Molecular characterization and resistance mechanisms of ertapenem-non-susceptible carbapenem-resistant Klebsiella pneumoniae co-harboring ESBLs or AmpC enzymes with porin loss or efflux pump overexpression
This study highlights the complex, multifactorial nature of carbapenem resistance in carbapenem-resistant Klebsiella pneumoniae (CRKP), involving enzyme-mediated resistance, reduced membrane porin expression, and overactive efflux pumps. These findings provide valuable insights into CRKP resistance...
Uložené v:
| Vydané v: | Journal of bacteriology Ročník 207; číslo 7; s. e0014825 |
|---|---|
| Hlavní autori: | , , , , , , |
| Médium: | Journal Article |
| Jazyk: | English |
| Vydavateľské údaje: |
United States
American Society for Microbiology
24.07.2025
|
| Predmet: | |
| ISSN: | 0021-9193, 1098-5530, 1098-5530 |
| On-line prístup: | Získať plný text |
| Tagy: |
Pridať tag
Žiadne tagy, Buďte prvý, kto otaguje tento záznam!
|
| Abstract | This study highlights the complex, multifactorial nature of carbapenem resistance in carbapenem-resistant Klebsiella pneumoniae (CRKP), involving enzyme-mediated resistance, reduced membrane porin expression, and overactive efflux pumps. These findings provide valuable insights into CRKP resistance mechanisms and can aid in controlling CRKP in China. |
|---|---|
| AbstractList | Carbapenem-resistant Klebsiella pneumoniae (CRKP) poses a significant challenge in clinical settings due to limited treatment options and high mortality rates. While carbapenemase-producing CRKP has been extensively studied, the mechanisms underlying resistance in non-carbapenemase-producing CRKP remain less understood. In this study, we investigated 30 ertapenem-resistant non-carbapenemase-producing CRKP clinical isolates. Antimicrobial susceptibility testing revealed multidrug resistance in all strains. Molecular analyses showed that all isolates carried extended-spectrum β-lactamase (ESBL) and/or AmpC β-lactamase genes. Sequencing of outer membrane porin (OMP) genes revealed mutations or deletions in ompK35 and/or ompK36 in the majority of isolates. SDS-PAGE analysis confirmed reduced or absent expression of the corresponding OMP proteins in these strains. Additionally, quantitative PCR showed that several isolates exhibited overexpression of efflux pump genes. These findings indicate that the combined effects of ESBL or AmpC production, porin loss at both the genetic and protein levels, and efflux pump overactivity contribute to ertapenem resistance in non-carbapenemase-producing CRKP. Our results underscore the complexity of resistance mechanisms and highlight the importance of integrated molecular and phenotypic assessments to inform appropriate antimicrobial therapy.Carbapenem-resistant Klebsiella pneumoniae (CRKP) poses a significant challenge in clinical settings due to limited treatment options and high mortality rates. While carbapenemase-producing CRKP has been extensively studied, the mechanisms underlying resistance in non-carbapenemase-producing CRKP remain less understood. In this study, we investigated 30 ertapenem-resistant non-carbapenemase-producing CRKP clinical isolates. Antimicrobial susceptibility testing revealed multidrug resistance in all strains. Molecular analyses showed that all isolates carried extended-spectrum β-lactamase (ESBL) and/or AmpC β-lactamase genes. Sequencing of outer membrane porin (OMP) genes revealed mutations or deletions in ompK35 and/or ompK36 in the majority of isolates. SDS-PAGE analysis confirmed reduced or absent expression of the corresponding OMP proteins in these strains. Additionally, quantitative PCR showed that several isolates exhibited overexpression of efflux pump genes. These findings indicate that the combined effects of ESBL or AmpC production, porin loss at both the genetic and protein levels, and efflux pump overactivity contribute to ertapenem resistance in non-carbapenemase-producing CRKP. Our results underscore the complexity of resistance mechanisms and highlight the importance of integrated molecular and phenotypic assessments to inform appropriate antimicrobial therapy.This study highlights the complex, multifactorial nature of carbapenem resistance in carbapenem-resistant Klebsiella pneumoniae (CRKP), involving enzyme-mediated resistance, reduced membrane porin expression, and overactive efflux pumps. These findings provide valuable insights into CRKP resistance mechanisms and can aid in controlling CRKP in China.IMPORTANCEThis study highlights the complex, multifactorial nature of carbapenem resistance in carbapenem-resistant Klebsiella pneumoniae (CRKP), involving enzyme-mediated resistance, reduced membrane porin expression, and overactive efflux pumps. These findings provide valuable insights into CRKP resistance mechanisms and can aid in controlling CRKP in China. Carbapenem-resistant Klebsiella pneumoniae (CRKP) poses a significant challenge in clinical settings due to limited treatment options and high mortality rates. While carbapenemase-producing CRKP has been extensively studied, the mechanisms underlying resistance in non-carbapenemase-producing CRKP remain less understood. In this study, we investigated 30 