{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T04:58:54Z","timestamp":1787979534748,"version":"build-2784847793"},"reference-count":27,"publisher":"American Society for Microbiology","issue":"5","license":[{"start":{"date-parts":[[2025,5,6]],"date-time":"2025-05-06T00:00:00Z","timestamp":1746489600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,5,6]],"date-time":"2025-05-06T00:00:00Z","timestamp":1746489600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"funder":[{"DOI":"10.13039\/501100002347","name":"Bundesministerium f\u00fcr Bildung und Forschung","doi-asserted-by":"publisher","award":["01KI2015"],"award-info":[{"award-number":["01KI2015"]}],"id":[{"id":"10.13039\/501100002347","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001655","name":"Deutscher Akademischer Austauschdienst","doi-asserted-by":"publisher","award":["57592343"],"award-info":[{"award-number":["57592343"]}],"id":[{"id":"10.13039\/501100001655","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002347","name":"Bundesministerium f\u00fcr Bildung und Forschung","doi-asserted-by":"publisher","award":["BMBF-01KI2207"],"award-info":[{"award-number":["BMBF-01KI2207"]}],"id":[{"id":"10.13039\/501100002347","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["Microbiol Spectr"],"published-print":{"date-parts":[[2025,5,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n          <jats:sec>\n            <jats:title\/>\n            <jats:p>\n              Carbapenem resistance in gram-negative rods is increasing in low- and middle-income countries. We conducted a single-center study to identify carbapenemase-encoding plasmids in carbapenem-resistant\n              <jats:italic>Klebsiella pneumoniae<\/jats:italic>\n              isolates causing human infections in Vietnam. The secondary objective was to investigate the prevalence of multidrug-resistant (MDR) and hypervirulent\n              <jats:italic>K. pneumoniae<\/jats:italic>\n              in this setting. Our genomic analysis study characterized 105 of 245 clinical\n              <jats:italic>K. pneumoniae<\/jats:italic>\n              isolates at the 108 Military Hospital in Hanoi, Vietnam, collected from intensive care unit and regular wards between 1 January 2021 and 31 December 2021. All isolates were characterized using long- and short-read sequencing, followed by hybrid assembly. Comprehensive genomic analysis was performed to identify carbapenemase-encoding plasmids, complemented by extended antibiotic susceptibility testing for commonly used and novel antibiotics. We observed a high prevalence of NDM-4-related carbapenem resistance (30.5%, 32\/105) mostly carried by a specific 83-kb IncFII plasmid co-carrying the\n              <jats:italic>bla<\/jats:italic>\n              <jats:sub>TEM-1<\/jats:sub>\n              (46.9%, 15\/32). The genomic content of the\n              <jats:italic>bla<\/jats:italic>\n              <jats:sub>NDM-4<\/jats:sub>\n              -harboring plasmids is highly variable. While\n              <jats:italic>bla<\/jats:italic>\n              <jats:sub>OXA-181<\/jats:sub>\n              and\n              <jats:italic>bla<\/jats:italic>\n              <jats:sub>OXA-48<\/jats:sub>\n              were predominantly located on an IncX3 and an IncL plasmid, respectively, the majority of plasmids harboring\n              <jats:italic>bla<\/jats:italic>\n              <jats:sub>KPC-2<\/jats:sub>\n              were not related to any named Inc-type. All isolates exhibited the MDR phenotype; however, the majority remained susceptible to the siderophore-cephalosporin cefiderocol (79%, 83\/105). All isolates were susceptible to aztreonam\/avibactam. In addition, we identified a hypervirulent, carbapenem-resistant\n              <jats:italic>K. pneumoniae<\/jats:italic>\n              ST23 strain, confirmed through both\n              <jats:italic>in vitro<\/jats:italic>\n              and\n              <jats:italic>in vivo<\/jats:italic>\n              experiments. Our study provides insights into plasmids harboring the carbapenemases New Delhi metallo-\u03b2-lactamase, oxacillinase-48 like, and\n              <jats:italic>K. pneumoniae<\/jats:italic>\n              carbapenemase-2 circulating in Vietnam.\n            <\/jats:p>\n            <jats:sec>\n              <jats:title>IMPORTANCE<\/jats:title>\n              <jats:p>\n                Carbapenem resistance in\n                <jats:italic>Klebsiella pneumoniae<\/jats:italic>\n                is a major public health threat, especially in low- and middle-income countries. This study examined resistant strains from a hospital in Vietnam to understand how they spread and which antibiotics might still work. We found that a significant number of these bacteria carried resistance genes on different types of plasmids. Despite their resistance to many antibiotics, most strains remained susceptible to newer substances like cefiderocol and aztreonam\/avibactam. Alarmingly, we also identified a hypervirulent strain that is carbapenem resistant, potentially posing an even greater risk to patients. This research provides insight into the epidemiology of the carbapenemase gene-harboring plasmids in a Vietnamese hospital. Understanding these resistance patterns can help guide antibiotic use and policy decisions to combat the growing threat of multidrug-resistant infections in Vietnam.