{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T20:28:55Z","timestamp":1778790535085,"version":"3.51.4"},"reference-count":12,"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><jats:italic>Klebsiella pneumoniae<\/jats:italic> is a major pathogen associated with hospital-acquired infections, particularly those involving multidrug-resistant strains. Carbapenem resistance, often driven by carbapenemases such as KPC, VIM, OXA-48, and NDM, poses a significant challenge in clinical settings. This study reports on <jats:italic>K. pneumoniae<\/jats:italic> strain A165, isolated from a blood culture of a 51-year-old female patient hospitalized for respiratory distress post-SARS-CoV-2 infection. This <jats:italic>K. pneumoniae<\/jats:italic> strain exhibited resistance to several antibiotics, including carbapenems, cephalosporins, aminoglycosides, and fluoroquinolones, but remained susceptible to gentamicin, colistin, and trimethoprim-sulfamethoxazole. Next-generation sequencing was performed on Ion torrent platform, that revealed a genome size of 5,676,404 bp, including a chromosome and six plasmids. The strain was classified as sequence type 11 (ST11), a high-risk lineage associated with carbapenem resistance. The resistome of A165 included multiple \u03b2-lactamase genes, such as <jats:italic>bla<\/jats:italic><jats:sub>NDM-1<\/jats:sub> and <jats:italic>bla<\/jats:italic><jats:sub>OXA-48<\/jats:sub>, as well as genes conferring resistance to other antibiotic classes. The virulome analysis identified genes involved in iron acquisition (yersiniabactin operon genes: <jats:italic>ybtE<\/jats:italic>, <jats:italic>ybtT<\/jats:italic>, <jats:italic>irp1<\/jats:italic>, <jats:italic>irp2<\/jats:italic>; aerobactin receptor: <jats:italic>iutA<\/jats:italic>), adhesion (<jats:italic>mrkA-J<\/jats:italic>, <jats:italic>fimA-K<\/jats:italic>), capsule and biofilm formation (<jats:italic>rcsA<\/jats:italic>, <jats:italic>rcsB<\/jats:italic>, <jats:italic>ompA<\/jats:italic>) and resistance to complement (<jats:italic>traT<\/jats:italic>) contributing to its pathogenic potential. The mobilome analysis revealed nine insertion sequences, including <jats:italic>IS<\/jats:italic>Kpn1, <jats:italic>IS<\/jats:italic>Kpn18, <jats:italic>IS<\/jats:italic>Kpn43, <jats:italic>IS<\/jats:italic>Kpn28, <jats:italic>IS<\/jats:italic>Kpn14, <jats:italic>IS<\/jats:italic>Ecp1, and <jats:italic>IS<\/jats:italic>6100. The strain also harbored six replicons: Col440II, ColRNAI, IncFIA(HI1), IncFIB(K), IncFII(K), and IncR, which are associated with the horizontal transfer of resistance and virulence genes. Comparative analysis with global isolates demonstrated the widespread dissemination of carbapenemase-producing <jats:italic>K. pneumoniae<\/jats:italic>, with notable occurrences in Europe, Asia, and the Americas. This study highlights the growing concern of multidrug-resistant <jats:italic>K. pneumoniae<\/jats:italic> in hospital settings and emphasizes the need for robust surveillance and infection control measures.<\/jats:p>","DOI":"10.1556\/030.2024.02468","type":"journal-article","created":{"date-parts":[[2024,12,13]],"date-time":"2024-12-13T10:12:13Z","timestamp":1734084733000},"page":"295-298","update-policy":"https:\/\/doi.org\/10.1556\/policypage.crossmark.crossref.2","source":"Crossref","is-referenced-by-count":4,"title":["Characterization of a carbapenemase-producing Klebsiella pneumoniae isolate of a patient in an intensive care unit in Greece: A study of resistome, virulome, and mobilome"],"prefix":"10.1556","volume":"71","author":[{"given":"Pandora","family":"Tsolakidou","sequence":"first","affiliation":[{"name":"Hospital of Volos, Polymeri 134, 38222, Volos, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aikaterini","family":"Papadimitriou","sequence":"additional","affiliation":[{"name":"General Hospital Papageorgiou, Thessaloniki, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kyriazis Athanasios","family":"Kyriazidis","sequence":"additional","affiliation":[{"name":"Medical School, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pessach","family":"Ilias","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences, School of Health Sciences, International Hellenic University, 