ertapenem-resistant non-carbapenemase-producing CRKP clinical isolates. Antimicrobial susceptibility testing revealed multidrug resistance in all strains. Molecular analyses showed that all isolates carried extended-spectrum β-lactamase (ESBL) and/or AmpC β-lactamase genes. Sequencing of outer membrane porin (OMP) genes revealed mutations or deletions in ompK35 and/or ompK36 in the majority of isolates. SDS-PAGE analysis confirmed reduced or absent expression of the corresponding OMP proteins in these strains. Additionally, quantitative PCR showed that several isolates exhibited overexpression of efflux pump genes. These findings indicate that the combined effects of ESBL or AmpC production, porin loss at both the genetic and protein levels, and efflux pump overactivity contribute to ertapenem resistance in non-carbapenemase-producing CRKP. Our results underscore the complexity of resistance mechanisms and highlight the importance of integrated molecular and phenotypic assessments to inform appropriate antimicrobial therapy.IMPORTANCEThis study highlights the complex, multifactorial nature of carbapenem resistance in carbapenem-resistant Klebsiella pneumoniae (CRKP), involving enzyme-mediated resistance, reduced membrane porin expression, and overactive efflux pumps. These findings provide valuable insights into CRKP resistance mechanisms and can aid in controlling CRKP in China. ABSTRACT Carbapenem-resistant Klebsiella pneumoniae (CRKP) poses a significant challenge in clinical settings due to limited treatment options and high mortality rates. While carbapenemase-producing CRKP has been extensively studied, the mechanisms underlying resistance in non-carbapenemase-producing CRKP remain less understood. In this study, we investigated 30 ertapenem-resistant non-carbapenemase-producing CRKP clinical isolates. Antimicrobial susceptibility testing revealed multidrug resistance in all strains. Molecular analyses showed that all isolates carried extended-spectrum β-lactamase (ESBL) and/or AmpC β-lactamase genes. Sequencing of outer membrane porin (OMP) genes revealed mutations or deletions in ompK35 and/or ompK36 in the majority of isolates. SDS-PAGE analysis confirmed reduced or absent expression of the corresponding OMP proteins in these strains. Additionally, quantitative PCR showed that several isolates exhibited overexpression of efflux pump genes. These findings indicate that the combined effects of ESBL or AmpC production, porin loss at both the genetic and protein levels, and efflux pump overactivity contribute to ertapenem resistance in non-carbapenemase-producing CRKP. Our results underscore the complexity of resistance mechanisms and highlight the importance of integrated molecular and phenotypic assessments to inform appropriate antimicrobial therapy.IMPORTANCEThis study highlights the complex, multifactorial nature of carbapenem resistance in carbapenem-resistant Klebsiella pneumoniae (CRKP), involving enzyme-mediated resistance, reduced membrane porin expression, and overactive efflux pumps. These findings provide valuable insights into CRKP resistance mechanisms and can aid in controlling CRKP in China. Carbapenem-resistant Klebsiella pneumoniae (CRKP) poses a significant challenge in clinical settings due to limited treatment options and high mortality rates. While carbapenemase-producing CRKP has been extensively studied, the mechanisms underlying resistance in non-carbapenemase-producing CRKP remain less understood. In this study, we investigated 30 ertapenem-resistant non-carbapenemase-producing CRKP clinical isolates. Antimicrobial susceptibility testing revealed multidrug resistance in all strains. Molecular analyses showed that all isolates carried extended-spectrum β-lactamase (ESBL) and/or AmpC β-lactamase genes. Sequencing of outer membrane porin (OMP) genes revealed mutations or deletions in ompK35 and/or ompK36 in the majority of isolates. SDS-PAGE analysis confirmed reduced or absent expression of the corresponding OMP proteins in these strains. Additionally, quantitative PCR showed that several isolates exhibited overexpression of efflux pump genes. These findings indicate that the combined effects of ESBL or AmpC production, porin loss at both the genetic and protein levels, and efflux pump overactivity contribute to ertapenem resistance in non-carbapenemase-producing CRKP. Our results underscore the complexity of resistance mechanisms and highlight the importance of integrated molecular and phenotypic assessments to inform appropriate antimicrobial therapy. This study highlights the complex, multifactorial nature of carbapenem resistance in carbapenem-resistant Klebsiella pneumoniae (CRKP), involving enzyme-mediated resistance, reduced membrane porin expression, and overactive efflux pumps. These findings provide valuable insights into CRKP resistance mechanisms and can aid in controlling CRKP in China. Carbapenem-resistant (CRKP) poses a significant challenge in clinical settings due to limited treatment options and high mortality rates. While carbapenemase-producing CRKP has been extensively studied, the mechanisms underlying resistance in non-carbapenemase-producing CRKP remain less