{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T12:32:08Z","timestamp":1781613128318,"version":"3.54.5"},"reference-count":13,"publisher":"Akademiai Kiado Zrt.","issue":"4","license":[{"start":{"date-parts":[[2024,12,19]],"date-time":"2024-12-19T00:00:00Z","timestamp":1734566400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["akjournals.com"],"crossmark-restriction":true},"short-container-title":["AMicr"],"published-print":{"date-parts":[[2024,12,19]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>This study investigated a strain of <jats:italic>Klebsiella pneumoniae<\/jats:italic>, identified as GRTHES, which exhibited extensive antibiotic resistance. The strain was resistant to all beta-lactams, including combinations with\u00a0newer agents such as meropenem\/vaborbactam and imipenem\/relebactam, as well as to aminoglycosides, fluoroquinolones, fosfomycin, trimethoprim-sulfamethoxazole and colistin. It remained susceptible to tigecycline. Whole-genome sequencing was performed by Ion Torrent platform on the <jats:italic>K.\u00a0pneumoniae<\/jats:italic> strain. Genomic analysis revealed a genome length of 5,808,650 bp and a GC content of 56.9%. Advanced sequencing techniques and bioinformatic tools were used to assess resistance genes\u00a0and plasmid replicons, highlighting the emergence of multidrug resistance and virulence traits. The\u00a0strain carried <jats:italic>bla<\/jats:italic><jats:sub>NDM-1<\/jats:sub> and <jats:italic>bla<\/jats:italic><jats:sub>KPC-3<\/jats:sub> genes and was designated to KL107 O2afg type. Colistin resistance-associated <jats:italic>mgrB\/pmrB<\/jats:italic> gene mutations were present, and the strain also harbored yersiniabactin-encoding <jats:italic>ybt<\/jats:italic> gene. Our findings provide insights into the genomic context of <jats:italic>bla<\/jats:italic><jats:sub>NDM-1<\/jats:sub> and <jats:italic>bla<\/jats:italic><jats:sub>KPC-3<\/jats:sub> carbapenemase-producing <jats:italic>K. pneumoniae<\/jats:italic> and emphasize the importance of continuous surveillance and novel therapeutic strategies to combat multidrug-resistant bacterial infections. It is the first time that an NDM-1 and KPC-3 co-producing strain of <jats:italic>K. pneumoniae<\/jats:italic> ST512 is identified in Greece. This study highlights the essential role of genomic surveillance as a proactive strategy to control the spread of carbapenemase-producing <jats:italic>K. pneumoniae<\/jats:italic> isolates, particularly when key antimicrobial resistance genes, such as <jats:italic>bla<\/jats:italic><jats:sub>NDM-1<\/jats:sub> and <jats:italic>bla<\/jats:italic><jats:sub>KPC-3<\/jats:sub>, are plasmid-mediated. Detailed characterization of these isolates could reveal plasmid similarities that facilitate adaptation and transmission within and between hospitals. Although data on patient movements are limited, it is plausible that carbapenem-resistant isolate was selected to co-produce KPC and NDM through plasmid acquisition.<\/jats:p>","DOI":"10.1556\/030.2024.02464","type":"journal-article","created":{"date-parts":[[2024,11,27]],"date-time":"2024-11-27T13:56:08Z","timestamp":1732715768000},"page":"289-294","update-policy":"https:\/\/doi.org\/10.1556\/policypage.crossmark.crossref.2","source":"Crossref","is-referenced-by-count":5,"title":["NDM-1 and KPC-3 co-producing Klebsiella pneumoniae ST512 in bronchial secretion from a patient in an intensive care unit of a Greek Tertiary Care Hospital"],"prefix":"10.1556","volume":"71","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2101-4546","authenticated-orcid":true,"given":"Maria","family":"Chatzidimitriou","sequence":"first","affiliation":[{"name":"Department of Biomedical Sciences, School of Health Sciences, International Hellenic University, 5400, Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pandora","family":"Tsolakidou","sequence":"additional","affiliation":[{"name":"Hospital of Volos, Polymeri 134, 38222, Volos, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Apostolos","family":"Voulgaridis","sequence":"additional","affiliation":[{"name":"Hippokration General Hospital, Konstantinoupoleos 49, 