{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T00:04:10Z","timestamp":1792800250938,"version":"4.5.0"},"reference-count":61,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,6,6]],"date-time":"2025-06-06T00:00:00Z","timestamp":1749168000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"},{"start":{"date-parts":[[2025,6,6]],"date-time":"2025-06-06T00:00:00Z","timestamp":1749168000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"funder":[{"name":"Guizhou Provincial Administration of Traditional Chinese Medicine","award":["QZYY-2024-016 and QZYY-2022-036"],"award-info":[{"award-number":["QZYY-2024-016 and QZYY-2022-036"]}]},{"name":"Guizhou Provincial Administration of Traditional Chinese Medicine","award":["QZYY-2024-016 and QZYY-2022-036"],"award-info":[{"award-number":["QZYY-2024-016 and QZYY-2022-036"]}]},{"name":"Talent research fund project of Anhui Agricultural University","award":["rc392109"],"award-info":[{"award-number":["rc392109"]}],"id":[{"id":"https:\/\/ror.org\/0327f3359","id-type":"ROR","asserted-by":"crossref"}]},{"name":"Guizhou Provincial Basic Research Program","award":["Qiankehebasic-ZK [2019] General 1022"],"award-info":[{"award-number":["Qiankehebasic-ZK [2019] General 1022"]}]},{"name":"Guizhou Provincial Basic Research Program","award":["Qiankehebasic-ZK [2022] General 501"],"award-info":[{"award-number":["Qiankehebasic-ZK [2022] General 501"]}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82460727"],"award-info":[{"award-number":["82460727"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100010828","name":"Department of Education of Guizhou Province","doi-asserted-by":"publisher","award":["Qianjiaohe KY [2022] 268"],"award-info":[{"award-number":["Qianjiaohe KY [2022] 268"]}],"id":[{"id":"10.13039\/501100010828","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100017957","name":"Health Commission of Guizhou Province","doi-asserted-by":"publisher","award":["gzwkj2021-395"],"award-info":[{"award-number":["gzwkj2021-395"]}],"id":[{"id":"10.13039\/100017957","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Microbiol"],"DOI":"10.1186\/s12866-025-04052-x","type":"journal-article","created":{"date-parts":[[2025,6,5]],"date-time":"2025-06-05T22:14:03Z","timestamp":1749161643000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Prevalence and molecular characterisation of multi-drug resistant ST11 hypervirulent Klebsiella pneumoniae in a teaching hospital"],"prefix":"10.1186","volume":"25","author":[{"given":"Xue","family":"Li","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kai","family":"Ma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ping","family":"Cheng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lailai","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yihui","family":"Chai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mingle","family":"Cao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuqi","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,6,6]]},"reference":[{"key":"4052_CR1","doi-asserted-by":"publisher","unstructured":"Sid Ahmed MA, Hamid JM, Hassan AMM, Abu Jarir S, Bashir Ibrahim E, Abdel Hadi H. Phenotypic and genotypic characterization of pan-drug-resistant Klebsiella pneumoniae isolated in Qatar. Antibiotics (Basel). 2024;13(3).\u00a0https:\/\/doi.org\/10.3390\/antibiotics13030275.","DOI":"10.3390\/antibiotics13030275"},{"issue":"7","key":"4052_CR2","doi-asserted-by":"publisher","first-page":"915","DOI":"10.1086\/428574","volume":"40","author":"JL Wang","year":"2005","unstructured":"Wang JL, Chen KY, Fang CT, Hsueh PR, Yang PC, Chang SC. Changing bacteriology of adult community-acquired lung abscess in Taiwan: Klebsiella pneumoniae versus anaerobes. Clin Infect Dis. 2005;40(7):915\u201322. https:\/\/doi.org\/10.1086\/428574.","journal-title":"Clin Infect Dis"},{"issue":"3","key":"4052_CR3","doi-asserted-by":"publisher","first-page":"629","DOI":"10.1128\/MMBR.00078-15","volume":"80","author":"MK