understood. In this study, we investigated 30 ertapenem-resistant non-carbapenemase-producing CRKP clinical isolates. Antimicrobial susceptibility testing revealed multidrug resistance in all strains. Molecular analyses showed that all isolates carried extended-spectrum β-lactamase (ESBL) and/or AmpC β-lactamase genes. Sequencing of outer membrane porin (OMP) genes revealed mutations or deletions in and/or in the majority of isolates. SDS-PAGE analysis confirmed reduced or absent expression of the corresponding OMP proteins in these strains. Additionally, quantitative PCR showed that several isolates exhibited overexpression of efflux pump genes. These findings indicate that the combined effects of ESBL or AmpC production, porin loss at both the genetic and protein levels, and efflux pump overactivity contribute to ertapenem resistance in non-carbapenemase-producing CRKP. Our results underscore the complexity of resistance mechanisms and highlight the importance of integrated molecular and phenotypic assessments to inform appropriate antimicrobial therapy. This study highlights the complex, multifactorial nature of carbapenem resistance in carbapenem-resistant (CRKP), involving enzyme-mediated resistance, reduced membrane porin expression, and overactive efflux pumps. These findings provide valuable insights into CRKP resistance mechanisms and can aid in controlling CRKP in China. |
| Author | Bi, Jinli Zhao, Wei Huang, Xin Zou, Guangmei Li, Taijie Su, Yingying Meng, Liqin |
| Author_xml | – sequence: 1 givenname: Yingying orcidid: 0009-0007-4372-6038 surname: Su fullname: Su, Yingying – sequence: 2 givenname: Guangmei orcidid: 0009-0009-0971-5233 surname: Zou fullname: Zou, Guangmei – sequence: 3 givenname: Xin orcidid: 0009-0006-8957-2057 surname: Huang fullname: Huang, Xin – sequence: 4 givenname: Jinli orcidid: 0009-0006-7360-3883 surname: Bi fullname: Bi, Jinli – sequence: 5 givenname: Liqin orcidid: 0009-0009-5196-8234 surname: Meng fullname: Meng, Liqin – sequence: 6 givenname: Wei orcidid: 0000-0002-7155-6108 surname: Zhao fullname: Zhao, Wei – sequence: 7 givenname: Taijie orcidid: 0009-0005-9634-4354 surname: Li fullname: Li, Taijie |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/40511945$$D View this record in MEDLINE/PubMed |
| BookMark | eNptkk1v1DAQQCNURLeFE3dkiQsSSrETO3FOqF21ULGIA3C2Js5k16vEDnZS2v5H_lO9H20p4mJLnuc3o5k5Sg6ss5gkrxk9YSyTH9b1CaWMyzQTz5IZo5VMhcjpQTKjNGNpxar8MDkKYb2huMheJIecCsYqLmbJn6-uQz114IlegQc9oje3MBpnCdiGeAwmjGA1kh4jYU3oA3EtQT_CgBb7NJaThiloHEZTd0g0-Hofuv89ki8d1sFg1wEZLE69swYi6tKYtHbe2CU5_362iGpPTvthTtDe3vQYyG8zrsiwIUjnwjaObdtN12SY-oG4K_R4PcREIZb8MnneQhfw1f4-Tn5enP-Yf04X3z5dzk8XKfCiGtOyZaipLqEVUmrdAKUFrVrZSikxayirqa405UJwUeQUCo6cViWTjYhHW-fHyeXO2zhYq8GbHvyNcmDU9sH5pQI_Gt2h0hqKomIF5kzzqhGyRGCyKgpZah2TRtfHnWuY6h4bjXb00D2RPo1Ys1JLd6VYlkkZ5xkN7_YG735NGEbVmziO2GuLbgoqz5jkZVnmPKJv_0HXbvI29ipSOac55wV7FELos0eCUbVZOLWu1XbhVCYi-ubv6h_Kvt-wCLzfAdrH8XlsH5D_6e4AswTmIQ |
| Cites_doi | 10.1128/JCM.00651-08 10.1128/spectrum.00507-22 10.1016/j.ijantimicag.2018.03.020 10.1371/journal.pone.0123690 10.1016/j.jinf.2007.07.017 10.1093/jac/dks301 10.1016/S1473-3099(12)70205-0 10.1128/AAC.48.8.3203-3206.2004 10.3760/cma.j.cn131368-20210531-00426 10.1186/s13756-020-0686-0 10.1016/j.jprot.2022.104715 10.1128/JCM.40.6.2153-2162.2002 10.1128/MMBR.00078-15 10.1038/srep38929 10.1128/JCM.02117-12 10.3389/fmicb.2020.00638 10.1080/1120009X.2018.1521773 10.1128/JCM.38.5.1791-1796.2000 10.1093/femsre/fux013 10.1099/jmm.0.000691 10.1186/s12941-017-0191-3 10.1016/j.biopha.2017.08.006 10.12703/P6-64 10.1099/13500872-145-3-673B4 10.3389/fphar.2013.00168 10.3855/jidc.6216 10.1016/j.ijantimicag.2003.07.011 10.1086/503264 10.3855/jidc.9677 10.1111/1574-6968.12273 10.1128/AAC.47.6.2056-2058.2003 10.1089/mdr.2012.0248 10.1128/JCM.01244-13 10.1099/jmm.0.008094-0 10.1128/CMR.00117-14 10.11816/cn.ni.2019-186170 10.1093/jac/dkq056 10.1128/AAC.00309-11 10.1128/jcm.24.3.330-332.1986 10.1128/JB.00590-16 |
| ContentType | Journal Article |
| Copyright | Copyright © 2025 Su et al. Copyright American Society for Microbiology 2025 Copyright © 2025 Su et al. 2025 Su et al. |
| Copyright_xml | – notice: Copyright © 2025 Su et al. – notice: Copyright American Society for Microbiology 2025 – notice: Copyright © 2025 Su et al. 2025 Su et al. |
| DBID | AAYXX CITATION CGR CUY CVF ECM EIF NPM 7QL 7TM 7U9 8FD C1K FR3 H94 M7N P64 RC3 7X8 5PM DOA |
| DOI | 10.1128/jb.00148-25 |
| DatabaseName | CrossRef Medline MEDLINE MEDLINE (Ovid) MEDLINE MEDLINE PubMed Bacteriology Abstracts (Microbiology B) Nucleic Acids Abstracts Virology and AIDS Abstracts Technology Research Database Environmental Sciences and Pollution Management Engineering Research Database AIDS and Cancer Research Abstracts Algology Mycology and Protozoology Abstracts (Microbiology C) Biotechnology and BioEngineering Abstracts Genetics Abstracts MEDLINE - Academic PubMed Central (Full Participant titles) DOAJ Directory of Open Access Journals |
