{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T16:57:01Z","timestamp":1791219421189,"version":"4.1.0"},"reference-count":13,"publisher":"Akademiai Kiado Zrt.","issue":"2","license":[{"start":{"date-parts":[[2025,6,20]],"date-time":"2025-06-20T00:00:00Z","timestamp":1750377600000},"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":[[2025,6,20]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The emergence of carbapenemase-producing <jats:italic>Klebsiella pneumoniae<\/jats:italic> poses a significant global health threat, particularly in hospital settings. This study reports on the first detection of a pandrug-resistant (PDR) high-risk ST15 <jats:italic>K<\/jats:italic>. <jats:italic>pneumoniae<\/jats:italic> strain co-producing NDM-1 and VIM-1 in Greece. The isolate was recovered from a blood culture of a male patient admitted to the Intensive Care Unit (ICU) of Volos Hospital in July 2024. Next generation Sequencing (NGS) confirmed the presence of <jats:italic>bla<\/jats:italic><jats:sub>NDM-1<\/jats:sub> and <jats:italic>bla<\/jats:italic><jats:sub>VIM-1<\/jats:sub> genes. Other beta-lactamase type (CTX-M-15) was detected in association with NDM and VIM enzymes. Furthermore, this isolate was resistant to other antimicrobial agents, including aminoglycosides [<jats:italic>aac(3)-II, aac(3)-IIe, aac(6\u2032)-Ib, aadA1, aph(3\u2033)-Ib, aph(6)-Id, aph(3\u2032)-Ia),<\/jats:italic> chloramphenicol (<jats:italic>catB3<\/jats:italic>), fluoroquinolones (<jats:italic>qnrS1<\/jats:italic>) and sulfonamides (<jats:italic>sul1<\/jats:italic> and <jats:italic>sul2<\/jats:italic>). The Multilocus Sequence Typing revealed that the strain belonged to ST15. According to Kaptive the strain belonged to KL48. Our study provides new data about MBL producing <jats:italic>K. pneumoniae<\/jats:italic> in Greece. Thus, we report for the first time the co-expression of <jats:italic>bla<\/jats:italic><jats:sub>NDM-1<\/jats:sub> and <jats:italic>bla<\/jats:italic><jats:sub>VIM-1<\/jats:sub> in our country in ST15 <jats:italic>K. pneumoniae<\/jats:italic>. This study provides crucial epidemiological data on MBL-producing <jats:italic>K. pneumoniae<\/jats:italic> in Greece and highlights the urgent need for enhanced surveillance, infection control strategies, and access to last-resort antibiotics such as aztreonam-avibactam.<\/jats:p>","DOI":"10.1556\/030.2025.02559","type":"journal-article","created":{"date-parts":[[2025,3,24]],"date-time":"2025-03-24T08:24:02Z","timestamp":1742804642000},"page":"93-98","update-policy":"https:\/\/doi.org\/10.1556\/policypage.crossmark.crossref.2","source":"Crossref","is-referenced-by-count":5,"title":["NDM-1 and VIM-1 dual metallo-beta-lactamase producing Klebsiella pneumoniae ST15 high-risk clone from a blood culture of a patient at Intensive Care Unit in a Greek Tertiary Care Hospital"],"prefix":"10.1556","volume":"72","author":[{"given":"Pandora","family":"Tsolakidou","sequence":"first","affiliation":[{"name":"Hospital of Volos, Polymeri 134, 38222, Volos, 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":"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":"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":"Ilias","family":"Frydas","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences, School of Health Sciences, International Hellenic University, 5400, Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyriazis Athanasios","family":"Kyriazidis","sequence":"additional","affiliation":[{"name":"Medical School, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kallirhoe","family":"Kalinderi","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":"Petros","family":"Skepastianos","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences, School of Health Sciences, International Hellenic University, 5400, Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"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":[{"vocabulary":"crossref","role":"author"}]}],"member":"425","reference":[{"key":"B1","series-title":"Beni-Suef Univ J Basic Appl Sci","first-page":"13","article-title":"Overcoming Klebsiella pneumoniae antibiotic resistance: new insights into mechanisms and drug discovery","volume":"13","author":"Huy TXN","year":"2024","unstructured":"Huy TXN. Overcoming Klebsiella pneumoniae antibiotic resistance: new insights into mechanisms and drug discovery. Beni-Suef Univ J Basic Appl Sci 2024; 13: 13. https:\/\/doi.org\/10.1186\/s43088-024-00470-4."