{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,5]],"date-time":"2026-07-05T04:30:18Z","timestamp":1783225818226,"version":"3.54.6"},"reference-count":18,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2024,6,15]],"date-time":"2024-06-15T00:00:00Z","timestamp":1718409600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Menarini","award":["COSC_RIC_N_COMP_REND_22_01-Ref N\/22-119\/ALT"],"award-info":[{"award-number":["COSC_RIC_N_COMP_REND_22_01-Ref N\/22-119\/ALT"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pathogens"],"abstract":"<jats:p>Background: Klebsiella pneumoniae is a concerning pathogen, responsible for hospital-associated outbreaks. Multi drug resistant (MDR) strains are especially hard to treat. We conducted whole-genome sequencing on a MDR K. pneumoniae strain in order to identify genomic features potentially linked to its phenotype. Methods: DNA sequencing was performed on the Illumina iSeq 100 platform. Genome assembly was carried out with SPAdes. The genome was annotated with RASTtk. Typing was performed with MLST and Kaptive. Antibiotic resistance genes were detected with AMRFinderPlus and Abricate, and further verified with BLAST. Results: The strain exhibited resistance to ceftazidime\/avibactam and cefiderocol, but remained susceptible to carbapenems. The strain belonged to sequence type ST101, serotype O1:K17. The analysis of antibiotic resistance genes indicated that the strain carried a novel KPC variant, designated as KPC-203, featuring a EL deletion at amino acid position 166\u2013167, within the \u03a9-loop, and a nine-amino-acid insertion (LAVYTRAPM) at position 259. Sequence alterations were found in porin genes ompK35 and ompK36. Unlike molecular testing, which was able to detect the KPC-203 variant, all phenotypic carbapenemase detection methods achieved negative results. Conclusions: KPC-203, a novel KPC variant, showed a sequence modification in a cephalosporin resistance-associated hotspot. Interestingly, such alterations typically correlate with the restoration of carbapenem susceptibility. We hypothesize that KPC-203 likely led to resistance to ceftazidime\/avibactam and cefiderocol, while maintaining susceptibility to carbapenems.<\/jats:p>","DOI":"10.3390\/pathogens13060507","type":"journal-article","created":{"date-parts":[[2024,6,17]],"date-time":"2024-06-17T08:48:31Z","timestamp":1718614111000},"page":"507","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Complete Genome Sequence of a Klebsiella pneumoniae Strain Carrying Novel Variant blaKPC-203, Cross-Resistant to Ceftazidime\/Avibactam and Cefiderocol, but Susceptible to Carbapenems, Isolated in Italy, 2023"],"prefix":"10.3390","volume":"13","author":[{"given":"Stefano","family":"Amadesi","sequence":"first","affiliation":[{"name":"Microbiology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40126 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8180-5075","authenticated-orcid":false,"given":"Gabriele","family":"Bianco","sequence":"additional","affiliation":[{"name":"Department of Experimental Medicine, University of Salento, 73100 Lecce, Italy"},{"name":"Microbiology and Virology Unit, University Hospital Citt\u00e0 della Salute e della Scienza di Torino, 10126 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benedetta","family":"Secci","sequence":"additional","affiliation":[{"name":"Microbiology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40126 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teresa","family":"Fasciana","sequence":"additional","affiliation":[{"name":"Department of Health Promotion, Maternal and Child Health, Internal Medicine and Specialty Excellence \u201cG. D\u2019Alessandro\u201d, University of Palermo, 90127 Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6726-2716","authenticated-orcid":false,"given":"Matteo","family":"Boattini","sequence":"additional","affiliation":[{"name":"Microbiology and Virology Unit, University Hospital Citt\u00e0 della Salute e della Scienza di Torino, 10126 Turin, Italy"},{"name":"Department of Public Health and Paediatrics, University of Torino, 10126 Turin, Italy"},{"name":"Lisbon Academic Medical Centre, 1649-028 Lisbon, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6549-4553","authenticated-orcid":false,"given":"Cristina","family":"Costa","sequence":"additional","affiliation":[{"name":"Microbiology and Virology Unit, University Hospital Citt\u00e0 della Salute e della Scienza di Torino, 10126 Turin, Italy"},{"name":"Department of Public Health and Paediatrics, University of Torino, 10126 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Gaibani","sequence":"additional","affiliation":[{"name":"Microbiology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40126 Bologna, Italy"},{"name":"Department of Diagnostic and Public Health, Microbiology Section, Verona University, 37134 Verona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,6,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Wang, G., Zhao, G., Chao, X., Xie, L., and Wang, H. 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