| DatabaseTitle | CrossRef MEDLINE Medline Complete MEDLINE with Full Text PubMed MEDLINE (Ovid) Genetics Abstracts Virology and AIDS Abstracts Technology Research Database Bacteriology Abstracts (Microbiology B) Algology Mycology and Protozoology Abstracts (Microbiology C) Nucleic Acids Abstracts AIDS and Cancer Research Abstracts Engineering Research Database Biotechnology and BioEngineering Abstracts Environmental Sciences and Pollution Management MEDLINE - Academic |
| DatabaseTitleList | MEDLINE - Academic Genetics Abstracts CrossRef MEDLINE |
| Database_xml | – sequence: 1 dbid: DOA name: DOAJ - Directory of Open Access Journals url: https://www.doaj.org/ sourceTypes: Open Website – sequence: 2 dbid: NPM name: PubMed url: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed sourceTypes: Index Database – sequence: 3 dbid: 7X8 name: MEDLINE - Academic url: https://search.proquest.com/medline sourceTypes: Aggregation Database |
| DeliveryMethod | fulltext_linktorsrc |
| Discipline | Biology |
| EISSN | 1098-5530 |
| Editor | Kendall, Melissa M. |
| Editor_xml | – sequence: 1 givenname: Melissa M. surname: Kendall fullname: Kendall, Melissa M. |
| ExternalDocumentID | oai_doaj_org_article_cca66916e31c49d587ea1896687cc09f PMC12288452 jb00148-25 40511945 10_1128_jb_00148_25 |
| Genre | Journal Article |
| GrantInformation_xml | – fundername: Guangxi Traditional Chinese Medical University grantid: GZZC2020208 – fundername: Natural Science Foundation of Guangxi Zhuang Autonomous Region grantid: 2023GXNSFAA026184 – fundername: Guangxi Traditional Chinese Medical University grantid: GZZC2020208 funderid: http://dx.doi.org/10.13039/501100004924 – fundername: Natural Science Foundation of Guangxi Zhuang Autonomous Region grantid: 2023GXNSFAA026184 funderid: http://dx.doi.org/10.13039/100012547 – fundername: ; grantid: 2023GXNSFAA026184 – fundername: ; grantid: GZZC2020208 |
| GroupedDBID | --- -DZ -~X .55 0R~ 18M 2WC 39C 4.4 5GY 5RE 5VS 79B 85S AAGFI AAYXX ABPPZ ABUFD ACGFO ACGOD ACNCT ACPRK ADBBV AENEX AFRAH ALMA_UNASSIGNED_HOLDINGS AOIJS BAWUL BKOMP BTFSW CITATION CJ0 CS3 DIK DU5 E3Z EBS F5P FRP GROUPED_DOAJ GX1 H13 HZ~ IH2 KQ8 L7B O9- OK1 P-S P2P PQQKQ RHI RNS RPM RSF RXW TAE TR2 UHB UKR UPT WH7 WOQ X7M YQT YR2 YZZ ZCA ~02 ~KM AGVNZ CGR CUY CVF ECM EIF NPM 7QL 7TM 7U9 8FD C1K FR3 H94 M7N P64 RC3 7X8 5PM |
| ID | FETCH-LOGICAL-a469t-7f1ec0c7af588ccda00609f8f888e2d01b0c9c045545630a64e409718d5718fb3 |
| IEDL.DBID | DOA |
| ISICitedReferencesCount | 0 |
| ISICitedReferencesURI | http://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=Summon&SrcAuth=ProQuest&DestLinkType=CitingArticles&DestApp=WOS_CPL&KeyUT=001507666100001&url=https%3A%2F%2Fcvtisr.summon.serialssolutions.com%2F%23%21%2Fsearch%3Fho%3Df%26include.ft.matches%3Dt%26l%3Dnull%26q%3D |
| ISSN | 0021-9193 1098-5530 |
| IngestDate | Mon Oct 20 20:15:20 EDT 2025 Tue Nov 04 02:02:29 EST 2025 Thu Oct 02 22:42:38 EDT 2025 Mon Jul 28 22:40:32 EDT 2025 Thu Jul 24 18:20:17 EDT 2025 Tue Jul 29 01:38:18 EDT 2025 Sat Nov 29 07:38:51 EST 2025 |
| IsDoiOpenAccess | true |
| IsOpenAccess | true |
| IsPeerReviewed | true |
| IsScholarly | true |
| Issue | 7 |
| Keywords | efflux pump carbapenemase carbapenem-resistant Klebsiella pneumonia mechanisms of drug resistance outer membrane porin |
| Language | English |
| License | This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International license. https://creativecommons.org/licenses/by/4.0 This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International license. |
| LinkModel | DirectLink |
| MergedId | FETCHMERGED-LOGICAL-a469t-7f1ec0c7af588ccda00609f8f888e2d01b0c9c045545630a64e409718d5718fb3 |
| Notes | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 14 content type line 23 Yingying Su and Guangmei Zou contributed equally to this article. Author order was determined by drawing straws. The authors declare no conflict of interest. |
| ORCID | 0000-0002-7155-6108 0009-0009-0971-5233 0009-0009-5196-8234 0009-0006-7360-3883 0009-0005-9634-4354 0009-0006-8957-2057 0009-0007-4372-6038 |
| OpenAccessLink | https://doaj.org/article/cca66916e31c49d587ea1896687cc09f |
| PMID | 40511945 |
| PQID | 3234034461 |
| PQPubID | 40724 |
| PageCount | 12 |
| ParticipantIDs | doaj_primary_oai_doaj_org_article_cca66916e31c49d587ea1896687cc09f pubmedcentral_primary_oai_pubmedcentral_nih_gov_12288452 proquest_miscellaneous_3218477734 proquest_journals_3234034461 asm2_journals_10_1128_jb_00148_25 pubmed_primary_40511945 crossref_primary_10_1128_jb_00148_25 |
| PublicationCentury | 2000 |
| PublicationDate | 2025-07-24 |
| PublicationDateYYYYMMDD | 2025-07-24 |
| PublicationDate_xml | – month: 07 year: 2025 text: 2025-07-24 day: 24 |
| PublicationDecade | 2020 |
| PublicationPlace | United States |
| PublicationPlace_xml | – name: United States – name: 1752 N St., N.W., Washington, DC – name: Washington |
| PublicationTitle | Journal of bacteriology |
| PublicationTitleAbbrev | J Bacteriol |
| PublicationTitleAlternate | J Bacteriol |
| PublicationYear | 2025 |
| Publisher | American Society for Microbiology |
| Publisher_xml | – name: American Society for Microbiology |
