{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T10:15:26Z","timestamp":1785406526178,"version":"3.56.0"},"reference-count":64,"publisher":"American Society for Microbiology","issue":"11","license":[{"start":{"date-parts":[[2025,11,4]],"date-time":"2025-11-04T00:00:00Z","timestamp":1762214400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,11,4]],"date-time":"2025-11-04T00:00:00Z","timestamp":1762214400000},"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":[[2025,11,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title\/>\n                    <jats:p>\n                      <jats:italic toggle=\"yes\">Klebsiella pneumoniae<\/jats:italic>\n                      is a major pathogen with substantial antimicrobial resistance driven by \u03b2-lactamase production. The co-existence of carbapenemase genes\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>IMP-8<\/jats:sub>\n                      in the prevalent\n                      <jats:italic toggle=\"yes\">K. pneumoniae<\/jats:italic>\n                      clone is rare and poses significant clinical challenges in China. In this study, we report the first identification of a clinical ST11\n                      <jats:italic toggle=\"yes\">K. pneumoniae<\/jats:italic>\n                      strain Kp4874, isolated from a hospitalized patient in China, co-carrying\n                      <jats:italic toggle=\"yes\">bla<\/jats:italic>\n                      <jats:sub>KPC-2<\/jats:sub>\n                      on a ~134 kb IncFII\/IncR hybrid plasmid and\n                      <jats:italic toggle=\"yes\">bla<\/jats:italic>\n                      <jats:sub>IMP-8<\/jats:sub>\n                      on a ~75 kb untypable plasmid. Whole-genome sequencing revealed key insertion sequences, including Tn\n                      <jats:italic toggle=\"yes\">As1<\/jats:italic>\n                      and IS\n                      <jats:italic toggle=\"yes\">26<\/jats:italic>\n                      , facilitating horizontal transfer of these resistance genes. Conjugation experiments confirmed the high transferability of both plasmids, particularly the\n                      <jats:italic toggle=\"yes\">bla<\/jats:italic>\n                      <jats:sub>KPC-2<\/jats:sub>\n                      plasmid. Despite harboring multiple virulence genes, the strain\u2019s clinical threat stems primarily from its multidrug-resistant profile. This study highlights the potential for rapid dissemination of such strains in healthcare settings and underscores the critical need for robust surveillance and infection control measures.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>IMPORTANCE<\/jats:title>\n                    <jats:p>\n                      This study is the first to report the co-existence 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>IMP-8<\/jats:sub>\n                      in an ST11\n                      <jats:italic toggle=\"yes\">Klebsiella pneumoniae<\/jats:italic>\n                      strain, underscoring the clinical threat posed by these carbapenemase genes. The identification of\n                      <jats:italic toggle=\"yes\">bla<\/jats:italic>\n                      <jats:sub>KPC-2<\/jats:sub>\n                      on an IncFII\/IncR hybrid plasmid, coupled with the successful conjugation of both resistance genes, highlights the significant potential for horizontal gene transfer and multidrug-resistant dissemination. These findings advance our understanding of plasmid-mediated resistance and emphasize the urgent need for enhanced monitoring and infection control strategies to mitigate the spread of such high-risk strains.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1128\/spectrum.03345-24","type":"journal-article","created":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T13:00:14Z","timestamp":1759928414000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":4,"title":["Emergence of ST11\n                    <i>Klebsiella pneumoniae<\/i>\n                    co-carrying\n                    <i>bla<\/i>\n                    <sub>KPC-2<\/sub>\n                    and\n                    <i>bla<\/i>\n                    <sub>IMP-8<\/sub>\n                    on conjugative 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Clinical Medicine of Henan University of Science and Technology","place":["Luoyang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaolu","family":"Yang","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/04epb4p87","id-type":"ROR","asserted-by":"publisher"}],"name":"School of Basic Medical Sciences, Zhejiang Chinese Medical University","place":["Hangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haowei","family":"Ye","sequence":"additional","affiliation":[{"name":"Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, the First Affiliated Hospital, Zhejiang University School of Medicine","place":["Hangzhou, 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