{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T01:15:18Z","timestamp":1788225318641,"version":"build-2803163510"},"reference-count":32,"publisher":"American Society for Microbiology","issue":"2","license":[{"start":{"date-parts":[[2026,2,3]],"date-time":"2026-02-03T00:00:00Z","timestamp":1770076800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,2,3]],"date-time":"2026-02-03T00:00:00Z","timestamp":1770076800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82202572"],"award-info":[{"award-number":["82202572"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Natural science research project funding of higher education institutions of Anhui province","award":["2023AH053175"],"award-info":[{"award-number":["2023AH053175"]}]}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["Microbiol Spectr"],"published-print":{"date-parts":[[2026,2,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title\/>\n                    <jats:p>\n                      In carbapenem-resistant\n                      <jats:italic toggle=\"yes\">Enterobacteriaceae<\/jats:italic>\n                      , the co-occurrence of carbapenem resistance genes poses a significant threat to global public health. This study investigated the phenotypic and genotypic characteristics of a clinical carbapenem-resistant\n                      <jats:italic toggle=\"yes\">Escherichia coli<\/jats:italic>\n                      strain B5, which harbors both\n                      <jats:italic toggle=\"yes\">bla<\/jats:italic>\n                      <jats:sub>KPC-2<\/jats:sub>\n                      and\n                      <jats:italic toggle=\"yes\">bla<\/jats:italic>\n                      <jats:sub>NDM-13<\/jats:sub>\n                      . Antimicrobial susceptibility testing and plasmid conjugation assays were performed on isolate B5, using\n                      <jats:italic toggle=\"yes\">E. coli<\/jats:italic>\n                      J53 (a standard recipient strain resistant to sodium azide) as the recipient, whereas passaging experiments and growth rate determination were conducted on J53 (pB5-KPC-NDM). Genetic characteristics of B5 were analyzed via whole-genome sequencing (WGS). B5 exhibits an extensive multidrug resistance phenotype, with susceptibility only to tigecycline and colistin. WGS revealed that B5 belongs to ST131, carries 11 plasmids, and co-harbors\n                      <jats:italic toggle=\"yes\">bla<\/jats:italic>\n                      <jats:sub>KPC-2<\/jats:sub>\n                      and\n                      <jats:italic toggle=\"yes\">bla<\/jats:italic>\n                      <jats:sub>NDM-13<\/jats:sub>\n                      on the IncB\/O\/K\/Z plasmid pB5-KPC-NDM. This plasmid also exhibited considerable stability in J53 (pB5-KPC-NDM), with a retention rate of 74% (37\/50) after 10 days of serial passage in antibiotic-free medium. Compared with the recipient strain J53, J53 (pB5-KPC-NDM) imposed a low fitness cost. Additionally, WGS further identified multiple additional resistance genes on pB5-KPC-NDM. Comparative analysis showed that\n                      <jats:italic toggle=\"yes\">bla<\/jats:italic>\n                      <jats:sub>KPC-2<\/jats:sub>\n                      resides within Tn\n                      <jats:italic toggle=\"yes\">6296<\/jats:italic>\n                      derivatives and\n                      <jats:italic toggle=\"yes\">bla<\/jats:italic>\n                      <jats:sub>NDM-13<\/jats:sub>\n                      within Tn\n                      <jats:italic toggle=\"yes\">125<\/jats:italic>\n                      derivatives on pB5-KPC-NDM, featuring both conserved and unique flanking contexts. Core structures potentially enabling horizontal transfer were identified: \u2206Tn\n                      <jats:italic toggle=\"yes\">6376-bla<\/jats:italic>\n                      <jats:sub>KPC-2<\/jats:sub>\n                      -\u2206IS\n                      <jats:italic toggle=\"yes\">Kpn6-korC-klcA-\u2206repB<\/jats:italic>\n                      -\u2206Tn\n                      <jats:italic toggle=\"yes\">1722<\/jats:italic>\n                      -5\u2019 for\n                      <jats:italic toggle=\"yes\">bla<\/jats:italic>\n                      <jats:sub>KPC-2<\/jats:sub>\n                      and IS\n                      <jats:italic toggle=\"yes\">1294<\/jats:italic>\n                      -\u2206IS\n                      <jats:italic toggle=\"yes\">Aba125-bla<\/jats:italic>\n                      <jats:sub>NDM-13<\/jats:sub>\n                      -\n                      <jats:italic toggle=\"yes\">ble<\/jats:italic>\n                      <jats:sub>MBL<\/jats:sub>\n                      -\n                      <jats:italic toggle=\"yes\">trpF-nagA<\/jats:italic>\n                      for\n                      <jats:italic toggle=\"yes\">bla<\/jats:italic>\n                      <jats:sub>NDM-13<\/jats:sub>\n                      . Notably, IS\n                      <jats:italic toggle=\"yes\">1294<\/jats:italic>\n                      (IS\n                      <jats:italic toggle=\"yes\">91<\/jats:italic>\n                      family), replaces IS\n                      <jats:italic toggle=\"yes\">Aba125<\/jats:italic>\n                      , is likely to mobilize\n                      <jats:italic toggle=\"yes\">bla<\/jats:italic>\n                      <jats:sub>NDM-13<\/jats:sub>\n                      . In conclusion, the pB5-KPC-NDM plasmid poses a severe threat due to its extensive resistance profile, high transferability, and low fitness cost, urging immediate intervention to prevent its dissemination.