| References | e_1_3_4_3_2 e_1_3_4_2_2 e_1_3_4_8_2 e_1_3_4_7_2 e_1_3_4_41_2 e_1_3_4_6_2 e_1_3_4_40_2 e_1_3_4_5_2 e_1_3_4_4_2 e_1_3_4_22_2 e_1_3_4_23_2 e_1_3_4_20_2 e_1_3_4_21_2 e_1_3_4_42_2 (e_1_3_4_9_2) 2023 e_1_3_4_26_2 e_1_3_4_27_2 e_1_3_4_24_2 e_1_3_4_25_2 e_1_3_4_28_2 e_1_3_4_29_2 e_1_3_4_30_2 e_1_3_4_11_2 e_1_3_4_34_2 e_1_3_4_12_2 e_1_3_4_33_2 e_1_3_4_32_2 e_1_3_4_10_2 e_1_3_4_31_2 e_1_3_4_15_2 e_1_3_4_38_2 e_1_3_4_16_2 e_1_3_4_37_2 e_1_3_4_13_2 e_1_3_4_36_2 e_1_3_4_14_2 e_1_3_4_35_2 e_1_3_4_19_2 e_1_3_4_17_2 e_1_3_4_18_2 e_1_3_4_39_2 Siu, LK, Yeh, K-M, Lin, J-C, Fung, C-P, Chang, F-Y (B3) 2012; 12 Li, XZ, Plésiat, P, Nikaido, H (B37) 2015; 28 Türkel, İ, Yıldırım, T, Yazgan, B, Bilgin, M, Başbulut, E (B18) 2018; 30 van der Zwaluw, K, de Haan, A, Pluister, GN, Bootsma, HJ, de Neeling, AJ, Schouls, LM (B9) 2015; 10 Hamzaoui, Z, Ocampo-Sosa, A, Fernandez Martinez, M, Landolsi, S, Ferjani, S, Maamar, E, Saidani, M, Slim, A, Martinez-Martinez, L, Boutiba-Ben Boubaker, I (B7) 2018; 52 Xiong, Z, Li, T, Xu, Y, Li, J (B12) 2007; 55 Pérez-Pérez, FJ, Hanson, ND (B16) 2002; 40 Doyle, D, Peirano, G, Lascols, C, Lloyd, T, Church, DL, Pitout, JDD (B11) 2012; 50 Jacoby, GA, Mills, DM, Chow, N (B25) 2004; 48 Amaral, L, Martins, A, Spengler, G, Molnar, J (B38) 2014; 4 Filgona, J, Banerjee, T, Anupurba, S (B39) 2015; 9 Leavitt, A, Chmelnitsky, I, Colodner, R, Ofek, I, Carmeli, Y, Navon-Venezia, S (B26) 2009; 47 Seecoomar, GD, Marmol, BC, Kwon, DH (B40) 2013; 348 Coudron, PE, Moland, ES, Thomson, KS (B10) 2000; 38 Wang, XD, Cai, JC, Zhou, HW, Zhang, R, Chen, G-X (B27) 2009; 58 (B8) 2023 Chen, J-H, Siu, LK, Fung, C-P, Lin, J-C, Yeh, K-M, Chen, T-L, Tsai, Y-K, Chang, F-Y (B32) 2010; 65 Zhu, WM, Yuan, Z, Zhou, HY (B24) 2020; 9 Navon-Venezia, S, Kondratyeva, K, Carattoli, A (B4) 2017; 41 Hernández-Allés, S, Albertí, S, Álvarez, D, Doménech-Sánchez, A, Martínez-Martínez, L, Gil, J, Tomás, JM, Benedí, VJ (B21) 1999; 145 Carlone, GM, Thomas, ML, Rumschlag, HS, Sottnek, FO (B20) 1986; 24 Briñas, L, Moreno, MA, Zarazaga, M, Porrero, C, Sáenz, Y, García, M, Dominguez, L, Torres, C (B15) 2003; 47 Elliott, E, Brink, AJ, van Greune, J, Els, Z, Woodford, N, Turton, J, Warner, M, Livermore, DM (B29) 2006; 42 Vardakas, KZ, Tansarli, GS, Rafailidis, PI, Falagas, ME (B5) 2012; 67 Xiong, Z, Zhu, D, Wang, F, Zhang, Y, Okamoto, R, Inoue, M (B14) 2004; 23 Wise, MG, Horvath, E, Young, K, Sahm, DF, Kazmierczak, KM (B22) 2018; 67 Sho, T, Muratani, T, Hamasuna, R, Yakushiji, H, Fujimoto, N, Matsumoto, T (B28) 2013; 19 Chi, Z, Hongru, L, Yusheng, C (B6) 2022; 42 Xu, L, Sun, X, Ma, X (B23) 2017; 16 Wang, M, Tian, Y, Xu, L, Zhang, F, Lu, H, Li, M, Li, B (B33) 2022; 10 Richter, L, du Plessis, EM, Duvenage, S, Korsten, L (B13) 2020; 11 Yazgan, B, Türkel, I, Güçkan, R, Kılınç, K, Yıldırım, T (B41) 2018; 12 Sugawara, E, Kojima, S, Nikaido, H (B34) 2016; 198 Wasfi, R, Elkhatib, WF, Ashour, HM (B17) 2016; 6 García-Sureda, L, Doménech-Sánchez, A, Barbier, M, Juan, C, Gascó, J, Albertí, S (B35) 2011; 55 Paczosa, MK, Mecsas, J (B1) 2016; 80 Haijian, T, Guanghui, X, Yayu, H (B19) 2019; 29 Poulou, A, Voulgari, E, Vrioni, G, Koumaki, V, Xidopoulos, G, Chatzipantazi, V, Markou, F, Tsakris, A (B30) 2013; 51 Khoshnood, S, Heidary, M, Mirnejad, R, Bahramian, A, Sedighi, M, Mirzaei, H (B36) 2017; 94 Yuan, P-B, Ling, J-H, Zhu, J-H, Peng, C, Chen, E-Z, Zhong, Y-X, Liu, W-T, Wang, L-J, Yang, L, Chen, D-Q (B31) 2022; 268 Broberg, CA, Palacios, M, Miller, VL (B2) 2014; 6 |
| References_xml | – ident: e_1_3_4_27_2 doi: 10.1128/JCM.00651-08 – ident: e_1_3_4_34_2 doi: 10.1128/spectrum.00507-22 – ident: e_1_3_4_8_2 doi: 10.1016/j.ijantimicag.2018.03.020 – ident: e_1_3_4_10_2 doi: 10.1371/journal.pone.0123690 – ident: e_1_3_4_13_2 doi: 10.1016/j.jinf.2007.07.017 – ident: e_1_3_4_6_2 doi: 10.1093/jac/dks301 – ident: e_1_3_4_4_2 doi: 10.1016/S1473-3099(12)70205-0 – ident: e_1_3_4_26_2 doi: 10.1128/AAC.48.8.3203-3206.2004 – ident: e_1_3_4_7_2 doi: 10.3760/cma.j.cn131368-20210531-00426 – ident: e_1_3_4_25_2 doi: 10.1186/s13756-020-0686-0 – ident: e_1_3_4_32_2 doi: 10.1016/j.jprot.2022.104715 – ident: e_1_3_4_17_2 doi: 10.1128/JCM.40.6.2153-2162.2002 – ident: e_1_3_4_2_2 doi: 10.1128/MMBR.00078-15 – ident: e_1_3_4_18_2 doi: 10.1038/srep38929 – ident: e_1_3_4_12_2 doi: 10.1128/JCM.02117-12 – ident: e_1_3_4_14_2 doi: 10.3389/fmicb.2020.00638 – ident: e_1_3_4_19_2 doi: 10.1080/1120009X.2018.1521773 – ident: e_1_3_4_11_2 doi: 10.1128/JCM.38.5.1791-1796.2000 – ident: e_1_3_4_5_2 doi: 10.1093/femsre/fux013 – ident: e_1_3_4_23_2 doi: 10.1099/jmm.0.000691 – ident: e_1_3_4_24_2 doi: 10.1186/s12941-017-0191-3 – ident: e_1_3_4_37_2 doi: 10.1016/j.biopha.2017.08.006 – ident: e_1_3_4_3_2 doi: 10.12703/P6-64 – ident: e_1_3_4_22_2 doi: 10.1099/13500872-145-3-673B4 – ident: e_1_3_4_39_2 doi: 10.3389/fphar.2013.00168 – ident: e_1_3_4_40_2 doi: 10.3855/jidc.6216 – ident: e_1_3_4_15_2 doi: 10.1016/j.ijantimicag.2003.07.011 – ident: e_1_3_4_30_2 doi: 10.1086/503264 – ident: e_1_3_4_42_2 doi: 10.3855/jidc.9677 – ident: e_1_3_4_41_2 doi: 10.1111/1574-6968.12273 – ident: e_1_3_4_16_2 doi: 10.1128/AAC.47.6.2056-2058.2003 – ident: e_1_3_4_29_2 doi: 10.1089/mdr.2012.0248 – ident: e_1_3_4_31_2 doi: 10.1128/JCM.01244-13 – ident: e_1_3_4_28_2 doi: 10.1099/jmm.0.008094-0 – ident: e_1_3_4_38_2 doi: 10.1128/CMR.00117-14 – ident: e_1_3_4_20_2 doi: 10.11816/cn.ni.2019-186170 – ident: e_1_3_4_33_2 doi: 10.1093/jac/dkq056 – ident: e_1_3_4_36_2 doi: 10.1128/AAC.00309-11 – ident: e_1_3_4_21_2 doi: 