Paczosa","year":"2016","unstructured":"Paczosa MK, Mecsas J. Klebsiella pneumoniae: going on the offense with a strong defense. Microbiol Mol Biol Rev. 2016;80(3):629\u201361. https:\/\/doi.org\/10.1128\/MMBR.00078-15.","journal-title":"Microbiol Mol Biol Rev"},{"issue":"2","key":"4052_CR4","doi-asserted-by":"publisher","first-page":"225","DOI":"10.1093\/cid\/cit675","volume":"58","author":"W Li","year":"2014","unstructured":"Li W, Sun G, Yu Y, Li N, Chen M, Jin R, et al. Increasing occurrence of antimicrobial-resistant hypervirulent (hypermucoviscous) Klebsiella pneumoniae isolates in China. Clin Infect Dis. 2014;58(2):225\u201332. https:\/\/doi.org\/10.1093\/cid\/cit675.","journal-title":"Clin Infect Dis"},{"issue":"3","key":"4052_CR5","doi-asserted-by":"publisher","first-page":"283","DOI":"10.1111\/joim.13007","volume":"287","author":"JE Choby","year":"2020","unstructured":"Choby JE, Howard-Anderson J, Weiss DS. Hypervirulent Klebsiella pneumoniae - clinical and molecular perspectives. J Intern Med. 2020;287(3):283\u2013300. https:\/\/doi.org\/10.1111\/joim.13007.","journal-title":"J Intern Med"},{"key":"4052_CR6","doi-asserted-by":"publisher","first-page":"483","DOI":"10.3389\/fcimb.2017.00483","volume":"7","author":"CR Lee","year":"2017","unstructured":"Lee CR, Lee JH, Park KS, Jeon JH, Kim YB, Cha CJ, et al. Antimicrobial resistance of hypervirulent Klebsiella pneumoniae: epidemiology, hypervirulence-associated determinants, and resistance mechanisms. Front Cell Infect Microbiol. 2017;7:483. https:\/\/doi.org\/10.3389\/fcimb.2017.00483.","journal-title":"Front Cell Infect Microbiol"},{"issue":"3","key":"4052_CR7","doi-asserted-by":"publisher","first-page":"268","DOI":"10.1111\/j.1469-0691.2011.03570.x","volume":"18","author":"AP Magiorakos","year":"2012","unstructured":"Magiorakos AP, Srinivasan A, Carey RB, Carmeli Y, Falagas ME, Giske CG, et al. Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance. Clin Microbiol Infect. 2012;18(3):268\u201381. https:\/\/doi.org\/10.1111\/j.1469-0691.2011.03570.x.","journal-title":"Clin Microbiol Infect"},{"issue":"6","key":"4052_CR8","doi-asserted-by":"publisher","first-page":"583","DOI":"10.1097\/QCO.0000000000000314","volume":"29","author":"M Bassetti","year":"2016","unstructured":"Bassetti M, Peghin M, Pecori D. The management of multidrug-resistant Enterobacteriaceae. Curr Opin Infect Dis. 2016;29(6):583\u201394. https:\/\/doi.org\/10.1097\/QCO.0000000000000314.","journal-title":"Curr Opin Infect Dis"},{"issue":"20\u201321","key":"4052_CR9","doi-asserted-by":"publisher","first-page":"345","DOI":"10.3238\/arztebl.2018.0345","volume":"115","author":"M Fritzenwanker","year":"2018","unstructured":"Fritzenwanker M, Imirzalioglu C, Herold S, Wagenlehner FM, Zimmer KP, Chakraborty T. Treatment options for carbapenem- resistant gram-negative infections. Dtsch Arztebl Int. 2018;115(20\u201321):345\u201352. https:\/\/doi.org\/10.3238\/arztebl.2018.0345.","journal-title":"Dtsch Arztebl Int"},{"issue":"3","key":"4052_CR10","doi-asserted-by":"publisher","first-page":"dlaa075","DOI":"10.1093\/jacamr\/dlaa075","volume":"2","author":"S Hughes","year":"2020","unstructured":"Hughes S, Gilchrist M, Heard K, Hamilton R, Sneddon J. Treating infections caused by carbapenemase-producing Enterobacterales (CPE): a pragmatic approach to antimicrobial stewardship on behalf of the UKCPA Pharmacy Infection Network (PIN). JAC Antimicrob Resist. 2020;2(3):dlaa075. https:\/\/doi.org\/10.1093\/jacamr\/dlaa075.","journal-title":"JAC Antimicrob Resist"},{"issue":"2","key":"4052_CR11","doi-asserted-by":"publisher","first-page":"106528","DOI":"10.1016\/j.ijantimicag.2022.106528","volume":"59","author":"YL Lee","year":"2022","unstructured":"Lee YL, Chen HM, Hii IM, Hsueh PR. Carbapenemase-producing Enterobacterales infections: recent advances in diagnosis and treatment. Int J Antimicrob Agents. 