\n              <\/jats:p>\n            <\/jats:sec>\n          <\/jats:sec>","DOI":"10.1128\/spectrum.03115-24","type":"journal-article","created":{"date-parts":[[2025,4,15]],"date-time":"2025-04-15T11:23:01Z","timestamp":1744716181000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":7,"title":["Genomic analysis of carbapenemase-encoding plasmids and antibiotic resistance in carbapenem-resistant\n            <i>Klebsiella pneumoniae<\/i>\n            isolates from Vietnam, 2021"],"prefix":"10.1128","volume":"13","author":[{"given":"Lisa","family":"G\u00f6pel","sequence":"first","affiliation":[{"name":"Institute of Medical Microbiology, University of L\u00fcbeck and University Hospital Schleswig-Holstein Campus L\u00fcbeck","place":["L\u00fcbeck, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Le Thi Kieu","family":"Linh","sequence":"additional","affiliation":[{"name":"Vietnamese - German Centre for Medical Research (VG-CARE)","place":["Hanoi, Vietnam"]},{"name":"Institute of Tropical Medicine, University of T\u00fcbingen","place":["T\u00fcbingen, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4615-0114","authenticated-orcid":false,"given":"Bui Tien","family":"Sy","sequence":"additional","affiliation":[{"name":"Vietnamese - German Centre for Medical Research (VG-CARE)","place":["Hanoi, Vietnam"]},{"name":"108 Military Central Hospital","place":["Hanoi, Vietnam"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S\u00e9bastien","family":"Boutin","sequence":"additional","affiliation":[{"name":"Institute of Medical Microbiology, University of L\u00fcbeck and University Hospital Schleswig-Holstein Campus L\u00fcbeck","place":["L\u00fcbeck, Germany"]},{"name":"German Center for Infection Research (DZIF), Partner Site Hamburg-L\u00fcbeck-Borstel-Riems, Hamburg-L\u00fcbeck-Borstel-Riems","place":["L\u00fcbeck, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simone","family":"Weikert-Asbeck","sequence":"additional","affiliation":[{"name":"Institute of Medical Microbiology, University of L\u00fcbeck and University Hospital Schleswig-Holstein Campus L\u00fcbeck","place":["L\u00fcbeck, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5514-8083","authenticated-orcid":true,"given":"Elias","family":"Eger","sequence":"additional","affiliation":[{"name":"Epidemiology and Ecology of Antimicrobial Resistance (GEAR), Helmholtz Institute for One Health (HIOH), Helmholtz Centre for Infection Research (HZI)","place":["Greifswald, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susanne","family":"Hauswaldt","sequence":"additional","affiliation":[{"name":"Institute of Medical Microbiology, University of L\u00fcbeck and University Hospital Schleswig-Holstein Campus L\u00fcbeck","place":["L\u00fcbeck, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2436-7897","authenticated-orcid":false,"given":"Truong Nhat","family":"My","sequence":"additional","affiliation":[{"name":"Vietnamese - German Centre for Medical Research (VG-CARE)","place":["Hanoi, Vietnam"]},{"name":"108 Military Central Hospital","place":["Hanoi, Vietnam"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1134-4197","authenticated-orcid":true,"given":"Kaan","family":"Kocer","sequence":"additional","affiliation":[{"name":"Institute of Medical Microbiology, University of L\u00fcbeck and University Hospital Schleswig-Holstein Campus L\u00fcbeck","place":["L\u00fcbeck, Germany"]},{"name":"German Center for Infection Research (DZIF), Partner Site Hamburg-L\u00fcbeck-Borstel-Riems, Hamburg-L\u00fcbeck-Borstel-Riems","place":["L\u00fcbeck, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nguyen Trong","family":"The","sequence":"additional","affiliation":[{"name":"Vietnamese - German Centre for Medical Research (VG-CARE)","place":["Hanoi, Vietnam"]},{"name":"108 Military Central Hospital","place":["Hanoi, Vietnam"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8722-1233","authenticated-orcid":true,"given":"Jan","family":"Rupp","sequence":"additional","affiliation":[{"name":"Institute of Medical Microbiology, University of L\u00fcbeck and University Hospital Schleswig-Holstein Campus L\u00fcbeck","place":["L\u00fcbeck, Germany"]},{"name":"German Center for Infection Research (DZIF), Partner Site Hamburg-L\u00fcbeck-Borstel-Riems, Hamburg-L\u00fcbeck-Borstel-Riems","place":["L\u00fcbeck, Germany"]},{"name":"Infectious Disease Clinic, University of L\u00fcbeck and University Hospital Schleswig-Holstein Campus L\u00fcbeck","place":["L\u00fcbeck, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Le Huu","family":"Song","sequence":"additional","affiliation":[{"name":"Vietnamese - German Centre for Medical Research (VG-CARE)","place":["Hanoi, Vietnam"]},{"name":"Institute of Tropical Medicine, University of T\u00fcbingen","place":["T\u00fcbingen, Germany"]},{"name":"108 Military Central Hospital","place":["Hanoi, Vietnam"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2669-8799","authenticated-orcid":false,"given":"Katharina","family":"Schaufler","sequence":"additional","affiliation":[{"name":"Epidemiology and Ecology of Antimicrobial Resistance (GEAR), Helmholtz Institute for One Health (HIOH), Helmholtz Centre for Infection Research (HZI)","place":["Greifswald, Germany"]},{"name":"University Medicine Greifswald","place":["Greifswald, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9809-9883","authenticated-orcid":false,"given":"Thirumalaisamy P.","family":"Velavan","sequence":"additional","affiliation":[{"name":"Vietnamese - German Centre for Medical Research (VG-CARE)","place":["Hanoi, Vietnam"]},{"name":"Institute of Tropical Medicine, University of T\u00fcbingen","place":["T\u00fcbingen, Germany"]},{"name":"Faculty of Medicine, Duy Tan University","place":["Da Nang, Vietnam"]},{"name":"German Center for Infection Research (DZIF), Partner Site T\u00fcbingen","place":["T\u00fcbingen, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1278-5939","authenticated-orcid":true,"given":"Dennis","family":"Nurjadi","sequence":"additional","affiliation":[{"name":"Institute of Medical Microbiology, University of L\u00fcbeck and University Hospital Schleswig-Holstein Campus L\u00fcbeck","place":["L\u00fcbeck, Germany"]},{"name":"Vietnamese - 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