{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T22:13:42Z","timestamp":1792793622377,"version":"4.5.0"},"reference-count":46,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2025,3,4]],"date-time":"2025-03-04T00:00:00Z","timestamp":1741046400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Major National Science and Technology Projects","award":["2018ZX10714-002"],"award-info":[{"award-number":["2018ZX10714-002"]}]},{"name":"Major National Science and Technology Projects","award":["Ym2023040"],"award-info":[{"award-number":["Ym2023040"]}]},{"name":"Major National Science and Technology Projects","award":["2023-2-33"],"award-info":[{"award-number":["2023-2-33"]}]},{"name":"Preventive Medicine Research Project of Jiangsu Province","award":["2018ZX10714-002"],"award-info":[{"award-number":["2018ZX10714-002"]}]},{"name":"Preventive Medicine Research Project of Jiangsu Province","award":["Ym2023040"],"award-info":[{"award-number":["Ym2023040"]}]},{"name":"Preventive Medicine Research Project of Jiangsu Province","award":["2023-2-33"],"award-info":[{"award-number":["2023-2-33"]}]},{"name":"Special Scientific Research Fund of Yangzhou Health Commission","award":["2018ZX10714-002"],"award-info":[{"award-number":["2018ZX10714-002"]}]},{"name":"Special Scientific Research Fund of Yangzhou Health Commission","award":["Ym2023040"],"award-info":[{"award-number":["Ym2023040"]}]},{"name":"Special Scientific Research Fund of Yangzhou Health Commission","award":["2023-2-33"],"award-info":[{"award-number":["2023-2-33"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pathogens"],"abstract":"<jats:p>In recent years, resistance of Klebsiella pneumoniae to the clinical last-resort drugs carbapenem and tigecycline has intensified, including Metallo-\u03b2-Lactamase-producing K. pneumoniae (MBL-KP), which demonstrated resistance to ceftazidime-avibactam (CZA), posing a significant public health threat. This study focused on the carbapenems, CZA, and tigecycline resistance mechanisms of MBL-producing Carbapenem-resistant K. pneumoniae (MBL-CRKP). A retrospective study and genomic epidemiological analysis of Carbapenem-resistant K. pneumoniae (CRKP) strains isolated from Yangzhou City, Jiangsu Province, China, between 2016 and 2023 was conducted. The detection rate of CRKP in Yangzhou City has increased significantly in recent years, with five strains carrying the Metallo-\u03b2-Lactamases (MBLs) gene, all of which exhibited resistance to carbapenems and CZA. Two strains even showed reduced susceptibility to tigecycline, with one harboring tmexCD2-toprJ2. Moreover, three CRKP strains carrying both blaKPC-2 and blaNDM-1\/blaNDM-29 genes were identified. Plasmids carrying MBL genes can horizontally transfer, leading to the spread of resistance, thus further exacerbating the difficulty of clinical treatment and the spread of resistance. In conclusion, this study not only revealed the resistance of MBL-CRKP strains to clinical last-resort therapeutic drugs but also explored the resistance mechanism and horizontal transfer through genomic analysis. Moreover, this study also suggested that microbial drug resistance surveillance should be conducted from the perspective of \u201cone health\u201d in the future to combat this global health challenge.<\/jats:p>","DOI":"10.3390\/pathogens14030253","type":"journal-article","created":{"date-parts":[[2025,3,4]],"date-time":"2025-03-04T07:47:37Z","timestamp":1741074457000},"page":"253","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Emergence of Tigecycline-Nonsusceptible Carbapenem-Resistant Klebsiella pneumoniae with Metallo-\u03b2-Lactamase and Transferable Ceftazidime-Avibactam Resistance in China"],"prefix":"10.3390","volume":"14","author":[{"given":"Yajuan","family":"Ni","sequence":"first","affiliation":[{"name":"Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing 210009, China"},{"name":"Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing 210009, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiefu","family":"Peng","sequence":"additional","affiliation":[{"name":"Department of Acute Infectious Disease Control and Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China"},{"name":"National Health Commission (NHC) Key Laboratory of Enteric Pathogenic Microbiology, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yawen","family":"Xu","sequence":"additional","affiliation":[{"name":"Yangzhou Center for Disease Control and Prevention, Yangzhou 225007, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liguo","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Acute Infectious Disease Control and Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China"},{"name":"National Health Commission (NHC) Key Laboratory of Enteric Pathogenic Microbiology, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao","family":"Wang","sequence":"additional","affiliation":[{"name":"Xuzhou Center for Disease Control and Prevention, Xuzhou 221006, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0071-9755","authenticated-orcid":false,"given":"Hui","family":"Jin","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing 210009, China"},{"name":"Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing 210009, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huimin","family":"Qian","sequence":"additional","affiliation":[{"name":"Department of Acute Infectious Disease Control and Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China"},{"name":"National Health Commission (NHC) Key Laboratory of Enteric Pathogenic Microbiology, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,3,4]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Martin, R.M., and Bachman, M.A. (2018). 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