{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T09:40:40Z","timestamp":1769161240220,"version":"3.49.0"},"reference-count":30,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2020,11,13]],"date-time":"2020-11-13T00:00:00Z","timestamp":1605225600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001871","name":"Funda\u00e7\u00e3o para a Ci\u00eancia e a Tecnologia","doi-asserted-by":"publisher","award":["DL57\/2016\/CP1346\/CT0032"],"award-info":[{"award-number":["DL57\/2016\/CP1346\/CT0032"]}],"id":[{"id":"10.13039\/501100001871","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100015621","name":"Applied Molecular Biosciences Unit","doi-asserted-by":"publisher","award":["UID\/Multi\/ UIDB\/04378\/2020"],"award-info":[{"award-number":["UID\/Multi\/ UIDB\/04378\/2020"]}],"id":[{"id":"10.13039\/501100015621","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antibiotics"],"abstract":"<jats:p>Carbapenem resistance rates increased exponentially between 2014 and 2017 in Portugal (~80%), especially in Klebsiella pneumoniae. We characterized the population of carbapanemase-producing Enterobacterales (CPE) infecting or colonizing hospitalized patients (2017\u20132018) in a central hospital from northern Portugal, where KPC-3-producing K. pneumoniae capsular type K64 has caused an initial outbreak. We gathered phenotypic (susceptibility data), molecular (population structure, carbapenemase, capsular type) and biochemical (FT-IR) data, together with patients\u2019 clinical and epidemiological information. A high diversity of Enterobacterales species, clones (including E. coli ST131) and carbapenemases (mainly KPC-3 but also OXA-48 and VIM) was identified three years after the onset of carbapenemases spread in the hospital studied. ST147-K64 K. pneumoniae, the initial outbreak clone, is still predominant though other high-risk clones have emerged (e.g., ST307, ST392, ST22), some of them with pandrug resistance profiles. Rectal carriage, previous hospitalization or antibiotherapy were presumptively identified as risk factors for subsequent infection. In addition, our previously described Fourier Transform infrared (FT-IR) spectroscopy method typed 94% of K. pneumoniae isolates with high accuracy (98%), and allowed to identify previously circulating clones. This work highlights an increasing diversity of CPE infecting or colonizing patients in Portugal, despite the infection control measures applied, and the need to improve the accuracy and speed of bacterial strain typing, a goal that can be met by simple and cost-effective FT-IR based typing.<\/jats:p>","DOI":"10.3390\/antibiotics9110806","type":"journal-article","created":{"date-parts":[[2020,11,13]],"date-time":"2020-11-13T08:44:02Z","timestamp":1605257042000},"page":"806","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Multiplicity of Carbapenemase-Producers Three Years after a KPC-3-Producing K. pneumoniae ST147-K64 Hospital Outbreak"],"prefix":"10.3390","volume":"9","author":[{"given":"Ana Margarida","family":"Guerra","sequence":"first","affiliation":[{"name":"UCIBIO, Faculdade de Farm\u00e1cia, Universidade do Porto, 4050-313 Porto, Portugal"}]},{"given":"Agostinho","family":"Lira","sequence":"additional","affiliation":[{"name":"Centro Hospitalar Vila Nova de Gaia\/Espinho, 4434-502 Vila Nova de Gaia, Portugal"}]},{"given":"Angelina","family":"Lameir\u00e3o","sequence":"additional","affiliation":[{"name":"Centro Hospitalar Vila Nova de Gaia\/Espinho, 4434-502 Vila Nova de Gaia, Portugal"}]},{"given":"Aur\u00e9lia","family":"Selaru","sequence":"additional","affiliation":[{"name":"Centro Hospitalar Vila Nova de Gaia\/Espinho, 4434-502 Vila Nova de Gaia, Portugal"}]},{"given":"Gabriela","family":"Abreu","sequence":"additional","affiliation":[{"name":"Centro Hospitalar Vila Nova de Gaia\/Espinho, 4434-502 Vila Nova de Gaia, Portugal"}]},{"given":"Paulo","family":"Lopes","sequence":"additional","affiliation":[{"name":"Centro Hospitalar Vila Nova de Gaia\/Espinho, 4434-502 Vila Nova de Gaia, Portugal"}]},{"given":"Margarida","family":"Mota","sequence":"additional","affiliation":[{"name":"Centro Hospitalar Vila Nova de Gaia\/Espinho, 4434-502 Vila Nova de Gaia, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1171-0326","authenticated-orcid":false,"given":"\u00c2ngela","family":"Novais","sequence":"additional","affiliation":[{"name":"UCIBIO, Faculdade de Farm\u00e1cia, Universidade do Porto, 4050-313 Porto, Portugal"}]},{"given":"Lu\u00edsa","family":"Peixe","sequence":"additional","affiliation":[{"name":"UCIBIO, Faculdade de Farm\u00e1cia, Universidade do Porto, 4050-313 Porto, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2020,11,13]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1016\/S1473-3099(18)30605-4","article-title":"Attributable deaths and disability-adjusted life-years caused by infections with antibiotic-resistant bacteria in the EU and the European Economic Area in 2015: A population-level modelling analysis","volume":"19","author":"Cassini","year":"2019","journal-title":"Lancet Infect. 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