{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T13:23:34Z","timestamp":1788269014701,"version":"build-2803163510"},"reference-count":41,"publisher":"American Society for Microbiology","issue":"9","license":[{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"funder":[{"DOI":"10.13039\/501100020084","name":"Guangzhou Municipal Science and Technology Bureau","doi-asserted-by":"crossref","award":["2025A03J3226"],"award-info":[{"award-number":["2025A03J3226"]}],"id":[{"id":"10.13039\/501100020084","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["Microbiol Spectr"],"published-print":{"date-parts":[[2026,9,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title\/>\n                    <jats:p>\n                      To characterize the plasmid architecture and molecular background of KPC-NDM coproducing carbapenem-resistant\n                      <jats:italic toggle=\"yes\">Klebsiella pneumoniae<\/jats:italic>\n                      (KN-CRKP) in a South China hospital. Five KN-CRKP isolates were collected, including three from one patient. All underwent Illumina sequencing; two (ST11 and ST1869) additionally had Nanopore sequencing. Antimicrobial susceptibility testing strain sequence types, conjugation assays, resistance gene profiling, plasmid typing, genetic structure comparison, core-genome single nucleotide polymorphisms (SNPs) analysis, and plasmid clustering were performed. All isolates exhibited an imipenem minimum inhibitory concentration (MIC) of \u2265128 \u00b5g\/mL and harbored multiple resistance genes. One isolate (1\/5) belonged to ST1869 and co-harbored\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-5<\/jats:sub>\n                      . The\n                      <jats:italic toggle=\"yes\">bla<\/jats:italic>\n                      <jats:sub>NDM-5<\/jats:sub>\n                      -carrying plasmid was a novel IncI1\/X3 fusion plasmid that also carried\n                      <jats:italic toggle=\"yes\">bla<\/jats:italic>\n                      <jats:sub>CMY-42<\/jats:sub>\n                      . Unlike several IncX3 plasmids carrying blaNDM in publicly available KN-CRKP genomes from South China, this IncI1\/X3 hybrid lacked a complete conjugative transfer system. ST11 was the predominant clone (4\/5), co-harboring\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-1<\/jats:sub>\n                      . A rare genetic structure,\n                      <jats:italic toggle=\"yes\">\u0394<\/jats:italic>\n                      IS\n                      <jats:italic toggle=\"yes\">Kpn6-bla<\/jats:italic>\n                      <jats:sub>KPC-2<\/jats:sub>\n                      -IS\n                      <jats:italic toggle=\"yes\">Kpn28<\/jats:italic>\n                      , was identified on IncFII plasmids carrying\n                      <jats:italic toggle=\"yes\">bla<\/jats:italic>\n                      <jats:sub>KPC-2<\/jats:sub>\n                      . Plasmid clustering analysis of 126 comparative KN-CRKP genomes showed diverse sequence types and plasmid backgrounds associated with the KPC\/NDM co-production pattern. The observed plasmid diversity and structural variation in KN-CRKP support continued genomic surveillance, with particular attention to the ST1869 clone, the novel IncI1\/X3 hybrid plasmid harboring\n                      <jats:italic toggle=\"yes\">bla<\/jats:italic>\n                      <jats:sub>NDM-5<\/jats:sub>\n                      and\n                      <jats:italic toggle=\"yes\">bla<\/jats:italic>\n                      <jats:sub>CMY-42<\/jats:sub>\n                      , and the rare \u201c\n                      <jats:italic toggle=\"yes\">\u0394<\/jats:italic>\n                      IS\n                      <jats:italic toggle=\"yes\">Kpn6-bla<\/jats:italic>\n                      <jats:sub>KPC-2<\/jats:sub>\n                      -IS\n                      <jats:italic toggle=\"yes\">Kpn28<\/jats:italic>\n                      \u201d genetic structure. Expanded genomic data on KN-CRKP are needed to further elucidate its resistance mechanisms and plasmid evolutionary trajectories.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>IMPORTANCE<\/jats:title>\n                    <jats:p>\n                      The co-production of KPC and NDM carbapenemases in\n                      <jats:italic toggle=\"yes\">Klebsiella pneumoniae<\/jats:italic>\n                      poses a formidable threat to clinical antimicrobial therapy, as these enzymes confer resistance to virtually all \u03b2-lactam agents, including carbapenems. Here, we report novel genomic features of KN-CRKP in South China, including the emergence of the ST1869 clone, a unique IncI1\/X3 hybrid plasmid harboring blaNDM-5 and blaCMY-42, and the rare \u0394ISKpn6-blaKPC-2-ISKpn28 genetic structure. These findings substantially expand current understanding of plasmid evolution and resistance gene dissemination in this region. The identification of diverse resistance mechanisms and clonal backgrounds supports enhanced genomic surveillance and infection-control awareness for pan-resistant Enterobacterales.