{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T04:54:27Z","timestamp":1787806467225,"version":"build-2784847793"},"reference-count":34,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2020,12,3]],"date-time":"2020-12-03T00:00:00Z","timestamp":1606953600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100012190","name":"Ministry of Science and Higher Education of the Russian Federation","doi-asserted-by":"publisher","award":["075-15-2019-1666"],"award-info":[{"award-number":["075-15-2019-1666"]}],"id":[{"id":"10.13039\/501100012190","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antibiotics"],"abstract":"<jats:p>Multidrug resistance (MDR) and hypervirulence (hv) have been long considered distinct evolutionary traits for Klebsiella pneumoniae (Kp), a versatile human pathogen. The recent emergence of Kp strains combining these traits poses a serious global threat. In this article, we describe the phenotypic and genomic characteristics of an MDR hvKp isolate, MAR14-456, representative of a nosocomial outbreak in Moscow, Russia, that was recovered from a postoperative wound in a patient who later developed multiple abscesses, fatal sepsis, and septic shock. Broth microdilution testing revealed decreased susceptibility of MAR14-456 to carbapenems (MICs 0.5\u20132 mg\/L) and a high-level resistance to most \u03b2-lactams, \u03b2-lactam-\u03b2-lactamase-inhibitor combinations, and non-\u03b2-lactam antibiotics, except ceftazidime-avibactam, amikacin, tigecycline, and colistin. Whole-genome sequencing using Illumina MiSeq and ONT MinION systems allowed to identify and completely assemble two conjugative resistance plasmids, a typical \u2018European\u2019 epidemic IncL\/M plasmid that carries the gene of OXA-48 carbapenemase, and an IncFIIK plasmid that carries the gene of CTX-M-15 ESBL and other resistance genes. MLST profile, capsular, lipopolysaccharide, virulence genes encoded on chromosome and IncHI1B\/FIB plasmid, and the presence of apparently functional type I-E* CRISPR-Cas system were all characteristic of hvKp ST23, serotype K1-O1v2. Phylogenetic analysis showed the closest relatedness of MAR14-456 to ST23 isolates from China. This report highlights the threat of multiple resistance acquisition by hvKp strain and its spread as a nosocomial pathogen.<\/jats:p>","DOI":"10.3390\/antibiotics9120862","type":"journal-article","created":{"date-parts":[[2020,12,3]],"date-time":"2020-12-03T11:15:43Z","timestamp":1606994143000},"page":"862","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":33,"title":["Antimicrobial Resistance and Genomic Characterization of OXA-48- and CTX-M-15-Co-Producing Hypervirulent Klebsiella pneumoniae ST23 Recovered from Nosocomial Outbreak"],"prefix":"10.3390","volume":"9","author":[{"given":"Elvira","family":"Shaidullina","sequence":"first","affiliation":[{"name":"Institute of Antimicrobial Chemotherapy, Smolensk State Medical University, 214019 Smolensk, Russia"},{"name":"Institute of Fundamental Medicine and Biology, Kazan Federal University, 420012 Kazan, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7409-077X","authenticated-orcid":false,"given":"Andrey","family":"Shelenkov","sequence":"additional","affiliation":[{"name":"Central Research Institute of Epidemiology, Rospotrebnadzor, 111123 Moscow, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuri","family":"Yanushevich","sequence":"additional","affiliation":[{"name":"Central Research Institute of Epidemiology, Rospotrebnadzor, 111123 Moscow, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yulia","family":"Mikhaylova","sequence":"additional","affiliation":[{"name":"Central Research Institute of Epidemiology, Rospotrebnadzor, 111123 Moscow, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dmitriy","family":"Shagin","sequence":"additional","affiliation":[{"name":"Central Research Institute of Epidemiology, Rospotrebnadzor, 111123 Moscow, Russia"},{"name":"Pirogov Russian National Research Medical University, 117997 Moscow, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irina","family":"Alexandrova","sequence":"additional","affiliation":[{"name":"N.N. Burdenko National Scientific and Practical Center for Neurosurgery, 125047 Moscow, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3175-2910","authenticated-orcid":false,"given":"Olga","family":"Ershova","sequence":"additional","affiliation":[{"name":"N.N. Burdenko National Scientific and Practical Center for Neurosurgery, 125047 Moscow, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vasiliy","family":"Akimkin","sequence":"additional","affiliation":[{"name":"Central Research Institute of Epidemiology, Rospotrebnadzor, 111123 Moscow, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8728-1113","authenticated-orcid":false,"given":"Roman","family":"Kozlov","sequence":"additional","affiliation":[{"name":"Institute of Antimicrobial Chemotherapy, Smolensk State Medical University, 214019 Smolensk, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4633-9910","authenticated-orcid":false,"given":"Mikhail","family":"Edelstein","sequence":"additional","affiliation":[{"name":"Institute of Antimicrobial Chemotherapy, Smolensk State Medical University, 214019 Smolensk, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,12,3]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1086\/595011","article-title":"Bad bugs, no drugs: No ESKAPE! 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