2022;59(2):106528. https:\/\/doi.org\/10.1016\/j.ijantimicag.2022.106528.","journal-title":"Int J Antimicrob Agents"},{"key":"4052_CR12","doi-asserted-by":"publisher","unstructured":"Tamma PD, Aitken SL, Bonomo RA, Mathers AJ, van Duin D, Clancy CJ. Infectious Diseases Society of America 2022 guidance on the treatment of Extended-Spectrum beta-lactamase Producing Enterobacterales (ESBL-E), Carbapenem-Resistant Enterobacterales (CRE), and Pseudomonas aeruginosa with Difficult-to-Treat Resistance (DTR-P. aeruginosa). Clin Infect Dis. 2022;75(2):187\u2013212; https:\/\/doi.org\/10.1093\/cid\/ciac268.","DOI":"10.1093\/cid\/ciac268"},{"issue":"1","key":"4052_CR13","doi-asserted-by":"publisher","first-page":"44","DOI":"10.1089\/mdr.2019.0482","volume":"27","author":"W Liao","year":"2021","unstructured":"Liao W, De Wang L, Li D, Du FL, Long D, Liu Y, et al. High prevalence of 16s rRNA methylase genes among carbapenem-resistant hypervirulent Klebsiella pneumoniae isolates in a Chinese Tertiary Hospital. Microb Drug Resist. 2021;27(1):44\u201352. https:\/\/doi.org\/10.1089\/mdr.2019.0482.","journal-title":"Microb Drug Resist"},{"issue":"3","key":"4052_CR14","doi-asserted-by":"publisher","first-page":"ofx176","DOI":"10.1093\/ofid\/ofx176","volume":"4","author":"B Cai","year":"2017","unstructured":"Cai B, Echols R, Magee G, Arjona Ferreira JC, Morgan G, Ariyasu M, et al. Prevalence of carbapenem-resistant gram-negative infections in the United States predominated by Acinetobacter baumannii and Pseudomonas aeruginosa. Open Forum Infect Dis. 2017;4(3):ofx176. https:\/\/doi.org\/10.1093\/ofid\/ofx176.","journal-title":"Open Forum Infect Dis"},{"issue":"9","key":"4052_CR15","doi-asserted-by":"publisher","first-page":"889","DOI":"10.1002\/phar.2446","volume":"40","author":"TP Lodise","year":"2020","unstructured":"Lodise TP, Kanakamedala H, Hsu WC, Cai B. Impact of incremental delays in appropriate therapy on the outcomes of hospitalized adult patients with gram-negative bloodstream infections: \u201cEvery day matters.\u201d Pharmacotherapy. 2020;40(9):889\u2013901. https:\/\/doi.org\/10.1002\/phar.2446.","journal-title":"Pharmacotherapy"},{"issue":"2","key":"4052_CR16","doi-asserted-by":"publisher","first-page":"115","DOI":"10.1016\/j.diagmicrobio.2012.11.009","volume":"75","author":"D van Duin","year":"2013","unstructured":"van Duin D, Kaye KS, Neuner EA, Bonomo RA. Carbapenem-resistant Enterobacteriaceae: a review of treatment and outcomes. Diagn Microbiol Infect Dis. 2013;75(2):115\u201320. https:\/\/doi.org\/10.1016\/j.diagmicrobio.2012.11.009.","journal-title":"Diagn Microbiol Infect Dis"},{"issue":"43","key":"4052_CR17","doi-asserted-by":"publisher","first-page":"e12984","DOI":"10.1097\/MD.0000000000012984","volume":"97","author":"T Kim","year":"2018","unstructured":"Kim T, Lee EJ, Park SY, Yu SN, Lee YM, Park KH, et al. Natural prognosis of carbapenem-resistant Acinetobacter baumannii bacteremia in patients who did not receive appropriate antibiotic treatment: a retrospective multicenter study in Korea. Medicine (Baltimore). 2018;97(43):e12984. https:\/\/doi.org\/10.1097\/MD.0000000000012984.","journal-title":"Medicine (Baltimore)"},{"issue":"11","key":"4052_CR18","doi-asserted-by":"publisher","first-page":"3146","DOI":"10.1093\/jac\/dkv218","volume":"70","author":"N Andria","year":"2015","unstructured":"Andria N, Henig O, Kotler O, Domchenko A, Oren I, Zuckerman T, et al. Mortality burden related to infection with carbapenem-resistant Gram-negative bacteria among haematological cancer patients: a retrospective cohort study. J Antimicrob Chemother. 2015;70(11):3146\u201353. https:\/\/doi.org\/10.1093\/jac\/dkv218.","journal-title":"J Antimicrob Chemother"},{"issue":"4","key":"4052_CR19","doi-asserted-by":"publisher","first-page":"391","DOI":"10.1080\/21505594.2016.1213472","volume":"8","author":"SM Pouch","year":"2017","unstructured":"Pouch SM, Satlin MJ. Carbapenem-resistant Enterobacteriaceae in special populations: solid organ transplant recipients, stem cell transplant recipients, and patients with hematologic malignancies. Virulence. 