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1128\/spectrum.04195-25","type":"journal-article","created":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T13:01:03Z","timestamp":1786626063000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":0,"title":["Genomic characterization of KPC-2 and NDM coproducing carbapenem-resistant\n                    <i>Klebsiella pneumoniae<\/i>\n                    in a hospital: discovery of ST1869 clone and a novel hybrid plasmid"],"prefix":"10.1128","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-0337-9438","authenticated-orcid":false,"given":"Chengfeng","family":"Lin","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/01vjw4z39","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Clinical Laboratory, Southern Medical University, Fifth Affiliated Hospital","place":["Guangzhou, China"]},{"id":[{"id":"https:\/\/ror.org\/01vjw4z39","id-type":"ROR","asserted-by":"publisher"}],"name":"School of Laboratory Medicine and Biotechnology, Southern Medical University","place":["Guangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingjie","family":"Song","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/01vjw4z39","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Clinical Laboratory, Southern Medical University, Fifth Affiliated Hospital","place":["Guangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rongjiao","family":"Li","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/01vjw4z39","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Clinical Laboratory, Southern Medical University, Fifth Affiliated Hospital","place":["Guangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leping","family":"Yan","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/01vjw4z39","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Clinical Laboratory, Southern Medical University, Fifth Affiliated Hospital","place":["Guangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mei","family":"Yuan","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/01vjw4z39","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Clinical Laboratory, Southern Medical University, Fifth Affiliated Hospital","place":["Guangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7264-0328","authenticated-orcid":false,"given":"Fangyin","family":"Zeng","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/01vjw4z39","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Clinical Laboratory, Southern Medical University, Fifth Affiliated Hospital","place":["Guangzhou, China"]},{"id":[{"id":"https:\/\/ror.org\/01vjw4z39","id-type":"ROR","asserted-by":"publisher"}],"name":"School of Laboratory Medicine and Biotechnology, Southern Medical University","place":["Guangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3867-1849","authenticated-orcid":false,"given":"Shihan","family":"Zeng","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/01vjw4z39","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Clinical Laboratory, Southern Medical University, Fifth Affiliated Hospital","place":["Guangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.3389\/fcimb.2020.00314"},{"key":"e_1_3_5_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jiph.2022.08.014"},{"key":"e_1_3_5_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.scitotenv.2023.163870"},{"key":"e_1_3_5_5_2","doi-asserted-by":"publisher","DOI":"10.3389\/fmicb.2023.1159912"},{"key":"e_1_3_5_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ebiom.2019.102599"},{"key":"e_1_3_5_7_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41467-025-60765-7"},{"key":"e_1_3_5_8_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10096-024-04993-7"},{"key":"e_1_3_5_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2666-5247(24)00018-1"},{"key":"e_1_3_5_10_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12941-024-00686-3"},{"key":"e_1_3_5_11_2","doi-asserted-by":"publisher","DOI":"10.1093\/molbev\/msae263"},{"key":"e_1_3_5_12_2","volume-title":"CLSI supplement M100","author":"Clinical and Laboratory Standards Institute","year":"2021","unstructured":"Clinical and Laboratory Standards Institute. 2021. 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