ArticleJournal of clinical microbiology2012
Characterization of ertapenem-resistant Enterobacter cloacae in a Taiwanese university hospital.
Article in Journal of clinical microbiology, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 37 papers, 1 of them a synthesis that pooled it.
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Who cites it
37 citing papers in PubMed, 1 synthesis or guideline pooled it, 84 citations in OpenAlex.
- Ertapenem as an Antibiotic Prophylaxis for Colectomies and Laparotomies: A Systematic Review.Surgical infections · 2026Pooled it
- Infections caused by clonal spread of metallo-beta-lactamase-producingMicrobiology spectrum · 2025Article
- Profile of outer membrane proteins of carbapenem-resistant Gram-negative bacilli in Ghana.BMC research notes · 2025Article
- Whole genome sequence-based molecular characterization of blood isolates of carbapenem-resistantMicrobiology spectrum · 2024Article
- The Resistance Mechanisms and Clinical Impact of Resistance to the Third Generation Cephalosporins in Species ofAntibiotics (Basel, Switzerland) · 2022Article
- Molecular Epidemiology, Risk Factors and Clinical Outcomes of Carbapenem-NonsusceptiblePathogens (Basel, Switzerland) · 2022Article
- Characterization of resistance mechanisms of Enterobacter cloacae Complex co-resistant to carbapenem and colistin.BMC microbiology · 2021Article
- Molecular Mechanisms and Epidemiology of Carbapenem-ResistantInfection and drug resistance · 2021Article
- Porins and small-molecule translocation across the outer membrane of Gram-negative bacteria.Nature reviews. Microbiology · 2020Review
- Treatment of Carbapenem-Resistant Enterobacteriaceae Infections in Children.Journal of the Pediatric Infectious Diseases Society · 2020Review
- Carbapenem-Resistant Enterobacterales: Considerations for Treatment in the Era of New Antimicrobials and Evolving Enzymology.Current infectious disease reports · 2020Review
- Antibiotic Resistance Profile, Outer Membrane Proteins, Virulence Factors and Genome Sequence Analysis Reveal Clinical Isolates ofFrontiers in cellular and infection microbiology · 2020Article
- Contribution ofThe Indian journal of medical research · 2019Article
- Outbreak OfInfection and drug resistance · 2019Article
- Molecular characterization and antimicrobial resistance profile of fecal contaminants and spoilage bacteria that emerge in rainbow trout (Bioscience of microbiota, food and health · 2019Article
- Detection of Plasmid-Mediated β-Lactamase Genes and Emergence of a Novel AmpC (CMH-1) inJournal of clinical medicine · 2018Article
- Intensive care unit-acquired complicated necrotizing pneumonia caused byIntractable & rare diseases research · 2018Article
- Complex gene response of herbicide-resistant3 Biotech · 2018Article
- Proteomic identification of Axc, a novel beta-lactamase with carbapenemase activity in a meropenem-resistant clinical isolate of Achromobacter xylosoxidans.Scientific reports · 2018Article
- Characteristics of Carbapenemase-Producing Enterobacteriaceae in Wastewater Revealed by Genomic Analysis.Antimicrobial agents and chemotherapy · 2018Article
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Authors and funding
4 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The emergence of carbapenem resistance in Enterobacteriaceae has become a great concern. The aim of this study was to characterize ertapenem-resistant Enterobacter cloacae isolates from a Taiwanese university hospital. A total of 355 nonduplicated E. cloacae isolates collected in 2007 were analyzed by antimicrobial susceptibility testing with and without an inhibitor of efflux pumps and AmpC β-lactamase. The phenotype of extended-spectrum β-lactamase (ESBL), profile of outer membrane proteins (OMPs), and clonal relatedness were investigated by the double-disk synergy test, urea/SDS-PAGE, and pulsed-field gel electrophoresis (PFGE), respectively. β-Lactamase genes were examined by PCR and sequencing, and the expression of efflux pump gene acrB was evaluated by reverse transcription-PCR. The contribution of porin deficiency to resistance was investigated by restoring functional porin genes on plasmids. We demonstrated that ertapenem resistance was prevalent (53/355; 14.9%) in E. cloacae. Among the strains, IMP-8, SHV-12, and TEM-1 β-lactamases were identified in 3 (5.7%), 40 (75.5%), and 46 (86.8%) isolates, respectively. PFGE showed clonal diversity among these isolates. Phenotypes of ESBL, AmpC β-lactamase overproduction, an active efflux pump, and change in the expression of OMPs were found in 18 (34%), 11 (20.8%), 51 (96.2%), and 23 (43.4%) of ertapenem-resistant strains, respectively. Ertapenem MICs were restored in strains with OmpC and OmpF expression plasmids. This study suggests that ESBL, AmpC β-lactamase overproduction, and decreased OMP expression combined with an active efflux pump contribute to the ertapenem resistance of E. cloacae. The presence of IMP-8 may also play a partial role in ertapenem resistance in Taiwan.
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