2017;8(4):391\u2013402. https:\/\/doi.org\/10.1080\/21505594.2016.1213472.","journal-title":"Virulence"},{"issue":"4","key":"4052_CR20","doi-asserted-by":"publisher","first-page":"427","DOI":"10.1080\/21505594.2016.1185577","volume":"8","author":"R Banerjee","year":"2017","unstructured":"Banerjee R, Humphries R. Clinical and laboratory considerations for the rapid detection of carbapenem-resistant Enterobacteriaceae. Virulence. 2017;8(4):427\u201339. https:\/\/doi.org\/10.1080\/21505594.2016.1185577.","journal-title":"Virulence"},{"key":"4052_CR21","unstructured":"WHO. WHO bacterial priority pathogens list, 2024 bacterial pathogens of public health importance to guide research, development and strategies to prevent and control antimicrobial resistance. Geneva: World Health Organization. 2024."},{"key":"4052_CR22","unstructured":"James S. Lewis II P, FIDSA. Performance standards for antimicrobial suspectibility testing. M100, 34th Edition. 2024."},{"issue":"3","key":"4052_CR23","doi-asserted-by":"publisher","first-page":"e25","DOI":"10.1086\/519424","volume":"45","author":"KA Nadasy","year":"2007","unstructured":"Nadasy KA, Domiati-Saad R, Tribble MA. Invasive Klebsiella pneumoniae syndrome in North America. Clin Infect Dis. 2007;45(3):e25\u20138. https:\/\/doi.org\/10.1086\/519424.","journal-title":"Clin Infect Dis"},{"key":"4052_CR24","doi-asserted-by":"publisher","unstructured":"Russo TA, Olson R, Fang CT, Stoesser N, Miller M, MacDonald U, et al. Identification of Biomarkers for Differentiation of Hypervirulent Klebsiella pneumoniae from Classical K. pneumoniae. J Clin Microbiol. 2018;56(9).https:\/\/doi.org\/10.1128\/JCM.00776-18.","DOI":"10.1128\/JCM.00776-18"},{"key":"4052_CR25","doi-asserted-by":"publisher","unstructured":"Yu F, Lv J, Niu S, Du H, Tang YW, Pitout JDD, et al. Multiplex PCR analysis for rapid detection of Klebsiella pneumoniae carbapenem-resistant (Sequence Type 258 [ST258] and ST11) and Hypervirulent (ST23, ST65, ST86, and ST375) Strains. J Clin Microbiol. 2018;56(9). https:\/\/doi.org\/10.1128\/JCM.00731-18.","DOI":"10.1128\/JCM.00731-18"},{"key":"4052_CR26","doi-asserted-by":"publisher","unstructured":"Russo TA, MacDonald U, Hassan S, Camanzo E, LeBreton F, Corey B, et al. An assessment of siderophore production, mucoviscosity, and mouse infection models for defining the virulence spectrum of hypervirulent Klebsiella pneumoniae. mSphere. 2021;6(2). https:\/\/doi.org\/10.1128\/mSphere.00045-21.","DOI":"10.1128\/mSphere.00045-21"},{"key":"4052_CR27","doi-asserted-by":"publisher","first-page":"916304","DOI":"10.3389\/fmicb.2022.916304","volume":"13","author":"S Li","year":"2022","unstructured":"Li S, Shen S, Ding L, Han R, Guo Y, Yin D, et al. First report of bla (CTX-M-167), bla (SHV-1), and bla (TEM-1B) carrying Klebsiella pneumonia showing high-level resistance to carbapenems. Front Microbiol. 2022;13:916304. https:\/\/doi.org\/10.3389\/fmicb.2022.916304.","journal-title":"Front Microbiol"},{"issue":"8","key":"4052_CR28","doi-asserted-by":"publisher","first-page":"4178","DOI":"10.1128\/JCM.43.8.4178-4182.2005","volume":"43","author":"L Diancourt","year":"2005","unstructured":"Diancourt L, Passet V, Verhoef J, Grimont PA, Brisse S. Multilocus sequence typing of Klebsiella pneumoniae nosocomial isolates. J Clin Microbiol. 2005;43(8):4178\u201382. https:\/\/doi.org\/10.1128\/JCM.43.8.4178-4182.2005.","journal-title":"J Clin Microbiol"},{"key":"4052_CR29","unstructured":"Surveillance atlas of infectious diseases. https:\/\/atlas.ecdc.europa.eu\/public\/index.aspx. Accessed 6 Apr 2024."},{"key":"4052_CR30","unstructured":"China antimicrobial surveillance network. https:\/\/www.chinets.com. Accessed 6 Apr 2024."