{"doi":"10.1093/jac/dkz550","title":"Klebsiella pneumoniae ST307 with OXA-181: threat of a high-risk clone and promiscuous plasmid in a resource-constrained healthcare setting","abstract":"INTRODUCTION: Klebsiella pneumoniae with OXA-48-like enzymes were introduced into Tshwane Tertiary Hospital (TTH) (Pretoria, South Africa) during September 2015, causing nosocomial outbreaks. METHODS: PCR methodologies and WGS were used to characterize K. pneumoniae with carbapenemases (n = 124) from TTH (July 2015-December 2016). RESULTS: PCR was used to track K. pneumoniae ST307 with OXA-181 among 60% of carbapenemase-positive isolates in different wards/units over time and showed the transmission of IncX3 plasmids to other K. pneumoniae clones. WGS identified different ST307 clades: 307_OXA181 (consisting of two lineages, A and B) with OXA-181 on IncX3 plasmids (named p72_X3_OXA181) and clade 307_VIM with VIM-1 on IncFII plasmids. Clade 307_OXA181 lineage B was responsible for the rapid increase and transmission of OXA-181 K. pneumoniae in various wards/units throughout TTH, while the numbers of clade 307_OXA181 lineage A and clade 307_VIM remained low. Separate outbreaks were due to K. pneumoniae ST17 and ST29 with p72_X3_OXA181 plasmids. CONCLUSIONS: The high-risk clone K. pneumoniae ST307 with OXA-181 rapidly spread to different wards/units despite infection and prevention measures. ST307 clades and lineages seemingly acted differently in outbreak situations. This study also highlighted the threat of promiscuous plasmids such as p72_X3_OXA181.","journal":"Journal of Antimicrobial Chemotherapy","year":2020,"id":63273,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":45,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.946,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2020-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":231557,"name":"Liang Chen","orcid":"0000-0001-5845-2235","position":1,"is_corresponding":false},{"id":334610,"name":"Marleen M. Kock","orcid":"0000-0002-1768-9268","position":2,"is_corresponding":false},{"id":334611,"name":"Anton Stoltz","orcid":"0000-0002-0704-0772","position":3,"is_corresponding":false},{"id":234203,"name":"Gisele Peirano","orcid":null,"position":4,"is_corresponding":false},{"id":334612,"name":"Diego B. Nóbrega","orcid":"0000-0001-9821-1436","position":5,"is_corresponding":false},{"id":334613,"name":"Michelle Lowe","orcid":"0000-0001-6399-6229","position":6,"is_corresponding":false},{"id":334614,"name":"Marthie M. Ehlers","orcid":"0000-0003-2199-6970","position":7,"is_corresponding":false},{"id":334615,"name":"Nontombi Mbelle","orcid":"0000-0001-8890-2663","position":8,"is_corresponding":false},{"id":231558,"name":"Barry N. Kreiswirth","orcid":"0000-0002-0243-131X","position":9,"is_corresponding":false},{"id":231559,"name":"Johann Pitout","orcid":"0000-0002-4547-4707","position":10,"is_corresponding":false},{"id":334609,"name":"Kathy‐Anne Strydom","orcid":"0000-0003-0771-8608","position":0,"is_corresponding":true}],"reference_count":19,"raw_metadata":null,"created_at":"2026-07-18T21:11:00.632961Z","pmid":"31953941","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}