{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T03:13:27Z","timestamp":1777432407794,"version":"3.51.4"},"reference-count":46,"publisher":"Public Library of Science (PLoS)","issue":"2","license":[{"start":{"date-parts":[[2021,2,26]],"date-time":"2021-02-26T00:00:00Z","timestamp":1614297600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Norte Portugal Regional Operational Programme","award":["(NORTE 2020)"],"award-info":[{"award-number":["(NORTE 2020)"]}]},{"DOI":"10.13039\/501100008530","name":"FEDER","doi-asserted-by":"crossref","award":["(PTDC\/CTA-AMB\/28196\/2017)"],"award-info":[{"award-number":["(PTDC\/CTA-AMB\/28196\/2017)"]}],"id":[{"id":"10.13039\/501100008530","id-type":"DOI","asserted-by":"crossref"}]},{"name":"National Funds from FCT \u2013 Funda\u00e7\u00e3o para a Ci\u00eancia e a Tecnologia"},{"name":"The Swedish Research Council, Sweden"},{"name":"Funda\u00e7\u00e3o para a Ci\u00eancia e a Tecnologia (FCT), Portugal"},{"name":"European Regional Development Fund (ERDF) European Regional Development Fund (ERDF), through COMPETE2020","award":["UID\/Multi\/50016\/2019, UID\/EQU\/00511\/2019 and \u201cLEPABE-2-ECO-INNOVATION\u201d \u2013 NORTE\u201001\u20100145\u2010 FEDER\u2010000005"],"award-info":[{"award-number":["UID\/Multi\/50016\/2019, UID\/EQU\/00511\/2019 and \u201cLEPABE-2-ECO-INNOVATION\u201d \u2013 NORTE\u201001\u20100145\u2010 FEDER\u2010000005"]}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:p>Carbapenem-resistant <jats:italic>Klebsiella pneumoniae<\/jats:italic> are a major global threat in healthcare facilities. The propagation of carbapenem resistance determinants can occur through vertical transmission, with genetic elements being transmitted by the host bacterium, or by horizontal transmission, with the same genetic elements being transferred among distinct bacterial hosts. This work aimed to track carbapenem resistance transmission by <jats:italic>K<\/jats:italic>. <jats:italic>pneumoniae<\/jats:italic> in a healthcare facility. The study involved a polyphasic approach based on conjugation assays, resistance phenotype and genotype analyses, whole genome sequencing, and plasmid characterization by pulsed field gel electrophoresis and optical DNA mapping. Out of 40 <jats:italic>K<\/jats:italic>. <jats:italic>pneumoniae<\/jats:italic> clinical isolates recovered over two years, five were carbapenem- and multidrug-resistant and belonged to multilocus sequence type ST147. These isolates harboured the carbapenemase encoding <jats:italic>bla<\/jats:italic><jats:sub>KPC-3<\/jats:sub> gene, integrated in conjugative plasmids of 140 kbp or 55 kbp, belonging to replicon types incFIA\/incFIIK or incN\/incFIIK, respectively. The two distinct plasmids encoding the <jats:italic>bla<\/jats:italic><jats:sub>KPC-3<\/jats:sub> gene were associated with distinct genetic lineages, as confirmed by optical DNA mapping and whole genome sequence analyses. These results suggested vertical (bacterial strain-based) transmission of the carbapenem-resistance genetic elements. Determination of the mode of transmission of antibiotic resistance in healthcare facilities, only possible based on polyphasic approaches as described here, is essential to control resistance propagation.<\/jats:p>","DOI":"10.1371\/journal.pone.0247058","type":"journal-article","created":{"date-parts":[[2021,2,26]],"date-time":"2021-02-26T18:29:05Z","timestamp":1614364145000},"page":"e0247058","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":4,"title":["Polyphasic characterization of carbapenem-resistant Klebsiella pneumoniae clinical isolates suggests vertical transmission of the blaKPC-3 gene"],"prefix":"10.1371","volume":"16","author":[{"given":"Catarina","family":"Ferreira","sequence":"first","affiliation":[]},{"given":"Santosh K.","family":"Bikkarolla","sequence":"additional","affiliation":[]},{"given":"Karolin","family":"Frykholm","sequence":"additional","affiliation":[]},{"given":"Saga","family":"Pohjanen","sequence":"additional","affiliation":[]},{"given":"Margarida","family":"Brito","sequence":"additional","affiliation":[]},{"given":"Catarina","family":"Lameiras","sequence":"additional","affiliation":[]},{"given":"Olga C.","family":"Nunes","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4767-4868","authenticated-orcid":true,"given":"Fredrik","family":"Westerlund","sequence":"additional","affiliation":[]},{"given":"C\u00e9lia M.","family":"Manaia","sequence":"additional","affiliation":[]}],"member":"340","published-online":{"date-parts":[[2021,2,26]]},"reference":[{"key":"pone.0247058.ref001","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1016\/j.bcp.2016.12.005","article-title":"Antibiotic resistance: A current epilogue","volume":"134","author":"DR Dodds","year":"2017","journal-title":"Biochem Pharmacol"},{"key":"pone.0247058.ref002","unstructured":"Organization WH. 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