},{"key":"4052_CR31","doi-asserted-by":"publisher","first-page":"65","DOI":"10.2147\/IDR.S397975","volume":"16","author":"F Hu","year":"2023","unstructured":"Hu F, Lin ML, Mou JL, Feng JH, Huang K, Lao YJ, et al. Molecular and clinical characteristics of carbapenem-resistant Klebsiella pneumoniae isolates at a tertiary hospital in Wuhan. China Infect Drug Resist. 2023;16:65\u201376. https:\/\/doi.org\/10.2147\/IDR.S397975.","journal-title":"China Infect Drug Resist"},{"issue":"10","key":"4052_CR32","doi-asserted-by":"publisher","first-page":"e0028322","DOI":"10.1128\/iai.00283-22","volume":"90","author":"SP Dias","year":"2022","unstructured":"Dias SP, Brouwer MC, van de Beek D. Sex and gender differences in bacterial infections. Infect Immun. 2022;90(10):e0028322. https:\/\/doi.org\/10.1128\/iai.00283-22.","journal-title":"Infect Immun"},{"issue":"5","key":"4052_CR33","first-page":"532","volume":"33","author":"SS Tsai","year":"2010","unstructured":"Tsai SS, Huang JC, Chen ST, Sun JH, Wang CC, Lin SF, et al. Characteristics of Klebsiella pneumoniae bacteremia in community-acquired and nosocomial infections in diabetic patients. Chang Gung Med J. 2010;33(5):532\u20139.","journal-title":"Chang Gung Med J"},{"issue":"9","key":"4052_CR34","doi-asserted-by":"publisher","first-page":"866","DOI":"10.1016\/j.amjmed.2009.03.034","volume":"122","author":"BL Meatherall","year":"2009","unstructured":"Meatherall BL, Gregson D, Ross T, Pitout JD, Laupland KB. Incidence, risk factors, and outcomes of Klebsiella pneumoniae bacteremia. Am J Med. 2009;122(9):866\u201373. https:\/\/doi.org\/10.1016\/j.amjmed.2009.03.034.","journal-title":"Am J Med"},{"issue":"6","key":"4052_CR35","doi-asserted-by":"publisher","first-page":"571","DOI":"10.1016\/j.ejim.2014.04.008","volume":"25","author":"S Chetcuti Zammit","year":"2014","unstructured":"Chetcuti Zammit S, Azzopardi N, Sant J. Mortality risk score for Klebsiella pneumoniae bacteraemia. Eur J Intern Med. 2014;25(6):571\u20136. https:\/\/doi.org\/10.1016\/j.ejim.2014.04.008.","journal-title":"Eur J Intern Med"},{"key":"4052_CR36","doi-asserted-by":"publisher","first-page":"24","DOI":"10.1186\/1471-2334-6-24","volume":"6","author":"AR Marra","year":"2006","unstructured":"Marra AR, Wey SB, Castelo A, Gales AC, Cal RG, Filho JR, et al. Nosocomial bloodstream infections caused by Klebsiella pneumoniae: impact of extended-spectrum beta-lactamase (ESBL) production on clinical outcome in a hospital with high ESBL prevalence. BMC Infect Dis. 2006;6:24. https:\/\/doi.org\/10.1186\/1471-2334-6-24.","journal-title":"BMC Infect Dis"},{"issue":"1","key":"4052_CR37","doi-asserted-by":"publisher","first-page":"214","DOI":"10.1378\/chest.107.1.214","volume":"107","author":"GM Jong","year":"1995","unstructured":"Jong GM, Hsiue TR, Chen CR, Chang HY, Chen CW. Rapidly fatal outcome of bacteremic Klebsiella pneumoniae pneumonia in alcoholics. Chest. 1995;107(1):214\u20137. https:\/\/doi.org\/10.1378\/chest.107.1.214.","journal-title":"Chest"},{"issue":"2","key":"4052_CR38","doi-asserted-by":"publisher","first-page":"327","DOI":"10.1093\/jac\/dkz446","volume":"75","author":"Y Zhang","year":"2020","unstructured":"Zhang Y, Jin L, Ouyang P, Wang Q, Wang R, Wang J, et al. Evolution of hypervirulence in carbapenem-resistant Klebsiella pneumoniae in China: a multicentre, molecular epidemiological analysis. J Antimicrob Chemother. 2020;75(2):327\u201336. https:\/\/doi.org\/10.1093\/jac\/dkz446.","journal-title":"J Antimicrob Chemother"},{"key":"4052_CR39","doi-asserted-by":"publisher","first-page":"1083009","DOI":"10.3389\/fcimb.2022.1083009","volume":"12","author":"Q Wang","year":"2022","unstructured":"Wang Q, Chen M, Ou Q, Zheng L, Chen X, Mao G, et al. Carbapenem-resistant hypermucoviscous Klebsiella pneumoniae clinical isolates from a tertiary hospital in China: Antimicrobial susceptibility, resistance phenotype, epidemiological characteristics, microbial virulence, and risk factors. Front Cell Infect Microbiol. 