5400, Thessaloniki, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stella","family":"Mitka","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences, School of Health Sciences, International Hellenic University, 5400, Thessaloniki, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2101-4546","authenticated-orcid":true,"given":"Maria","family":"Chatzidimitriou","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences, School of Health Sciences, International Hellenic University, 5400, Thessaloniki, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"425","reference":[{"key":"B1","series-title":"J Glob Antimicrob Resist","first-page":"81","article-title":"Emergence of Klebsiella pneumoniae ST11 co-producing NDM-1 and OXA-48 carbapenemases in Greece","volume":"19","author":"Protonotariou E","year":"2019","unstructured":"Protonotariou E, Meletis G, Chatzopoulou F, Malousi A, Chatzidimitriou D, Skoura L. Emergence of Klebsiella pneumoniae ST11 co-producing NDM-1 and OXA-48 carbapenemases in Greece. J Glob Antimicrob Resist 2019; 19: 81\u201382. https:\/\/doi.org\/10.1016\/j.jgar.2019.08.020."},{"issue":"20","key":"B2","series-title":"Euro Surveill","article-title":"Cross-border spread of blaNDM-1- and blaOXA-48-positive Klebsiella pneumoniae: a European collaborative analysis of whole genome sequencing and epidemiological data, 2014 to 2019","volume":"25","author":"Ludden C","year":"2020","unstructured":"Ludden C, L\u00f6tsch F, Alm E, Kumar N, Johansson K, Albiger B, et al. Cross-border spread of blaNDM-1- and blaOXA-48-positive Klebsiella pneumoniae: a European collaborative analysis of whole genome sequencing and epidemiological data, 2014 to 2019. Euro Surveill 2020; 25(20): 2000627. https:\/\/doi.org\/10.2807\/1560-7917.ES.2020.25.20.2000627."},{"key":"B3","series-title":"Front Microbiol","first-page":"133","article-title":"Coexistence of\u00a0blaOXA-48 and truncated blaNDM-1 on different plasmids in a Klebsiella pneumoniae isolate in China","volume":"8","author":"Xie L","year":"2017","unstructured":"Xie L, Dou Y, Zhou K, Chen Y, Han L, Guo X, et al. Coexistence of\u00a0blaOXA-48 and truncated blaNDM-1 on different plasmids in a Klebsiella pneumoniae isolate in China. Front Microbiol 2017; 8: 133. https:\/\/doi.org\/10.3389\/fmicb.2017.00133."},{"issue":"6","key":"B4","series-title":"J Chemother","first-page":"344","article-title":"Molecular characterization of carbapenem- resistant Enterobacteriaceae yields increasing rates of NDM-1 carbapenemases and colistin resistance in an OXA-48- endemic area","volume":"29","author":"Cizmeci Z","year":"2017","unstructured":"Cizmeci Z, Aktas E, Otlu B, Acikgoz O, Ordekci S. Molecular characterization of carbapenem- resistant Enterobacteriaceae yields increasing rates of NDM-1 carbapenemases and colistin resistance in an OXA-48- endemic area. J Chemother 2017; 29(6): 344\u2013350. https:\/\/doi.org\/10.1080\/1120009X.2017.1323149."},{"issue":"6","key":"B5","series-title":"J Antimicrob Chemother","first-page":"1517","article-title":"Molecular epidemiology of NDM-1- and OXA-48-producing Klebsiella pneumoniae in an Iranian hospital: clonal dissemination of ST11 and ST893","volume":"73","author":"Solgi H","year":"2018","unstructured":"Solgi H, Badmasti F, Giske CG, Aghamohammad S, Shahcheraghi F. Molecular epidemiology of NDM-1- and OXA-48-producing Klebsiella pneumoniae in an Iranian hospital: clonal dissemination of ST11 and ST893. J Antimicrob Chemother 2018; 73(6): 1517\u20131524. https:\/\/doi.org\/10.1093\/jac\/dky081."},{"issue":"1","key":"B6","series-title":"BMC Microbiol","first-page":"98","article-title":"High frequency of NDM-1 and OXA-48 carbapenemase genes among Klebsiella pneumoniae isolates in central Iran","volume":"23","author":"Abbasi E","year":"2023","unstructured":"Abbasi E, Ghaznavi-Rad E. High frequency of NDM-1 and OXA-48 carbapenemase genes among Klebsiella pneumoniae isolates in central Iran. BMC Microbiol 2023; 23(1): 98. https:\/\/doi.org\/10.1186\/s12866-023-02840-x."