{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T07:02:26Z","timestamp":1779951746859,"version":"3.53.1"},"reference-count":31,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T00:00:00Z","timestamp":1779926400000},"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. Microbiol."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>\n                      Carbapenem-resistant\n                      <jats:italic>Enterobacteriaceae<\/jats:italic>\n                      (CRE) is the most common clinical pathogens. Investigating the antimicrobial resistance, hypervirulence and clinical characteristics of CRE isolated from children is helpful to guide for anti-infection treatments.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Nonduplicated CRE clinical strains were isolated and mass spectrometry was applied to identify clinical isolated strains. VITEK 2 Compact system and Kirby-Bauer method were used to analyze the antimicrobial susceptibility. Besides, the drug resistance and hypervirulence associated genes were detected by polymerase chain reaction (PCR) and sequencing.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 281 non-duplicated CRE strains were identified in this study.\n                      <jats:italic>Klebsiella pneumoniae<\/jats:italic>\n                      (55.87%),\n                      <jats:italic>Escherichia coli<\/jats:italic>\n                      (36.65%) and\n                      <jats:italic>Klebsiella aerogenes<\/jats:italic>\n                      (3.20%) were the top 3 CRE strains. These strains showed high resistance to most of antimicrobial agents and carried carbapenemase genes, including\n                      <jats:italic>bla<\/jats:italic>\n                      <jats:sub>OXA-232<\/jats:sub>\n                      (38.08%),\n                      <jats:italic>bla<\/jats:italic>\n                      <jats:sub>KPC-2<\/jats:sub>\n                      (20.28%),\n                      <jats:italic>bla<\/jats:italic>\n                      <jats:sub>OXA-1<\/jats:sub>\n                      (17.08%),\n                      <jats:italic>bla<\/jats:italic>\n                      <jats:sub>NDM-5<\/jats:sub>\n                      (10.32%) and\n                      <jats:italic>bla<\/jats:italic>\n                      <jats:sub>NDM-1<\/jats:sub>\n                      (8.90%). In addition,\n                      <jats:italic>bla<\/jats:italic>\n                      <jats:sub>TEM-1<\/jats:sub>\n                      (98.93%),\n                      <jats:italic>bla<\/jats:italic>\n                      <jats:sub>CTX-M-14<\/jats:sub>\n                      (88.61%) and\n                      <jats:italic>bla<\/jats:italic>\n                      <jats:sub>SHV-11<\/jats:sub>\n                      (87.54%) were the prevalent extended-spectrum \u03b2-lactamase (ESBL) genes in these strains, while the detection rate of AmpC cephalosporinase genes were not high. Besides, 45 (28.66%) carbapenem-resistant\n                      <jats:italic>Klebsiella pneumoniae<\/jats:italic>\n                      (CRKP) strains carried hypervirulence associated genes\n                      <jats:italic>iucA<\/jats:italic>\n                      (24.84%),\n                      <jats:italic>\n                        <jats:sub>p<\/jats:sub>\n                        rmpA\n                      <\/jats:italic>\n                      (17.83%),\n                      <jats:italic>peg-344<\/jats:italic>\n                      (17.20%), and\n                      <jats:italic>\n                        <jats:sub>p<\/jats:sub>\n                        rmpA2\n                      <\/jats:italic>\n                      (9.55%). Among them, 22 (14.01%) CRKP strains were also identified as carbapenem-resistant and hypervirulent\n                      <jats:italic>Klebsiella pneumoniae<\/jats:italic>\n                      (CR-HVKP). What\u2019s worse, the patients infected with CR-HVKP had a worse prognosis overall.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study revealed the drug resistance, hypervirulence and epidemiology of CRE strains in pediatric patients in Suzhou of eastern China. Unfortunately, CR-HVKP strains with more several infection were also identified, which should be of great concern to clinicians.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmicb.2026.1734516","type":"journal-article","created":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T06:16:19Z","timestamp":1779948979000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["The epidemiology and clinical characteristics of carbapenem-resistant Enterobacteriaceae (CRE) isolates from children in eastern China"],"prefix":"10.3389","volume":"17","author":[{"given":"Yihan","family":"Zheng","sequence":"first","affiliation":[{"name":"Department of Respiratory Medicine, Children\u2019s Hospital of Soochow University","place":["Suzhou, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peng","family":"Mo","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Children\u2019s Hospital of Soochow University","place":["Suzhou, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, The Second Affiliated Hospital of Soochow University","place":["Suzhou, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lin","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Children\u2019s Hospital of Soochow University","place":["Suzhou, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuqing","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Children\u2019s Hospital of Soochow University","place":["Suzhou, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Canhong","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Children\u2019s Hospital of Soochow University","place":["Suzhou, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yongdong","family":"Yan","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Children\u2019s Hospital of Soochow University","place":["Suzhou, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chuangli","family":"Hao","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Children\u2019s Hospital of Soochow University","place":["Suzhou, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuejun","family":"Shao","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, Children\u2019s Hospital of Soochow University","place":["Suzhou, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yang","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, Children\u2019s Hospital of Soochow University","place":["Suzhou, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhengrong","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Children\u2019s Hospital of Soochow University","place":["Suzhou, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,5,28]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"3483","DOI":"10.1128\/JCM.00726-14","article-title":"First isolate of KPC-2-producing Klebsiella pneumonaie sequence type 23 from the Americas","volume":"52","author":"Cejas","year":"2014","journal-title":"J. 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