2022;12:1083009. https:\/\/doi.org\/10.3389\/fcimb.2022.1083009.","journal-title":"Front Cell Infect Microbiol"},{"key":"4052_CR40","doi-asserted-by":"publisher","first-page":"166","DOI":"10.1186\/s13756-019-0615-2","volume":"8","author":"S Zhang","year":"2019","unstructured":"Zhang S, Zhang X, Wu Q, Zheng X, Dong G, Fang R, et al. Clinical, microbiological, and molecular epidemiological characteristics of Klebsiella pneumoniae-induced pyogenic liver abscess in southeastern China. Antimicrob Resist Infect Control. 2019;8:166. https:\/\/doi.org\/10.1186\/s13756-019-0615-2.","journal-title":"Antimicrob Resist Infect Control"},{"issue":"12","key":"4052_CR41","doi-asserted-by":"publisher","first-page":"1717","DOI":"10.1086\/588383","volume":"197","author":"PF Hsieh","year":"2008","unstructured":"Hsieh PF, Lin TL, Lee CZ, Tsai SF, Wang JT. Serum-induced iron-acquisition systems and TonB contribute to virulence in Klebsiella pneumoniae causing primary pyogenic liver abscess. J Infect Dis. 2008;197(12):1717\u201327. https:\/\/doi.org\/10.1086\/588383.","journal-title":"J Infect Dis"},{"key":"4052_CR42","doi-asserted-by":"publisher","first-page":"1003783","DOI":"10.3389\/fmicb.2022.1003783","volume":"13","author":"YL Han","year":"2022","unstructured":"Han YL, Wen XH, Zhao W, Cao XS, Wen JX, Wang JR, et al. Epidemiological characteristics and molecular evolution mechanisms of carbapenem-resistant hypervirulent Klebsiella pneumoniae. Front Microbiol. 2022;13:1003783. https:\/\/doi.org\/10.3389\/fmicb.2022.1003783.","journal-title":"Front Microbiol"},{"issue":"12","key":"4052_CR43","doi-asserted-by":"publisher","first-page":"611","DOI":"10.1016\/j.hlife.2024.06.005","volume":"2","author":"T Chen","year":"2024","unstructured":"Chen T, Ying L, Xiong L, Wang X, Lu P, Wang Y, et al. Understanding carbapenem-resistant hypervirulent Klebsiella pneumoniae: key virulence factors and evolutionary convergence. hLife. 2024;2(12):611\u201324. https:\/\/doi.org\/10.1016\/j.hlife.2024.06.005.","journal-title":"hLife"},{"issue":"3","key":"4052_CR44","doi-asserted-by":"publisher","first-page":"487","DOI":"10.1093\/jac\/dks426","volume":"68","author":"P Nordmann","year":"2013","unstructured":"Nordmann P, Poirel L. Strategies for identification of carbapenemase-producing Enterobacteriaceae. J Antimicrob Chemother. 2013;68(3):487\u20139. https:\/\/doi.org\/10.1093\/jac\/dks426.","journal-title":"J Antimicrob Chemother"},{"issue":"3","key":"4052_CR45","doi-asserted-by":"publisher","first-page":"969","DOI":"10.1128\/AAC.01009-09","volume":"54","author":"K Bush","year":"2010","unstructured":"Bush K, Jacoby GA. Updated functional classification of beta-lactamases. Antimicrob Agents Chemother. 2010;54(3):969\u201376. https:\/\/doi.org\/10.1128\/AAC.01009-09.","journal-title":"Antimicrob Agents Chemother"},{"issue":"10","key":"4052_CR46","doi-asserted-by":"publisher","first-page":"1791","DOI":"10.3201\/eid1710.110655","volume":"17","author":"P Nordmann","year":"2011","unstructured":"Nordmann P, Naas T, Poirel L. Global spread of carbapenemase-producing Enterobacteriaceae. Emerg Infect Dis. 2011;17(10):1791\u20138. https:\/\/doi.org\/10.3201\/eid1710.110655.","journal-title":"Emerg Infect Dis"},{"issue":"5","key":"4052_CR47","doi-asserted-by":"publisher","first-page":"1633","DOI":"10.1128\/AAC.50.5.1633-1641.2006","volume":"50","author":"J Quale","year":"2006","unstructured":"Quale J, Bratu S, Gupta J, Landman D. Interplay of efflux system, ampC, and oprD expression in carbapenem resistance of Pseudomonas aeruginosa clinical isolates. Antimicrob Agents Chemother. 