},{"issue":"5","key":"B2","series-title":"Antimicrob Agents Chemother","first-page":"e02313","article-title":"Meropenem-vaborbactam versus ceftazidime-avibactam for treatment of carbapenem-resistant Enterobacteriaceae infections","volume":"64","author":"Ackley R","year":"2020","unstructured":"Ackley R, Roshdy D, Meredith J, Minor S, Anderson WE, Capraro GA, et al. Meropenem-vaborbactam versus ceftazidime-avibactam for treatment of carbapenem-resistant Enterobacteriaceae infections. Antimicrob Agents Chemother 2020; 64(5): e02313\u201319. https:\/\/doi.org\/10.1128\/AAC.02313-19."},{"issue":"2","key":"B3","series-title":"JAC Antimicrob Resist","article-title":"Aztreonam\/avibactam activity against a large collection of carbapenem-resistant Enterobacterales (CRE) collected in hospitals from Europe, Asia and Latin America (2019\u201321)","volume":"5","author":"Sader HS","year":"2023","unstructured":"Sader HS, Castanheira M, Kimbrough JH, Kantro V, Mendes RE. Aztreonam\/avibactam activity against a large collection of carbapenem-resistant Enterobacterales (CRE) collected in hospitals from Europe, Asia and Latin America (2019\u201321). JAC Antimicrob Resist 2023; 5(2): dlad032. https:\/\/doi.org\/10.1093\/jacamr\/dlad032."},{"issue":"11","key":"B4","series-title":"Microbiol Spectr","article-title":"In vitro activity assessment of cefiderocol against Enterobacterales, Pseudomonas aeruginosa, and Acinetobacter spp., including \u03b2-lactam nonsusceptible molecularly characterized isolates, collected from 2020 to 2021 in the United States and European hospitals","volume":"12","author":"Kimbrough JH","year":"2024","unstructured":"Kimbrough JH, Maher JM, Sader HS, Castanheira M, Mendes RE. In vitro activity assessment of cefiderocol against Enterobacterales, Pseudomonas aeruginosa, and Acinetobacter spp., including \u03b2-lactam nonsusceptible molecularly characterized isolates, collected from 2020 to 2021 in the United States and European hospitals. Microbiol Spectr 2024; 12(11): e0147424. https:\/\/doi.org\/10.1128\/spectrum.01474-24."},{"issue":"10","key":"B5","series-title":"Microb Drug Resist","first-page":"1219","article-title":"Genetic relatedness of NDM-producing Klebsiella pneumoniae Co-occurring VIM, KPC, and OXA-48 enzymes from surveillance cultures from an intensive care unit","volume":"26","author":"Flores C","year":"2020","unstructured":"Flores C, Bianco K, de Filippis I, Clementino MM, Rom\u00e3o CMCPA. Genetic relatedness of NDM-producing Klebsiella pneumoniae Co-occurring VIM, KPC, and OXA-48 enzymes from surveillance cultures from an intensive care unit. Microb Drug Resist 2020; 26(10): 1219\u20131226. https:\/\/doi.org\/10.1089\/mdr.2019.0483."},{"issue":"5\u20136","key":"B6","series-title":"Chemotherapy","first-page":"199","article-title":"Detection of NDM-1 and VIM genes in carbapenem-resistant Klebsiella pneumoniae isolates from a tertiary health-care center in Kathmandu, Nepal","volume":"66","author":"Thapa S","year":"2 December 2021","unstructured":"Thapa S, Adhikari N, Shah AK, Lamichhane I, Dhungel B, Shrestha UT, et al. Detection of NDM-1 and VIM genes in carbapenem-resistant Klebsiella pneumoniae isolates from a tertiary health-care center in Kathmandu, Nepal. Chemotherapy 2 December 2021; 66(5\u20136): 199\u2013209. https:\/\/doi.org\/10.1159\/00051825."},{"issue":"3","key":"B7","series-title":"Diagn Microbiol Infect Dis","first-page":"295","article-title":"Emergence of sequence type 11 Klebsiella pneumoniae coproducing NDM-1 and VIM-1 metallo-\u03b2-lactamases in a Greek hospital","volume":"87","author":"Papagiannitsis CC","year":"2017","unstructured":"Papagiannitsis CC, Malli E, Florou Z, Sarrou S, Hrabak J, Mantzarlis K, et al. Emergence of sequence type 11 Klebsiella pneumoniae coproducing NDM-1 and VIM-1 metallo-\u03b2-lactamases in a Greek hospital. Diagn Microbiol Infect Dis 2017; 87(3): 295\u2013297. https:\/\/doi.org\/10.1016\/j.diagmicrobio.2016.12.008."},{"issue":"8","key":"B8","series-title":"J\u00a0Antimicrob Chemother","first-page":"2197","article-title":"Emergence of NDM-1-producing Klebsiella pneumoniae in Greece: evidence of a widespread clonal outbreak","volume":"74","author":"Politi L","year":"2019","unstructured":"Politi L, Gartzonika K, Spanakis N, Zarkotou O, Poulou A, Skoura L, et al. Emergence of NDM-1-producing Klebsiella pneumoniae in Greece: evidence of a widespread clonal outbreak. J\u00a0Antimicrob Chemother 2019; 74(8): 2197\u20132202. https:\/\/doi.org\/10.1093\/jac\/dkz176."},{"key":"B9","series-title":"APMIS","first-page":"887","article-title":"Clonal dissemination of multilocus sequence type ST15 KPC-2 producing Klebsiella pneumoniae in Bulgaria","volume":"123","author":"Markovska R","year":"2015","unstructured":"Markovska R, Stoeva T, Schneider I, Boyanova L, Popova V, Dacheva D, et al. 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