{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T03:08:59Z","timestamp":1793502539388,"version":"4.5.0"},"reference-count":33,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,12,15]],"date-time":"2021-12-15T00:00:00Z","timestamp":1639526400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100007129","name":"Natural Science Foundation of Shandong Province","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100007129","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:p><jats:bold>Background:<\/jats:bold> The purpose of this study is to use whole genome sequencing (WGS) combined with epidemiological data to track a hospital infection of the carbapenem-resistant <jats:italic>Klebsiella pneumoniae<\/jats:italic> (CRKP), which affected 3 neonatal patients in the neonatal intensive care unit (NICU).<\/jats:p><jats:p><jats:bold>Methods:<\/jats:bold> The minimum inhibitory concentrations for the antimicrobial agents were determined according to the guidelines of the Clinical and Laboratory Standards Institute. Beta-lactamases were investigated using the polymerase chain reaction and DNA sequencing. The transferability of the plasmid was investigated by a conjugation experiment. The clonal relationships were evaluated using multilocus sequence typing (MLST) and pulsed-field gel electrophoresis (PFGE). WGS and single nucleotide polymorphisms (SNPs) analysis were performed on the CRKP isolates to investigate how the infection might progress.<\/jats:p><jats:p><jats:bold>Results:<\/jats:bold> Nine CRKP isolates were obtained from the NICU, seven from three patients, one from a duster cloth and one from the hand of a nurse, they all harbored <jats:italic>bla<\/jats:italic>IMP-4. Other resistance genes including <jats:italic>bla<\/jats:italic>KPC-2, <jats:italic>bla<\/jats:italic>IMP-4, <jats:italic>bla<\/jats:italic>SHV-1, <jats:italic>bla<\/jats:italic>TEM-1, <jats:italic>bla<\/jats:italic>CTX-M-15, and <jats:italic>bla<\/jats:italic>DHA-1 were also detected. PFGE analysis showed that IMP-4-producing <jats:italic>K. pneumoniae<\/jats:italic> were clonally related, and MLST assigned them to a new sequence type 2253. The SNP variations throughout the genome divided the 9 strains into three clades. Clade 1 comprised 7 strains (K1- K2 and K4-K8), whereas clade 2 and 3 consisted of only one strain each: K3 and K9, respectively.The sputum isolate K3 from patient 3 was the most distinct one differing from the other eight isolates by 239-275 SNPs.<\/jats:p><jats:p><jats:bold>Conclusions:<\/jats:bold> This is a report of using WGS to track a hospital infecion of IMP-4-producing <jats:italic>K. pneumoniae<\/jats:italic> ST2253 among neonates. Nosocomial surveillance systems are needed to limit the spread of the infection caused by these pathogens resulting from the environmental exposure in NICUs.<\/jats:p>","DOI":"10.3389\/fpubh.2021.755252","type":"journal-article","created":{"date-parts":[[2021,12,15]],"date-time":"2021-12-15T06:45:38Z","timestamp":1639550738000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":10,"title":["Using Whole Genome Sequencing to Trace, Control and Characterize a Hospital Infection of IMP-4-Producing Klebsiella pneumoniae ST2253 in a Neonatal Unit in a Tertiary Hospital, China"],"prefix":"10.3389","volume":"9","author":[{"given":"Yuanyuan","family":"Bai","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chunhong","family":"Shao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yingying","family":"Hao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yueling","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Jin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2021,12,15]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"609","DOI":"10.1097\/QCO.0000000000000608","article-title":"Epidemiology of carbapenem-resistant gram-negative infections 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