10.1128/jcm.24.3.330-332.1986 – ident: e_1_3_4_35_2 doi: 10.1128/JB.00590-16 – volume-title: Standards for antimicrobial susceptibility testing, 33 ed year: 2023 ident: e_1_3_4_9_2 – volume: 41 start-page: 252 year: 2017 end-page: 275 ident: B4 article-title: Klebsiella pneumoniae: a major worldwide source and shuttle for antibiotic resistance publication-title: FEMS Microbiol Rev doi: 10.1093/femsre/fux013 – volume: 48 start-page: 3203 year: 2004 end-page: 3206 ident: B25 article-title: Role of beta-lactamases and porins in resistance to ertapenem and other beta-lactams in Klebsiella pneumoniae publication-title: Antimicrob Agents Chemother doi: 10.1128/AAC.48.8.3203-3206.2004 – volume: 12 start-page: 881 year: 2012 end-page: 887 ident: B3 article-title: Klebsiella pneumoniae liver abscess: a new invasive syndrome publication-title: Lancet Infect Dis doi: 10.1016/S1473-3099(12)70205-0 – volume: 19 start-page: 274 year: 2013 end-page: 281 ident: B28 article-title: The mechanism of high-level carbapenem resistance in Klebsiella pneumoniae: underlying Ompk36-deficient strains represent a threat of emerging high-level carbapenem-resistant K. pneumoniae with IMP-1 β-lactamase production in Japan publication-title: Microb Drug Resist doi: 10.1089/mdr.2012.0248 – volume: 268 start-page: 104715 year: 2022 ident: B31 article-title: Proteomics profiling of ertapenem challenged major porin deficient carbapenem-resistant Klebsiella pneumoniae publication-title: J Proteomics doi: 10.1016/j.jprot.2022.104715 – volume: 6 year: 2014 ident: B2 article-title: Klebsiella: a long way to go towards understanding this enigmatic jet-setter publication-title: F1000Prime Rep doi: 10.12703/P6-64 – volume: 11 year: 2020 ident: B13 article-title: Occurrence, phenotypic and molecular characterization of extended-spectrum- and AmpC- β-lactamase producing enterobacteriaceae isolated from selected commercial spinach supply chains in South Africa publication-title: Front Microbiol doi: 10.3389/fmicb.2020.00638 – volume: 40 start-page: 2153 year: 2002 end-page: 2162 ident: B16 article-title: Detection of plasmid-mediated AmpC beta-lactamase genes in clinical isolates by using multiplex PCR publication-title: J Clin Microbiol doi: 10.1128/JCM.40.6.2153-2162.2002 – volume: 24 start-page: 330 year: 1986 end-page: 332 ident: B20 article-title: Rapid microprocedure for isolating detergent-insoluble outer membrane proteins from Haemophilus species publication-title: J Clin Microbiol doi: 10.1128/jcm.24.3.330-332.1986 – volume: 94 start-page: 982 year: 2017 end-page: 994 ident: B36 article-title: Drug-resistant gram-negative uropathogens: a review publication-title: Biomedicine & Pharmacotherapy doi: 10.1016/j.biopha.2017.08.006 – volume: 12 start-page: 156 year: 2018 end-page: 163 ident: B41 article-title: Comparison of biofilm formation and efflux pumps in ESBL and carbapenemase producing Klebsiella pneumoniae publication-title: J Infect Dev Ctries doi: 10.3855/jidc.9677 – volume: 6 year: 2016 ident: B17 article-title: Molecular typing and virulence analysis of multidrug resistant Klebsiella pneumoniae clinical isolates recovered from Egyptian hospitals publication-title: Sci Rep doi: 10.1038/srep38929 – volume: 80 start-page: 629 year: 2016 end-page: 661 ident: B1 article-title: Klebsiella pneumoniae: going on the offense with a strong defense publication-title: Microbiol Mol Biol Rev doi: 10.1128/MMBR.00078-15 – volume: 4 year: 2014 ident: B38 article-title: Efflux pumps of gram-negative bacteria: what they do, how they do it, with what and how to deal with them publication-title: Front Pharmacol doi: 10.3389/fphar.2013.00168 – volume: 67 start-page: 289 year: 2018 end-page: 295 ident: B22 article-title: Global survey of Klebsiella pneumoniae major porins from ertapenem non-susceptible isolates lacking carbapenemases publication-title: J Med Microbiol doi: 10.1099/jmm.0.000691 – volume: 55 start-page: e125 year: 2007 end-page: 8 ident: B12 article-title: Detection of CTX-M-14 extended-spectrum beta-lactamase in Shigella sonnei isolates from China publication-title: J Infect doi: 10.1016/j.jinf.2007.07.017 – volume: 47 start-page: 969 year: 2009 end-page: 974 ident: B26 article-title: Ertapenem resistance among extended-spectrum-beta-lactamase-producing Klebsiella pneumoniae isolates publication-title: J Clin Microbiol doi: 10.1128/JCM.00651-08 – volume: 348 start-page: 120 year: 2013 end-page: 126 ident: B40 article-title: Promoter deletions of Klebsiella pneumoniae carbapenemase (KPC)-encoding genes (blaKPC -2) and efflux pump (AcrAB) on β-lactam susceptibility in KPC-producing Enterobacteriaceae publication-title: FEMS Microbiol Lett doi: 10.1111/1574-6968.12273 – volume: 58 start-page: 1196 year: 2009 end-page: 1202 ident: B27 article-title: Reduced susceptibility to carbapenems in Klebsiella pneumoniae clinical isolates associated with plasmid-mediated beta-lactamase production and OmpK36 porin deficiency publication-title: J Med Microbiol doi: 10.1099/jmm.0.008094-0 – volume: 29 start-page: 1921 year: 2019 end-page: 1926 ident: B19 article-title: Transcriptional levels of porin proteins OmpK35 and OmpK36 genes in carbapenemase-producing