000170971 001__ 170971
000170971 005__ 20260430151736.0
000170971 0247_ $$2doi$$a10.1007/s10096-026-05478-5
000170971 0248_ $$2sideral$$a149001
000170971 037__ $$aART-2026-149001
000170971 041__ $$aeng
000170971 100__ $$aRiesgo-Magaña, María
000170971 245__ $$aClonal dissemination and plasmid plasticity of KPC-3–producing Klebsiella pneumoniae ST512 during a hospital outbreak in Spain
000170971 260__ $$c2026
000170971 5060_ $$aAccess copy available to the general public$$fUnrestricted
000170971 5203_ $$aPurpose
To describe the first outbreak of KPC-3-producing Klebsiella pneumoniae ST512 in Aragón, Spain, and characterize its clinical, microbiological, and genomic features, including plasmid dynamics, resistance mechanisms, and phylogenetic context.
Methods
Between July 2022 and July 2024, 130 KPC-3-producing K. pneumoniae isolates were recovered from 33 patients during an outbreak at a tertiary-care hospital in Zaragoza. Antimicrobial susceptibility testing and whole-genome sequencing were performed. Phylogenomic (SNP and cgMLST) and plasmid analyses defined clonal relatedness and plasmid structures. Comparative genomics with 985 international ST512/KPC-3 genomes determined phylogeographic relationships.
Results
Most cases (84.6%) were detected through active surveillance. All the isolates were resistant to β-lactams, ceftolozane/tazobactam, tobramycin and amikacin, while 64.4% remained susceptible to gentamicin. All the isolates were susceptible to cefiderocol, colistin, and tigecycline. One ceftazidime/avibactam-resistant isolate carrying blaKPC−70 emerged after prolonged therapy. Genomic analysis confirmed a clonal outbreak of Klebsiella pneumoniae ST512 (≤ 16 SNPs; ≤13 cgMLST allelic differences). Phylogenetic comparison showed that the isolates were genetically close to those from Italy and central Spain. All isolates carried blaKPC−3 within Tn4401b. Three blaKPC−3 plasmid structures were identified: an IncFII(K) plasmid (pHCUKPC3), a ColEST258 variant, and a novel cointegrate plasmid (pHCUKPC3co). The virulence-associated factors identified included yersiniabactin (ybt10/ICEKp4), KL107 capsular type, and O2afg O-antigen.
Conclusion
This study documents the wider dissemination of ST512/KPC-3 as a high-risk clone in Spain, characterized by persistence driven by clonal dissemination, selective pressure, and plasmid plasticity. Our findings highlight the need to integrate genomic and plasmidomic surveillance to anticipate resistance evolution and contain high-risk clones.
000170971 536__ $$9info:eu-repo/grantAgreement/ES/ISCIII/CB21-13-00054$$9info:eu-repo/grantAgreement/ES/ISCIII/CB21-13-00087
000170971 540__ $$9info:eu-repo/semantics/openAccess$$aby$$uhttps://creativecommons.org/licenses/by/4.0/deed.es
000170971 655_4 $$ainfo:eu-repo/semantics/article$$vinfo:eu-repo/semantics/publishedVersion
000170971 700__ $$aMoreno-Mingorance, Albert
000170971 700__ $$aBueno, Jessica$$uUniversidad de Zaragoza
000170971 700__ $$aArnal, Sara
000170971 700__ $$aAlvarado, Elena
000170971 700__ $$aGonzález-López, Juan José
000170971 700__ $$0(orcid)0000-0002-9742-1463$$aSeral, Cristina$$uUniversidad de Zaragoza
000170971 7102_ $$11011$$2630$$aUniversidad de Zaragoza$$bDpto. Microb.Ped.Radio.Sal.Pú.$$cÁrea Microbiología
000170971 773__ $$g(2026), [14 pp.]$$pEur. j. clin. microbiol. infect. dis.$$tEUROPEAN JOURNAL OF CLINICAL MICROBIOLOGY & INFECTIOUS DISEASES$$x0934-9723
000170971 8564_ $$s1673692$$uhttps://zaguan.unizar.es/record/170971/files/texto_completo.pdf$$yVersión publicada
000170971 8564_ $$s2123936$$uhttps://zaguan.unizar.es/record/170971/files/texto_completo.jpg?subformat=icon$$xicon$$yVersión publicada
000170971 909CO $$ooai:zaguan.unizar.es:170971$$particulos$$pdriver
000170971 951__ $$a2026-04-30-13:58:09
000170971 980__ $$aARTICLE