2006;50(5):1633\u201341. https:\/\/doi.org\/10.1128\/AAC.50.5.1633-1641.2006.","journal-title":"Antimicrob Agents Chemother"},{"issue":"1","key":"4052_CR48","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1128\/CMR.masthead.30-1","volume":"30","author":"LY Hsu","year":"2017","unstructured":"Hsu LY, Apisarnthanarak A, Khan E, Suwantarat N, Ghafur A, Tambyah PA. Carbapenem-resistant acinetobacter baumannii and Enterobacteriaceae in South and Southeast Asia. Clin Microbiol Rev. 2017;30(1):1\u201322. https:\/\/doi.org\/10.1128\/CMR.masthead.30-1.","journal-title":"Clin Microbiol Rev"},{"issue":"1","key":"4052_CR49","doi-asserted-by":"publisher","first-page":"841","DOI":"10.1080\/22221751.2022.2049458","volume":"11","author":"X Yang","year":"2022","unstructured":"Yang X, Sun Q, Li J, Jiang Y, Li Y, Lin J, et al. Molecular epidemiology of carbapenem-resistant hypervirulent Klebsiella pneumoniae in China. Emerg Microbes Infect. 2022;11(1):841\u20139. https:\/\/doi.org\/10.1080\/22221751.2022.2049458.","journal-title":"Emerg Microbes Infect"},{"key":"4052_CR50","doi-asserted-by":"publisher","unstructured":"Han YL, Wang H, Zhu HZ, Lv YY, Zhao W, Wang YY, et al. Phenotypic and genomic characterization of ST11-K1 CR-hvKP with highly homologous bla(KPC-2)-bearing plasmids in China. mSystems. 2024;9(12):e0110124; https:\/\/doi.org\/10.1128\/msystems.01101-24.","DOI":"10.1128\/msystems.01101-24"},{"key":"4052_CR51","doi-asserted-by":"publisher","unstructured":"Jacoby GA, Strahilevitz J, Hooper DC. Plasmid-mediated quinolone resistance. Microbiol Spectr. 2014;2(5). https:\/\/doi.org\/10.1128\/microbiolspec.PLAS-0006-2013.","DOI":"10.1128\/microbiolspec.PLAS-0006-2013"},{"issue":"6","key":"4052_CR52","doi-asserted-by":"publisher","first-page":"151","DOI":"10.1016\/j.drup.2010.08.003","volume":"13","author":"MS Ramirez","year":"2010","unstructured":"Ramirez MS, Tolmasky ME. Aminoglycoside modifying enzymes. Drug Resist Updat. 2010;13(6):151\u201371. https:\/\/doi.org\/10.1016\/j.drup.2010.08.003.","journal-title":"Drug Resist Updat"},{"issue":"2","key":"4052_CR53","doi-asserted-by":"publisher","first-page":"523","DOI":"10.1016\/j.idc.2016.02.011","volume":"30","author":"Y Doi","year":"2016","unstructured":"Doi Y, Wachino JI, Arakawa Y. Aminoglycoside resistance: the emergence of acquired 16S ribosomal RNA methyltransferases. Infect Dis Clin North Am. 2016;30(2):523\u201337. https:\/\/doi.org\/10.1016\/j.idc.2016.02.011.","journal-title":"Infect Dis Clin North Am"},{"issue":"10","key":"4052_CR54","doi-asserted-by":"publisher","first-page":"e0100921","DOI":"10.1128\/AAC.01009-21","volume":"65","author":"A Kawai","year":"2021","unstructured":"Kawai A, Suzuki M, Tsukamoto K, Minato Y, Doi Y. Functional and structural characterization of acquired 16S rRNA methyltransferase NpmB1 conferring pan-aminoglycoside resistance. Antimicrob Agents Chemother. 2021;65(10):e0100921. https:\/\/doi.org\/10.1128\/AAC.01009-21.","journal-title":"Antimicrob Agents Chemother"},{"issue":"2","key":"4052_CR55","doi-asserted-by":"publisher","first-page":"e0237121","DOI":"10.1128\/spectrum.02371-21","volume":"10","author":"Y Zhou","year":"2022","unstructured":"Zhou Y, Ai W, Guo Y, Wu X, Wang B, Xu Y, et al. Co-occurrence of rare ArmA-, RmtB-, and KPC-2-encoding multidrug-resistant plasmids and hypervirulence iuc operon in ST11-KL47 Klebsiella pneumoniae. Microbiol Spectr. 2022;10(2):e0237121. https:\/\/doi.org\/10.1128\/spectrum.02371-21.","journal-title":"Microbiol Spectr"},{"key":"4052_CR56","doi-asserted-by":"publisher","unstructured":"Xia P, Yi M, Yuan Y, Huang J, Yang B, Liao J, et al. Coexistence of multidrug resistance and virulence in a single conjugative plasmid from a hypervirulent Klebsiella pneumoniae isolate of sequence type 25. mSphere. 