{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T19:19:36Z","timestamp":1792351176971,"version":"4.4.0"},"reference-count":98,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T00:00:00Z","timestamp":1770249600000},"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                      This study investigated the epidemiology and distribution of carbapenem resistance and virulence genes in\n                      <jats:italic>Klebsiella pneumoniae<\/jats:italic>\n                      strains isolated from the oral cavity of hospitalized patients, highlighting their role as reservoirs in non-epidemic contexts.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Carbapenem-resistant\n                      <jats:italic>Klebsiella<\/jats:italic>\n                      spp. were isolated from the oral cavity of 180 hospitalized patients in medical wards at two hospitals in Bejaia, Algeria. Screening for carbapenem resistance was performed on oral mucosa and saliva using Carba-MTL broth. Antibiotic susceptibility was assessed with the Vitek2 system and interpreted according to EUCAST guidelines. Whole genome sequencing (WGS) was carried out using Oxford Nanopore Technologies, with ABRicate used for resistance\/virulence gene detection and Kleborate for hypervirulence assessment. Whole-genome sequences were further examined to identify single-nucleotide polymorphisms (SNPs) and to reconstruct a SNP-based phylogenetic tree in order to assess the genetic relatedness among the isolates.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Twenty\n                      <jats:italic>Klebsiella<\/jats:italic>\n                      strains were identified as\n                      <jats:italic>K. pneumoniae<\/jats:italic>\n                      . Among these, 85% were carbapenem-resistant, carrying\n                      <jats:italic>OXA-48<\/jats:italic>\n                      (80%) or\n                      <jats:italic>NDM-5<\/jats:italic>\n                      (5%), and all harbored\n                      <jats:italic>blaCTX-M-15<\/jats:italic>\n                      . WGS of the 20\n                      <jats:italic>K. pneumoniae<\/jats:italic>\n                      strains revealed a broad resistome, including\n                      <jats:italic>\u03b2<\/jats:italic>\n                      -lactamases (\n                      <jats:italic>CTX-M-15, CMY-4, OXA-1, TEM-1<\/jats:italic>\n                      ), sulfonamide (\n                      <jats:italic>sul1, sul2<\/jats:italic>\n                      ), aminoglycoside (\n                      <jats:italic>aac(3)-IIa, aadA2, aph(3\u2032)-VI, armA, strA, strB<\/jats:italic>\n                      ), trimethoprim (\n                      <jats:italic>dfrA12, dfrA5, dfrA14<\/jats:italic>\n                      ), and tetracycline (\n                      <jats:italic>tetA<\/jats:italic>\n                      ). Quinolone resistance was linked to QRDR mutations (\n                      <jats:italic>gyrA S83I, parC S80I<\/jats:italic>\n                      ) and plasmid-mediated genes (\n                      <jats:italic>qnrS1, qnrB10, qnrS10, aac(6\u2032)-Ib-cr<\/jats:italic>\n                      ). Five distinct sequence types (STs) were identified, including high-risk clones ST13 and ST48. Virulence profiling revealed\n                      <jats:italic>yersiniabactin<\/jats:italic>\n                      (85%), frequently linked to ICEKp elements (ICEKp4, ICEKp10), and colibactin (40%) among OXA-48 isolates. Notably, a single\n                      <jats:italic>K. pneumoniae<\/jats:italic>\n                      isolate harboring NDM-5 (K21) carried both hypervirulence markers (\n                      <jats:italic>ybt9\/ICEKp3, iuc1, rmp1\/kpvp-1<\/jats:italic>\n                      ) and carbapenem resistance, documenting, for the first time in Algeria, the convergence of these traits in oral isolates. ICEKp was identified as the key vehicle for dissemination of\n                      <jats:italic>yersiniabactin<\/jats:italic>\n                      and\n                      <jats:italic>colibactin<\/jats:italic>\n                      , and a novel association between ICEKp and\n                      <jats:italic>kpvp-1<\/jats:italic>\n                      was observed. Capsular typing showed predominance of K57-O1\/O2v2 among OXA-48 producers and K27\/O4 among NDM-5 strains.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      This study provides the first evidence in Algeria of OXA-48- and NDM-5-producing\n                      <jats:italic>K. pneumoniae<\/jats:italic>\n                      in the oral cavity of hospitalized patients. The coexistence of carbapenem resistance and hypervirulence underscores the oral cavity as a critical reservoir, potentially fueling nosocomial infections and the dissemination of high-risk clones within hospitals and the wider community.