{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:19:08Z","timestamp":1787026748427,"version":"build-2736575974"},"reference-count":49,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T00:00:00Z","timestamp":1783555200000},"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>Background<\/jats:title>\n                    <jats:p>\n                      Carbapenem-resistant\n                      <jats:italic>Pseudomonas aeruginosa<\/jats:italic>\n                      (CRPA) is a major healthcare-associated pathogen with high multidrug resistance and mortality. Regional clonal spread of high-risk lineages carrying carbapenemase genes poses significant challenges for infection control.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analyzed 100 non-duplicate CRPA clinical isolates collected from June 2020 to December 2024 in Deqing, Zhejiang Province, China. Antimicrobial susceptibility was determined by automated systems, and molecular characterization was performed via whole-genome sequencing, multilocus sequence typing (MLST), core-genome single nucleotide polymorphism (SNP) phylogeny, resistance and virulence gene profiling, and phylogeographic analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The observed resistance rates were 95% for imipenem and 91% for meropenem. Carbapenemase-producing isolates comprised 44% (44\/100), with\n                      <jats:italic>bla<\/jats:italic>\n                      <jats:sub>\n                        <jats:italic>KPC<\/jats:italic>\n                        \u20132\n                      <\/jats:sub>\n                      predominating (95.5%, 42\/44). MLST identified 44 sequence types, including novel ST5216. ST1076 was the dominant clone (23%, 23\/100), followed by ST463 (17%). Among ST1076 isolates, 87.0% carried\n                      <jats:italic>bla<\/jats:italic>\n                      <jats:sub>\n                        <jats:italic>KPC<\/jats:italic>\n                        \u20132\n                      <\/jats:sub>\n                      . Core-genome SNP analysis revealed tight clustering of 22\/23 ST1076 isolates (4\u2013105 SNPs), suggesting possible prolonged nosocomial transmission centered in the Intensive Care Unit (ICU) since mid-2020. Phylogeographic analysis showed strong clustering with ST1076 strains from Ningbo and Hangzhou, supporting intra-provincial dissemination within Zhejiang. Virulence profiling demonstrated high prevalence of T3SS effectors (\n                      <jats:italic>exoT<\/jats:italic>\n                      100%,\n                      <jats:italic>exoY<\/jats:italic>\n                      97%) and frequent\n                      <jats:italic>oprD<\/jats:italic>\n                      inactivation.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      This study reveals the emergence and sustained ICU-associated transmission of\n                      <jats:italic>bla<\/jats:italic>\n                      <jats:sub>\n                        <jats:italic>KPC<\/jats:italic>\n                        \u20132\n                      <\/jats:sub>\n                      -harboring ST1076 CRPA as a regionally dominant clone in Zhejiang, China, while preserving high susceptibility to ceftazidime\/avibactam (CZA). Enhanced local surveillance and strict infection control measures are urgently needed to prevent further spread of this high-risk lineage.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmicb.2026.1839819","type":"journal-article","created":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T05:34:12Z","timestamp":1783575252000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Emergence of ST1076 as a dominant high-risk clone carrying blaKPC\u20132 in carbapenem-resistant Pseudomonas aeruginosa from Deqing, Zhejiang, China: a 5-year genomic epidemiology study"],"prefix":"10.3389","volume":"17","author":[{"given":"Xiaolan","family":"Shou","sequence":"first","affiliation":[{"name":"Department of Clinical Laboratory, Deqing People\u2019s Hospital (Deqing Campus, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University), Deqing","place":["Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiangchen","family":"Li","sequence":"additional","affiliation":[{"name":"Jiaxing Key Laboratory of Clinical Laboratory Diagnostics and Translational Research, Affiliated Hospital of Jiaxing University","place":["Jiaxing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongyin","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, Feicheng Hospital of Traditional Chinese Medicine, Taian","place":["Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaofan","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, Feicheng Hospital of Traditional Chinese Medicine, Taian","place":["Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,9]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"D690","DOI":"10.1093\/nar\/gkac920","article-title":"CARD 2023: Expanded curation, support for machine learning, and resistome prediction at the comprehensive antibiotic resistance database.","volume":"51","author":"Alcock","year":"2023","journal-title":"Nucleic Acids Res."},{"key":"B2","doi-asserted-by":"publisher","first-page":"6248","DOI":"10.1128\/aac.00825-15","article-title":"Mutations in \u03b2-lactamase AmpC increase resistance of Pseudomonas aeruginosa isolates to antipseudomonal cephalosporins.","volume":"59","author":"Berrazeg","year":"2015","journal-title":"Antimicrob. 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