{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T22:06:29Z","timestamp":1792188389727,"version":"4.4.0"},"reference-count":45,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2023,2,11]],"date-time":"2023-02-11T00:00:00Z","timestamp":1676073600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003443","name":"Ministry of Science and Higher Education of the Russian Federation","doi-asserted-by":"publisher","award":["075-15-2019-1671"],"award-info":[{"award-number":["075-15-2019-1671"]}],"id":[{"id":"10.13039\/501100003443","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Microorganisms"],"abstract":"<jats:p>Background: Klebsiella pneumoniae, a member of the ESKAPE group of bacterial pathogens, has developed multi-antimicrobial resistance (AMR), including resistance to carbapenems, which has increased alarmingly due to the acquisition of carbapenemase genes located on specific plasmids. Methods: Four clinical K.\u00a0pneumoniae isolates were collected from four patients of a neuro-intensive care unit in Moscow, Russia, during the point prevalence survey. The AMR phenotype was estimated using the Vitec-2 instrument, and whole genome sequencing (WGS) was done using Illumina and Nanopore technologies. Results: All strains were resistant to beta-lactams, nitrofurans, fluoroquinolones, sulfonamides, aminoglycosides, and tetracyclines. WGS analysis revealed that all strains were closely related to K.\u00a0pneumoniae ST39, capsular type K-23, with 99.99% chromosome identity. The novelty of the study is the description of the strains carrying simultaneously three large plasmids of the IncHI1B, IncC, and IncFIB groups carrying the carbapenemase genes of three types, blaOXA-48, blaNDM-1, and blaKPC-2, respectively. The first of them, highly identical in all strains, was a hybrid plasmid that combined two regions of the resistance genes (blaOXA-48 and blaTEM-1 + blaCTX-M-15 + blaOXA-1 + catB + qnrS1 + int1) and a region of the virulence genes (iucABCD, iutA, terC, and rmpA2::IS110). Conclusion: The spread of K. pneumoniae strains carrying multiple plasmids conferring resistance even to last-resort antibiotics is of great clinical concern.<\/jats:p>","DOI":"10.3390\/microorganisms11020459","type":"journal-article","created":{"date-parts":[[2023,2,13]],"date-time":"2023-02-13T04:07:19Z","timestamp":1676261239000},"page":"459","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["High-Molecular-Weight Plasmids Carrying Carbapenemase Genes blaNDM-1, blaKPC-2, and blaOXA-48 Coexisting in Clinical Klebsiella pneumoniae Strains of ST39"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5681-7616","authenticated-orcid":false,"given":"Ekaterina S.","family":"Kuzina","sequence":"first","affiliation":[{"name":"Department of Training and Improvement of Specialists, State Research Center for Applied Microbiology and Biotechnology, Territory \u201cKvartal A\u201d, 142279 Obolensk, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angelina A.","family":"Kislichkina","sequence":"additional","affiliation":[{"name":"Department of Culture Collection, State Research Center for Applied Microbiology and Biotechnology, Territory \u201cKvartal A\u201d, 142279 Obolensk, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angelika A.","family":"Sizova","sequence":"additional","affiliation":[{"name":"Department of Culture Collection, State Research Center for Applied Microbiology and Biotechnology, Territory \u201cKvartal A\u201d, 142279 Obolensk, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5748-995X","authenticated-orcid":false,"given":"Yury P.","family":"Skryabin","sequence":"additional","affiliation":[{"name":"Department of Molecular Microbiology, State Research Center for Applied Microbiology and Biotechnology, Territory \u201cKvartal A\u201d, 142279 Obolensk, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tatiana S.","family":"Novikova","sequence":"additional","affiliation":[{"name":"Department of Molecular Microbiology, State Research Center for Applied Microbiology and Biotechnology, Territory \u201cKvartal A\u201d, 142279 Obolensk, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olga N.","family":"Ershova","sequence":"additional","affiliation":[{"name":"Department of Clinical Epidemiology, National Medical Research Center of Neurosurgery Named after Academician N.N. Burdenko, 125047 Moscow, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivan A.","family":"Savin","sequence":"additional","affiliation":[{"name":"Department of Clinical Epidemiology, National Medical Research Center of Neurosurgery Named after Academician N.N. Burdenko, 125047 Moscow, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olga E.","family":"Khokhlova","sequence":"additional","affiliation":[{"name":"Department of Molecular Microbiology, State Research Center for Applied Microbiology and Biotechnology, Territory \u201cKvartal A\u201d, 142279 Obolensk, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander G.","family":"Bogun","sequence":"additional","affiliation":[{"name":"Department of Culture Collection, State Research Center for Applied Microbiology and Biotechnology, Territory \u201cKvartal A\u201d, 142279 Obolensk, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6053-2621","authenticated-orcid":false,"given":"Nadezhda K.","family":"Fursova","sequence":"additional","affiliation":[{"name":"Department of Molecular Microbiology, State Research Center for Applied Microbiology and Biotechnology, Territory \u201cKvartal A\u201d, 142279 Obolensk, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,2,11]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"719421","DOI":"10.3389\/fcimb.2022.719421","article-title":"Predictors and outcomes of healthcare-associated infections caused by carbapenem-nonsusceptible Enterobacterales: A parallel matched case-control study","volume":"12","author":"Hoo","year":"2022","journal-title":"Front. 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