2022;7(6):e0047722. https:\/\/doi.org\/10.1128\/msphere.00477-22.","DOI":"10.1128\/msphere.00477-22"},{"key":"4052_CR57","doi-asserted-by":"publisher","first-page":"3885","DOI":"10.1016\/j.csbj.2023.08.004","volume":"21","author":"X Li","year":"2023","unstructured":"Li X, Jiang T, Wu C, Kong Y, Ma Y, Wu J, et al. Molecular epidemiology and genomic characterization of a plasmid-mediated mcr-10 and bla(NDM-1) co-harboring multidrug-resistant Enterobacter asburiae. Comput Struct Biotechnol J. 2023;21:3885\u201393. https:\/\/doi.org\/10.1016\/j.csbj.2023.08.004.","journal-title":"Comput Struct Biotechnol J"},{"key":"4052_CR58","doi-asserted-by":"publisher","unstructured":"Girijan SK, Paul R, V JR, Pillai D. Investigating the impact of hospital antibiotic usage on aquatic environment and aquaculture systems: a molecular study of quinolone resistance in Escherichia coli. Sci Total Environ. 2020;748:141538. https:\/\/doi.org\/10.1016\/j.scitotenv.2020.141538.","DOI":"10.1016\/j.scitotenv.2020.141538"},{"key":"4052_CR59","doi-asserted-by":"publisher","first-page":"198","DOI":"10.3389\/fmicb.2013.00198","volume":"4","author":"YT Deng","year":"2013","unstructured":"Deng YT, Zeng ZL, Tian W, Yang T, Liu JH. Prevalence and characteristics of rmtB and qepA in Escherichia coli isolated from diseased animals in China. Front Microbiol. 2013;4:198. https:\/\/doi.org\/10.3389\/fmicb.2013.00198.","journal-title":"Front Microbiol"},{"issue":"11","key":"4052_CR60","doi-asserted-by":"publisher","first-page":"873","DOI":"10.1089\/fpd.2015.2025","volume":"12","author":"Y Yang","year":"2015","unstructured":"Yang Y, Zhang A, Lei C, Wang H, Guan Z, Xu C, et al. Characteristics of plasmids coharboring 16S rRNA methylases, CTX-M, and virulence factors in Escherichia coli and Klebsiella pneumoniae isolates from chickens in China. Foodborne Pathog Dis. 2015;12(11):873\u201380. https:\/\/doi.org\/10.1089\/fpd.2015.2025.","journal-title":"Foodborne Pathog Dis"},{"key":"4052_CR61","doi-asserted-by":"publisher","unstructured":"Corona A, De Santis V, Agarossi A, Prete A, Cattaneo D, Tomasini G, et al. Antibiotic therapy strategies for treating gram-negative severe infections in the critically ill: a narrative review. Antibiotics (Basel). 2023;12(8). https:\/\/doi.org\/10.3390\/antibiotics12081262.","DOI":"10.3390\/antibiotics12081262"}],"container-title":["BMC Microbiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12866-025-04052-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12866-025-04052-x\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12866-025-04052-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,5]],"date-time":"2025-06-05T22:14:07Z","timestamp":1749161647000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcmicrobiol.biomedcentral.com\/articles\/10.1186\/s12866-025-04052-x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,6]]},"references-count":61,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["4052"],"URL":"https:\/\/doi.org\/10.1186\/s12866-025-04052-x","relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.3.rs-5028260\/v1","asserted-by":"object"}]},"ISSN":["1471-2180"],"issn-type":[{"value":"1471-2180","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6,6]]},"assertion":[{"value":"4 September 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"15 May 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"6 June 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study was conducted in accordance with the principles of the Declaration of Helsinki. Ethical approval was granted by the Ethics Committee of The Second Affiliated Hospital of Guizhou University of Traditional Chinese Medicine (Guizhou, China), which waived the requirement for informed consent given the retrospective, observational nature of the research and the use of anonymized patient data.Animal studies were reviewed and approved by the Guizhou University Traditional Chinese Medicine Laboratory Animal Management Committee, ensuring compliance with the Guidelines for the Ethical Review of Laboratory Animal Welfare (People's Republic of China National Standard GB\/T 35892\u20132018). All procedures were performed to minimize animal suffering, including the use of analgesics and humane endpoints as specified in the guidelines.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"352"}}