{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T13:03:27Z","timestamp":1792155807200,"version":"4.4.0"},"reference-count":43,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,9,11]],"date-time":"2024-09-11T00:00:00Z","timestamp":1726012800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cell. Infect. Microbiol."],"abstract":"<jats:p>Carbapenemase-producing <jats:italic>Klebsiella pneumoniae<\/jats:italic> strains (CP-Kps) have recently been observed to spread rapidly worldwide. New Delhi metallo-\u03b2-lactamase (NDM) producing clones of <jats:italic>Klebsiella pneumoniae (K. pneumoniae)<\/jats:italic> cause a significant healthcare burden, particularly in Indian sub-continent, where this clone is circulating widely. However, in Italy, data on the incidence of these new clones is limited, and an ST437 NDM-producing <jats:italic>K. pneumoniae<\/jats:italic> strain has not been reported to date. A sacral ulcer infection caused by a <jats:italic>K. pneumoniae<\/jats:italic> strain was identified in an 85-year-old Italian male patient with several comorbidities. Antimicrobial susceptibility testing revealed an extensive resistance to a wide range of antimicrobials, including novel agents such as cefiderocol and ceftazidime\/avibactam. Genomic analysis identified the pathogen as an ST437 <jats:italic>K. pneumoniae<\/jats:italic> strain harboring <jats:italic>bla<\/jats:italic><jats:sub>NDM-5<\/jats:sub>, <jats:italic>bla<\/jats:italic><jats:sub>OXA-232<\/jats:sub> and <jats:italic>bla<\/jats:italic><jats:sub>CTX-M-15<\/jats:sub> genes. Following the identification of this first case, several infection control measures were implemented in healthcare settings, including direct precautions and reinforcement of standard cross-transmission control measures. The emergence of pathogenic microbial clones carrying new genetic determinants, particularly in a little city, requires prompt diagnosis and therapeutic protocols. An effective infection control system for the early detection and\/or control of the transmission of NDM-producing <jats:italic>Enterobacteriaceae<\/jats:italic> is also needed. Further investigations are required to better understand the potential transmission routes and evolution of these clones.<\/jats:p>","DOI":"10.3389\/fcimb.2024.1426817","type":"journal-article","created":{"date-parts":[[2024,9,11]],"date-time":"2024-09-11T05:10:31Z","timestamp":1726031431000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":11,"title":["First report of a blaNDM-producing extensively drug resistant Klebsiella pneumoniae ST437 in Italy"],"prefix":"10.3389","volume":"14","author":[{"given":"Sofia Chiatamone","family":"Ranieri","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vittoria","family":"Fabbrizi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ada Maria","family":"D\u2019 Amario","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Giuseppina","family":"Frascella","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valeria","family":"Di Biase","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cinzia","family":"Di Francesco","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefania","family":"Di Sante","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luigino","family":"De Berardis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Massimo","family":"De Martinis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Massimo","family":"Partenza","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra","family":"Chiaverini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriella","family":"Centorotola","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cesare","family":"Camm\u00e0","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Pomilio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandra","family":"Cornacchia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2024,9,11]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"652","DOI":"10.1089\/mdr.2019.0166","article-title":"Population structure of KPC-2-producing klebsiella pneumoniae isolated from surveillance rectal swabs in Brazil","volume":"26","author":"Aires","year":"2020","journal-title":"Microb. 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