54642, Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Anna","family":"Kyriazidi","sequence":"additional","affiliation":[{"name":"Medical School, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fani","family":"Chatzopoulou","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences, School of Health Sciences, International Hellenic University, 5400, Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Mavridou","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences, School of Health Sciences, International Hellenic University, 5400, Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sotiris","family":"Varlamis","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences, School of Health Sciences, International Hellenic University, 5400, Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stella","family":"Mitka","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences, School of Health Sciences, International Hellenic University, 5400, Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eleni","family":"Vagdatli","sequence":"additional","affiliation":[{"name":"Hippokration General Hospital, Konstantinoupoleos 49, 54642, Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"425","reference":[{"issue":"1","key":"B1","series-title":"Microb Drug Resist","first-page":"63","article-title":"Spread of carbapenem and colistin-resistant Klebsiella pneumoniae ST512 clinical isolates in Israel: a cause for vigilance","volume":"25","author":"Lalaoui R","year":"2019 Jan\/Feb","unstructured":"Lalaoui R, Bakour S, Livnat K, Assous MV, Diene SM, Rolain JM. Spread of carbapenem and colistin-resistant Klebsiella pneumoniae ST512 clinical isolates in Israel: a cause for vigilance. Microb Drug Resist 2019 Jan\/Feb; 25(1): 63\u201371. Epub 2018 Aug 21. PMID: 30129868. https:\/\/doi.org\/10.1089\/mdr.2018.0014."},{"issue":"47","key":"B2","series-title":"Euro Surveill","article-title":"Emergence and persistent spread of carbapenemase-producing Klebsiella pneumoniae high-risk clones in Greek hospitals, 2013 to 2022","volume":"28","author":"Tryfinopoulou K","year":"2023 Nov","unstructured":"Tryfinopoulou K, Linkevicius M, Pappa O, Alm E, Karadimas K, Greek CCRE study group; Members of the Greek CCRE study group, et al. Emergence and persistent spread of carbapenemase-producing Klebsiella pneumoniae high-risk clones in Greek hospitals, 2013 to 2022. Euro Surveill 2023 Nov; 28(47): 2300571. PMID: 37997662; PMCID: PMC10668257. https:\/\/doi.org\/10.2807\/1560-7917.ES.2023.28.47.2300571."},{"issue":"1","key":"B3","series-title":"Acta Microbiol Immunol Hung","first-page":"10","article-title":"Carbapenem-resistant Klebsiella pneumoniae in the Balkans: clonal distribution and associated resistance determinants","volume":"71","author":"Chatzidimitriou M","year":"2024 Feb\u00a021","unstructured":"Chatzidimitriou M, Kavvada A, Kavvadas D, Kyriazidi MA, Eleftheriadis K, Varlamis S, et\u00a0al. Carbapenem-resistant Klebsiella pneumoniae in the Balkans: clonal distribution and associated resistance determinants. Acta Microbiol Immunol Hung 2024 Feb\u00a021; 71(1): 10\u201324. 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PMID: 21632901; PMCID: PMC3147720. https:\/\/doi.org\/10.1128\/JCM.00666-11."},{"issue":"1","key":"B7","series-title":"Biosensors (Basel).","first-page":"2","article-title":"Multiplex lateral flow immunoassay: an overview of strategies towards high-throughput point-of-need testing","volume":"9","author":"Anfossi L","year":"2018 Dec 26","unstructured":"Anfossi L, Di Nardo F, Cavalera S, Giovannoli C, Baggiani C. Multiplex lateral flow immunoassay: an overview of strategies towards high-throughput point-of-need testing. Biosensors (Basel). 2018 Dec 26; 9(1): 2. PMID: 30587769; PMCID: PMC6468474. https:\/\/doi.org\/10.3390\/bios9010002."},{"issue":"11","key":"B8","series-title":"Hum Immunol","first-page":"801","article-title":"Next-generation sequencing technologies: an overview","volume":"82","author":"Hu T","year":"2021 Nov","unstructured":"Hu T, Chitnis N, Monos D, Dinh A. Next-generation sequencing technologies: an overview. Hum Immunol 2021 Nov; 82(11): 801\u2013811. 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