Klebsiella pneumoniae publication-title: Chinese Journal of Nosocomiology doi: 10.11816/cn.ni.2019-186170 – volume: 145 start-page: 673 year: 1999 end-page: 679 ident: B21 article-title: Porin expression in clinical isolates of Klebsiella pneumoniae publication-title: Microbiology (Reading) doi: 10.1099/13500872-145-3-673B4 – volume: 28 start-page: 337 year: 2015 end-page: 418 ident: B37 article-title: The challenge of efflux-mediated antibiotic resistance in Gram-negative bacteria publication-title: Clin Microbiol Rev doi: 10.1128/CMR.00117-14 – volume: 55 start-page: 4742 year: 2011 end-page: 4747 ident: B35 article-title: OmpK26, a novel porin associated with carbapenem resistance in Klebsiella pneumoniae publication-title: Antimicrob Agents Chemother doi: 10.1128/AAC.00309-11 – volume: 42 start-page: 470 year: 2022 end-page: 475 ident: B6 article-title: Drug resistance mechanism and research progress of Klebsiellapneumoniae publication-title: International Journal of Respiration doi: 10.3760/cma.j.cn131368-20210531-00426 – volume: 51 start-page: 3176 year: 2013 end-page: 3182 ident: B30 article-title: Outbreak caused by an ertapenem-resistant, CTX-M-15-producing Klebsiella pneumoniae sequence type 101 clone carrying an OmpK36 porin variant publication-title: J Clin Microbiol doi: 10.1128/JCM.01244-13 – volume: 67 start-page: 2793 year: 2012 end-page: 2803 ident: B5 article-title: Carbapenems versus alternative antibiotics for the treatment of bacteraemia due to Enterobacteriaceae producing extended-spectrum β-lactamases: a systematic review and meta-analysis publication-title: J Antimicrob Chemother doi: 10.1093/jac/dks301 – volume: 10 year: 2015 ident: B9 article-title: The carbapenem inactivation method (CIM), a simple and low-cost alternative for the Carba NP test to assess phenotypic carbapenemase activity in gram-negative rods publication-title: PLoS One doi: 10.1371/journal.pone.0123690 – volume: 198 start-page: 3200 year: 2016 end-page: 3208 ident: B34 article-title: Klebsiella pneumoniae major porins OmpK35 and OmpK36 allow more efficient diffusion of β-lactams than their Escherichia coli homologs OmpF and OmpC publication-title: J Bacteriol doi: 10.1128/JB.00590-16 – volume: 50 start-page: 3877 year: 2012 end-page: 3880 ident: B11 article-title: Laboratory detection of Enterobacteriaceae that produce carbapenemases publication-title: J Clin Microbiol doi: 10.1128/JCM.02117-12 – volume: 16 year: 2017 ident: B23 article-title: Systematic review and meta-analysis of mortality of patients infected with carbapenem-resistant Klebsiella pneumoniae publication-title: Ann Clin Microbiol Antimicrob doi: 10.1186/s12941-017-0191-3 – volume: 42 start-page: e95 year: 2006 end-page: 8 ident: B29 article-title: In vivo development of ertapenem resistance in a patient with pneumonia caused by Klebsiella pneumoniae with an extended-spectrum beta-lactamase publication-title: Clin Infect Dis doi: 10.1086/503264 – volume: 47 start-page: 2056 year: 2003 end-page: 2058 ident: B15 article-title: Detection of CMY-2, CTX-M-14, and SHV-12 beta-lactamases in Escherichia coli fecal-sample isolates from healthy chickens publication-title: Antimicrob Agents Chemother doi: 10.1128/AAC.47.6.2056-2058.2003 – volume: 38 start-page: 1791 year: 2000 end-page: 1796 ident: B10 article-title: Occurrence and detection of AmpC beta-lactamases among Escherichia coli, Klebsiella pneumoniae, and Proteus mirabilis isolates at a veterans medical center publication-title: J Clin Microbiol doi: 10.1128/JCM.38.5.1791-1796.2000 – volume: 30 start-page: 354 year: 2018 end-page: 363 ident: B18 article-title: Relationship between antibiotic resistance, efflux pumps, and biofilm formation in extended-spectrum β-lactamase producing Klebsiella pneumoniae publication-title: J Chemother doi: 10.1080/1120009X.2018.1521773 – volume: 9 start-page: 815 year: 2015 end-page: 820 ident: B39 article-title: Role of efflux pumps inhibitor in decreasing antibiotic resistance of Klebsiella pneumoniae in a tertiary hospital in North India publication-title: J Infect Dev Ctries doi: 10.3855/jidc.6216 – year: 2023 ident: B8 publication-title: Standards for antimicrobial susceptibility testing, 33 ed – volume: 23 start-page: 262 year: 2004 end-page: 267 ident: B14 article-title: A Klebsiella pneumoniae producing three kinds of class A beta-lactamases encoded by one single plasmid isolated from a patient in Huashan Hospital, Shanghai, China publication-title: Int J Antimicrob Agents doi: 10.1016/j.ijantimicag.2003.07.011 – volume: 65 start-page: 986 year: 2010 end-page: 990 ident: B32 article-title: Contribution of outer membrane protein K36 to antimicrobial resistance and virulence in Klebsiella pneumoniae publication-title: J Antimicrob Chemother doi: 10.1093/jac/dkq056 – volume: 10 year: 2022 ident: B33 article-title: High osmotic stress increases OmpK36 expression through the regulation of KbvR to decrease the antimicrobial resistance of Klebsiella pneumoniae publication-title: Microbiol Spectr doi: 10.1128/spectrum.00507-22 – volume: 52 start-page: 898 year: 2018 end-page: 905 ident: B7 article-title: Role of association of OmpK35 and OmpK36 alteration and blaESBL and/or blaAmpC genes in conferring carbapenem resistance among non-carbapenemase-producing Klebsiella pneumoniae publication-title: Int J Antimicrob Agents doi: 10.1016/j.ijantimicag.2018.03.020 – volume: 9 year: 2020 ident: B24 article-title: Risk factors for carbapenem-resistant Klebsiella pneumoniae infection relative to two types of control patients: a systematic review and meta-analysis publication-title: Antimicrob Resist Infect Control doi: 10.1186/s13756-020-0686-0 |