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmicb.2026.1751947","type":"journal-article","created":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T06:44:18Z","timestamp":1770273858000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["The oral cavity as a reservoir for resistance- and hypervirulence-associated genes of Klebsiella pneumoniae in hospitalized patients"],"prefix":"10.3389","volume":"17","author":[{"given":"Karima","family":"Zenati","sequence":"first","affiliation":[{"name":"Laboratory of Microbial Ecology, Department of Microbiology, Faculty of Natural and Life Sciences, University of Bejaia , Bejaia","place":["Algeria"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sascha D.","family":"Braun","sequence":"additional","affiliation":[{"name":"Leibniz Institute of Photonic Technology, Member of the Research Alliance \u201cLeibniz Health Technologies\u201d and the Leibniz Centre for Photonics in Infection Research (LPI)","place":["Jena, Germany"]},{"name":"Center for Translational Medicine (CETRAMED), Jena University Hospital, Friedrich Schiller University Jena","place":["Jena, Germany"]},{"name":"InfectoGnostics Research Campus Jena e.V.","place":["Jena, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Djellali","family":"Belhadi","sequence":"additional","affiliation":[{"name":"Laboratory of Microbial Ecology, Department of Microbiology, Faculty of Natural and Life Sciences, University of Bejaia , Bejaia","place":["Algeria"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amira A.","family":"Moawad","sequence":"additional","affiliation":[{"name":"Friedrich-Loeffler-Institut, Institute of Bacterial Infections and Zoonoses","place":["Jena, Germany"]},{"name":"Animal Health Research Institute, Agriculture Research Center (ARC)","place":["Giza, Egypt"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elke","family":"M\u00fcller","sequence":"additional","affiliation":[{"name":"Leibniz Institute of Photonic Technology, Member of the Research Alliance \u201cLeibniz Health Technologies\u201d and the Leibniz Centre for Photonics in Infection Research (LPI)","place":["Jena, Germany"]},{"name":"Center for Translational Medicine (CETRAMED), Jena University Hospital, Friedrich Schiller University Jena","place":["Jena, Germany"]},{"name":"InfectoGnostics Research Campus Jena e.V.","place":["Jena, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Celia","family":"Diezel","sequence":"additional","affiliation":[{"name":"Leibniz Institute of Photonic Technology, Member of the Research Alliance \u201cLeibniz Health Technologies\u201d and the Leibniz Centre for Photonics in Infection Research (LPI)","place":["Jena, Germany"]},{"name":"Center for Translational Medicine (CETRAMED), Jena University Hospital, Friedrich Schiller University Jena","place":["Jena, Germany"]},{"name":"InfectoGnostics Research Campus Jena e.V.","place":["Jena, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Brandt","sequence":"additional","affiliation":[{"name":"InfectoGnostics Research Campus Jena e.V.","place":["Jena, Germany"]},{"name":"Institute of Infectious Diseases and Infection Control, Jena University Hospital, Friedrich Schiller University","place":["Jena, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raouya","family":"Mostefaoui","sequence":"additional","affiliation":[{"name":"Laboratory of Microbial Ecology, Department of Microbiology, Faculty of Natural and Life Sciences, University of Bejaia , Bejaia","place":["Algeria"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Monecke","sequence":"additional","affiliation":[{"name":"Leibniz Institute of Photonic Technology, Member of the Research Alliance \u201cLeibniz Health Technologies\u201d and the Leibniz Centre for Photonics in Infection Research (LPI)","place":["Jena, Germany"]},{"name":"Center for Translational Medicine (CETRAMED), Jena University Hospital, Friedrich Schiller University Jena","place":["Jena, Germany"]},{"name":"Institute for Medical Microbiology and Virology, Dresden University Hospital","place":["Dresden, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fatma Zohra","family":"Zaidi","sequence":"additional","affiliation":[{"name":"Laboratory of Microbial Ecology, Department of Microbiology, Faculty of Natural and Life Sciences, University of Bejaia , Bejaia","place":["Algeria"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed","family":"Belmahdi","sequence":"additional","affiliation":[{"name":"Department of Biology, Faculty of Natural and Life Sciences, University of Djelfa","place":["Djelfa, Algeria"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdelaziz","family":"Touati","sequence":"additional","affiliation":[{"name":"Laboratory of Microbial Ecology, Department of Microbiology, Faculty of Natural and Life Sciences, University of Bejaia , Bejaia","place":["Algeria"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ralf","family":"Ehricht","sequence":"additional","affiliation":[{"name":"Leibniz Institute of Photonic Technology, Member of the Research Alliance \u201cLeibniz Health Technologies\u201d and the Leibniz Centre for Photonics in Infection Research (LPI)","place":["Jena, Germany"]},{"name":"Center for Translational Medicine (CETRAMED), Jena University Hospital, Friedrich Schiller University Jena","place":["Jena, Germany"]},{"name":"InfectoGnostics Research Campus Jena e.V.","place":["Jena, Germany"]},{"name":"Institute of Physical Chemistry, Friedrich Schiller University Jena","place":["Jena, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,2,5]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.3390\/antibiotics11060750","article-title":"Dissemination of OXA-48- and NDM-1-producing Enterobacterales isolates in an Algerian hospital","volume":"11","author":"Abderrahim","year":"2022","journal-title":"Antibiotics (Basel)"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"895","DOI":"10.1089\/mdr.2016.0213","article-title":"First case of NDM-1-producing Klebsiella pneumoniae in Annaba university hospital, Algeria","volume":"23","author":"Abderrahim","year":"2017","journal-title":"Microb. 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