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>IMPORTANCE<\/jats:title>\n                    <jats:p>\n                      Antimicrobial resistance has become a serious global public health concern, severely limiting therapeutic options. The global proliferation of carbapenem-resistant\n                      <jats:italic toggle=\"yes\">Enterobacteriaceae<\/jats:italic>\n                      , driven by plasmid-mediated horizontal gene transfer of carbapenemase-encoding elements, constitutes a critical antimicrobial resistance crisis. This study provides the first evidence of\n                      <jats:italic toggle=\"yes\">bla<\/jats:italic>\n                      <jats:sub>KPC-2<\/jats:sub>\n                      and\n                      <jats:italic toggle=\"yes\">bla<\/jats:italic>\n                      <jats:sub>NDM-13<\/jats:sub>\n                      co-occurring on an IncB\/O\/K\/Z plasmid (pB5-KPC-NDM), as well as the first detection of these genes in a clinical\n                      <jats:italic toggle=\"yes\">Escherichia coli<\/jats:italic>\n                      isolate (B5). Phenotypic and genotypic analyses demonstrate efficient horizontal transfer capacity and stability across bacterial generations of pB5-KPC-NDM, facilitating the spreading of multidrug resistance. This dual carbapenemase co-localization represents a pivotal escalation in the dissemination potential of resistance and consequently heightens the threat of its spread worldwide. These findings emphasize the critical need for enhanced genomic surveillance programs and the implementation of stringent infection control measures to mitigate the global dissemination of such multidrug-resistant plasmids carrying high-risk carbapenemase variants.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1128\/spectrum.00528-25","type":"journal-article","created":{"date-parts":[[2025,12,18]],"date-time":"2025-12-18T14:00:31Z","timestamp":1766066431000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":1,"title":["First report of an\n                    <i>Escherichia coli<\/i>\n                    ST131 clinical isolate co-harboring\n                    <i>bla<\/i>\n                    <sub>KPC-2<\/sub>\n                    and\n                    <i>bla<\/i>\n                    <sub>NDM-13<\/sub>\n                    on an IncB\/O\/K\/Z plasmid in China"],"prefix":"10.1128","volume":"14","author":[{"given":"Yi-Yu","family":"Lyu","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/012f2cn18","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Clinical Laboratory, the Second Affiliated Hospital of Anhui Medical University","place":["Hefei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie-Hao","family":"Tai","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/012f2cn18","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Clinical Laboratory, the Second Affiliated Hospital of Anhui Medical University","place":["Hefei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cui-Ying","family":"Guo","sequence":"additional","affiliation":[{"name":"Department of Hospital Infection Prevention and Control, the First People\u2019s Hospital of Bengbu","place":["Bengbu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yin-Yin","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, the First People\u2019s Hospital of Bengbu","place":["Bengbu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yao","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, the First People\u2019s Hospital of Bengbu","place":["Bengbu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiang","family":"Zhou","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/012f2cn18","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Clinical Laboratory, the Second Affiliated Hospital of Anhui Medical University","place":["Hefei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0110-806X","authenticated-orcid":false,"given":"Wen-Wen","family":"Chu","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/012f2cn18","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Clinical Laboratory, the Second Affiliated Hospital of Anhui Medical University","place":["Hefei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0153-4904","authenticated-orcid":true,"given":"Yi-Le","family":"Wu","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/012f2cn18","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Hospital Infection Prevention and Control, the Second Affiliated Hospital of Anhui Medical University","place":["Hefei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(21)02724-0"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.tibs.2019.05.005"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.drup.2016.09.002"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmi.2019.04.013"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(19)30210-5"},{"key":"e_1_3_4_7_2","unstructured":"China Antimicrobial Resistance Surveillance System (CARSS). 2023. 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