},{"issue":"9","key":"B7","series-title":"Eur J Clin Microbiol Infect Dis","first-page":"1687","article-title":"Emergence of two novel sequence types (3366 and 3367) NDM-1- and OXA-48-co-producing K. pneumoniae in Italy","volume":"38","author":"Gona F","year":"2019","unstructured":"Gona F, Bongiorno D, Aprile A, Corazza E, Pasqua B, Scuderi MG, et al. Emergence of two novel sequence types (3366 and 3367) NDM-1- and OXA-48-co-producing K. pneumoniae in Italy. Eur J Clin Microbiol Infect Dis 2019; 38(9): 1687\u20131691. https:\/\/doi.org\/10.1007\/s10096-019-03597-w."},{"issue":"1","key":"B8","series-title":"New Microbiol","first-page":"41","article-title":"OXA-48 and NDM-1 Klebsiella pneumoniae of Sequence Type 101 from blood in a patient with travel history abroad, Italy","volume":"43","author":"Nucleo E","year":"2020","unstructured":"Nucleo E, Marchetti VM, Mercato A, Quatela M, Villa L, Migliavacca R. OXA-48 and NDM-1 Klebsiella pneumoniae of Sequence Type 101 from blood in a patient with travel history abroad, Italy. New Microbiol 2020; 43(1): 41\u201343."},{"key":"B9","series-title":"Rapid risk assessment: outbreak of carbapenemase-producing (NDM-1 and OXA-48) and colistin-resistant Klebsiella pneumoniae ST307, north-east Germany","volume":"2019","author":"European Centre for Disease Prevention and Control (ECDC)","year":"2019","unstructured":"European Centre for Disease Prevention and Control (ECDC). Rapid risk assessment: outbreak of carbapenemase-producing (NDM-1 and OXA-48) and colistin-resistant Klebsiella pneumoniae ST307, north-east Germany, 2019. Stockholm: ECDC; 2019. Available from: https:\/\/www.ecdc.europa.eu\/sites\/default\/files\/documents\/Klebsiella-pneumoniae-resistance-Germany-risk-assessment.pdf."},{"issue":"50","key":"B10","series-title":"Euro Surveill","article-title":"Increase in NDM-1 and NDM-1\/OXA-48-producing Klebsiella pneumoniae in Germany associated with the war in Ukraine, 2022","volume":"27","author":"Sandfort M","year":"2022","unstructured":"Sandfort M, Hans JB, Fischer MA, Reichert F, Cremanns M, Eisfeld J, et al. Increase in NDM-1 and NDM-1\/OXA-48-producing Klebsiella pneumoniae in Germany associated with the war in Ukraine, 2022. Euro Surveill 2022; 27(50): 2200926. https:\/\/doi.org\/10.2807\/1560-7917.ES.2022.27.50.2200926."},{"issue":"7","key":"B11","series-title":"Microorganisms","first-page":"1717","article-title":"Clinical and genomic characterization of carbapenem-resistant Klebsiella pneumoniae with concurrent production of NDM and OXA-48-like carbapenemases in Southern California, 2016\u20132022","volume":"11","author":"Cer\u00f3n S","year":"2023","unstructured":"Cer\u00f3n S, Salem-Bango Z, Contreras DA, Ranson EL, Yang S. Clinical and genomic characterization of carbapenem-resistant Klebsiella pneumoniae with concurrent production of NDM and OXA-48-like carbapenemases in Southern California, 2016\u20132022. Microorganisms 2023; 11(7): 1717. https:\/\/doi.org\/10.3390\/microorganisms11071717."},{"key":"B12","series-title":"Infect Drug Resist","first-page":"2105","article-title":"Novel carbapenem-resistant Klebsiella pneumoniae ST147 coharboring blaNDM-1, blaOXA-48 and extended-spectrum \u03b2-lactamases from Pakistan","volume":"13","author":"Gondal AJ","year":"2020","unstructured":"Gondal AJ, Saleem S, Jahan S, Choudhry N, Yasmin N. Novel carbapenem-resistant Klebsiella pneumoniae ST147 coharboring blaNDM-1, blaOXA-48 and extended-spectrum \u03b2-lactamases from Pakistan. Infect Drug Resist 2020; 13: 2105\u20132115. https:\/\/doi.org\/10.2147\/IDR.S251532."}],"container-title":["Acta Microbiologica et Immunologica Hungarica"],"original-title":[],"link":[{"URL":"https:\/\/akjournals.com\/view\/journals\/030\/71\/4\/article-p295.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/akjournals.com\/downloadpdf\/journals\/030\/71\/4\/article-p295.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/akjournals.com\/downloadpdf\/journals\/030\/71\/4\/article-p295.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,12,19]],"date-time":"2024-12-19T13:45:21Z","timestamp":1734615921000},"score":1,"resource":{"primary":{"URL":"https:\/\/akjournals.com\/view\/journals\/030\/71\/4\/article-p295.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12,19]]},"references-count":12,"journal-issue":{"issue":"4"},"URL":"https:\/\/doi.org\/10.1556\/030.2024.02468","relation":{},"ISSN":["1217-8950","1588-2640"],"issn-type":[{"value":"1217-8950","type":"print"},{"value":"1588-2640","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,12,19]]}}}