285-z"},{"key":"e_1_3_4_46_2","doi-asserted-by":"publisher","DOI":"10.3343\/alm.2021.41.1.86"},{"key":"e_1_3_4_47_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.diagmicrobio.2016.12.012"},{"key":"e_1_3_4_48_2","doi-asserted-by":"publisher","DOI":"10.2217\/fmb-2018-0022"},{"key":"e_1_3_4_49_2","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.00001-19"},{"key":"e_1_3_4_50_2","doi-asserted-by":"publisher","DOI":"10.1111\/joim.13007"},{"key":"e_1_3_4_51_2","doi-asserted-by":"publisher","DOI":"10.1128\/spectrum.00376-22"},{"key":"e_1_3_4_52_2","doi-asserted-by":"publisher","DOI":"10.4161\/viru.22718"},{"key":"e_1_3_4_53_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.00776-18"},{"key":"e_1_3_4_54_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(17)30489-9"},{"key":"e_1_3_4_55_2","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkz446"}],"container-title":["Microbiology Spectrum"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.asm.org\/doi\/pdf\/10.1128\/spectrum.00126-25","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.asm.org\/doi\/pdf\/10.1128\/spectrum.00126-25","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,5]],"date-time":"2025-08-05T13:04:35Z","timestamp":1754399075000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.asm.org\/doi\/10.1128\/spectrum.00126-25"}},"subtitle":[],"editor":[{"given":"Dhammika H.","family":"Navarathna","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2025,8,5]]},"references-count":54,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2025,8,5]]}},"alternative-id":["10.1128\/spectrum.00126-25"],"URL":"https:\/\/doi.org\/10.1128\/spectrum.00126-25","relation":{},"ISSN":["2165-0497"],"issn-type":[{"value":"2165-0497","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,5]]},"assertion":[{"value":"2025-01-11","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-04-28","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-06-12","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e00126-25"}}