| SSID | ssj0014452 |
| Score | 2.4828863 |
| Snippet | This study highlights the complex, multifactorial nature of carbapenem resistance in carbapenem-resistant Klebsiella pneumoniae (CRKP), involving... Carbapenem-resistant (CRKP) poses a significant challenge in clinical settings due to limited treatment options and high mortality rates. While... Carbapenem-resistant Klebsiella pneumoniae (CRKP) poses a significant challenge in clinical settings due to limited treatment options and high mortality rates.... ABSTRACT Carbapenem-resistant Klebsiella pneumoniae (CRKP) poses a significant challenge in clinical settings due to limited treatment options and high... |
| SourceID | doaj pubmedcentral proquest asm2 pubmed crossref |
| SourceType | Open Website Open Access Repository Aggregation Database Index Database |
| StartPage | e0014825 |
| SubjectTerms | Anti-Bacterial Agents - pharmacology Bacterial Proteins - genetics Bacterial Proteins - metabolism Bacteriology beta-Lactamases - genetics beta-Lactamases - metabolism carbapenem-resistant Klebsiella pneumonia Carbapenemase Carbapenems Carbapenems - pharmacology Clinical isolates Drug Resistance, Multiple, Bacterial Efflux efflux pump Ertapenem Ertapenem - pharmacology Gene Expression Regulation, Bacterial Gene sequencing Genes Humans Klebsiella Klebsiella Infections - microbiology Klebsiella pneumoniae Klebsiella pneumoniae - drug effects Klebsiella pneumoniae - enzymology Klebsiella pneumoniae - genetics Klebsiella pneumoniae - metabolism mechanisms of drug resistance Microbial Sensitivity Tests Multidrug resistance N-Acetylmuramoyl-L-alanine Amidase - genetics N-Acetylmuramoyl-L-alanine Amidase - metabolism outer membrane porin Porins - genetics Porins - metabolism Proteins Research Article β Lactamase |
| Title | Molecular characterization and resistance mechanisms of ertapenem-non-susceptible carbapenem-resistant Klebsiella pneumoniae co-harboring ESBLs or AmpC enzymes with porin loss or efflux pump overexpression |
| URI | https://www.ncbi.nlm.nih.gov/pubmed/40511945 https://journals.asm.org/doi/10.1128/jb.00148-25 https://www.proquest.com/docview/3234034461 https://www.proquest.com/docview/3218477734 https://pubmed.ncbi.nlm.nih.gov/PMC12288452 https://doaj.org/article/cca66916e31c49d587ea1896687cc09f |
| Volume | 207 |
| WOSCitedRecordID | wos001507666100001&url=https%3A%2F%2Fcvtisr.summon.serialssolutions.com%2F%23%21%2Fsearch%3Fho%3Df%26include.ft.matches%3Dt%26l%3Dnull%26q%3D |
| hasFullText | 1 |
| inHoldings | 1 |
| isFullTextHit | |
| isPrint | |
| journalDatabaseRights | – providerCode: PRVAON databaseName: DOAJ - Directory of Open Access Journals customDbUrl: eissn: 1098-5530 dateEnd: 99991231 omitProxy: false ssIdentifier: ssj0014452 issn: 0021-9193 databaseCode: DOA dateStart: 20250101 isFulltext: true titleUrlDefault: https://www.doaj.org/ providerName: Directory of Open Access Journals |
| link | http://cvtisr.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwrV3da9swEBdb2GAvY99N1xUN-ipqyXIkPbalZbCtDLZB3owkS8wldkycjLb_4_6n3fkja0ZhL3vxQ3SxT7476Xe-0x0hR8bYIpOOM-GUZzLTnunMWQZbYfTOaqV57JpNqMtLPZ-bL3dafWFOWF8euH9xx_CE2QwwTEi5l6bItAqWawDpWnmfmIirb6LM6EwN8QMps6FOOAdzNulwMg8W4-Mrh9EHCfoB-8nEtpXY2ZK6yv33wc2_sybvbEMXz8jTAT_Sk57v5-RBqF-Qx31HyZuX5Nfnsd0t9dtSzP1JS2rrgoJzjYARJE2rgId-y7Zq6TJSjMk3sO5VrF7WrN20XbqLWwTqMSLRD43_XtOPi-DaEjOnaFOHDehyaYF0yeChrsvpo-dfTz_BrVf0pGrOaKhvb6rQUvzuSxukoAt4GTgeYlxsrmkDikUxoTRcD8m59Svy_eL829kHNnRsYBbc7DVTkQefeGVjprX3hcVyLybqCH52EEXCXeKNBxSJuC1N7EwGrLfFdZHBJbr0NZnALMMeoWkWjCgUdx4hm5VGwW5ewIIkexg4Je9Rdvlgcm3eeTNC51cu7-Sbi2xKjkbB5k1fvON-slMU-pYEK253P4Ae5oMe5v_Swyk5GFXmD0-pAHZT8Lg5sLsdBgPGqIytw3KDNOBkKwUTm5I3vYZtOQE0zbmRwKHe0b0dVndH6vJHVyScC6E1WMH-_5jcW_JEYN_jRDEhD8hkvdqEd-SR_7ku29Uheajm-rAzwN_05Dd4 |
| linkProvider | Directory of Open Access Journals |
| openUrl | ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=Molecular+characterization+and+resistance+mechanisms+of+ertapenem-non-susceptible+carbapenem-resistant+Klebsiella+pneumoniae+co-harboring+ESBLs+or+AmpC+enzymes+with+porin+loss+or+efflux+pump+overexpression&rft.jtitle=Journal+of+bacteriology&rft.au=Su%2C+Yingying&rft.au=Zou%2C+Guangmei&rft.au=Huang%2C+Xin&rft.au=Bi%2C+Jinli&rft.date=2025-07-24&rft.pub=American+Society+for+Microbiology&rft.issn=0021-9193&rft.eissn=1098-5530&rft.volume=207&rft.issue=7&rft.spage=1&rft_id=info:doi/10.1128%2Fjb.00148-25&rft.externalDBID=NO_FULL_TEXT |
| thumbnail_l | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/lc.gif&issn=0021-9193&client=summon |
| thumbnail_m | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/mc.gif&issn=0021-9193&client=summon |
| thumbnail_s | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/sc.gif&issn=0021-9193&client=summon |