ArticleJournal of clinical microbiology2012
Heteroresistance to cephalosporins and penicillins in Acinetobacter baumannii.
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 26 papers, 1 of them a synthesis that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
26 citing papers in PubMed, 1 synthesis or guideline pooled it, 38 citations in OpenAlex.
- Global trends and research profile of antibiotic heteroresistance: a bibliometric and visual analysis.Frontiers in microbiology · 2026Pooled it
- Chemical profiling and evaluation of in vitro antibacterial and antibiotic synergistic activities of Cleistanthus bracteosus Jabl. from Malaysian rainforests.BMC complementary medicine and therapies · 2026Article
- Bacterial strain type and TEM-1 enzyme allele impact antibiotic susceptibility distribution in monoclonal populations: a single-cell droplet approach.Royal Society open science · 2025Article
- Clinical characteristics, molecular epidemiology and mechanisms of colistin heteroresistance inFrontiers in cellular and infection microbiology · 2025Article
- Article
- Cephalosporin resistance, tolerance, and approaches to improve their activities.The Journal of antibiotics · 2024Review
- Antimicrobial resistance patterns ofVeterinary world · 2023Article
- Performance of Fully Automated Antimicrobial Disk Diffusion Susceptibility Testing Using Copan WASP Colibri Coupled to the Radian In-Line Carousel and Expert System.Journal of clinical microbiology · 2021Article
- Deciphering colistin heteroresistance in Acinetobacter baumannii clinical isolates from Wenzhou, China.The Journal of antibiotics · 2020Article
- Antibiotic Resistance Profiles, Molecular Mechanisms and Innovative Treatment Strategies ofMicroorganisms · 2020Review
- Mechanisms and clinical relevance of bacterial heteroresistance.Nature reviews. Microbiology · 2019Review
- Colistin heteroresistance in Enterobacter cloacae is regulated by PhoPQ-dependent 4-amino-4-deoxy-l-arabinose addition to lipid A.Molecular microbiology · 2019Article
- Antimicrobial Susceptibility Testing for Polymyxins: Challenges, Issues, and Recommendations.Journal of clinical microbiology · 2019Review
- Detection and characterization of tigecycline heteroresistance in E. cloacae: clinical and microbiological findings.Emerging microbes & infections · 2019Article
- Article
- Efflux Pump Overexpression Contributes to Tigecycline Heteroresistance inFrontiers in cellular and infection microbiology · 2017Article
- Epidemiological and clinical features for cefepime heteroresistant Escherichia coli infections in Southwest China.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2016Article
- Relationship between Antibiotic Resistance, Biofilm Formation, and Biofilm-Specific Resistance in Acinetobacter baumannii.Frontiers in microbiology · 2016Article
- Rapid induction of high-level carbapenem resistance in heteroresistant KPC-producing Klebsiella pneumoniae.Antimicrobial agents and chemotherapy · 2015Article
- Antimicrobial heteroresistance: an emerging field in need of clarity.Clinical microbiology reviews · 2015Review
Corrections and comments
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Heteroresistance to antimicrobial agents may affect susceptibility test results and therapeutic success. In this study, we investigated heteroresistance to cephalosporins and penicillins in Acinetobacter baumannii, a major pathogen causing nosocomial infections. Two A. baumannii isolates exhibited heteroresistance to ampicillin-sulbactam, ticarcillin-clavulanic acid, cefepime, and cefpirome, showing a distinct colony morphology of circular rings within the inhibition halos. Pulsed-field gel electrophoresis (PFGE) and outer membrane protein (OMP) analysis demonstrated that subpopulations around the disks/Etest strips and the original strains all belonged to the same PFGE type and OMP profile. Population analysis profile (PAP) showed the presence of heteroresistant subpopulations with high cefepime resistance levels in two isolates (008 and 328). Interestingly, A. baumannii 008 contained two peaks: one was grown in the presence of up to 1 μg of cefepime/ml, the other apparently occurred when the concentration of cefepime was raised to 256 μg/ml. After serial passages without exposure to cefepime, the PAP curve maintained the same trend observed for the original strain of A. baumannii 008. However, the PAP curve showed a shift to relatively lower cefepime resistance (from 256 to 64 μg/ml) in A. baumannii 328 after 10 passages in antibiotic-free Mueller-Hinton agar plates. Convergence to a monotypic resistance phenotype did not occur. Growth rate analysis revealed that slower growth in resistant subpopulations may provide a strategy against antibiotic challenge. To our knowledge, this is the first report of heteroresistance to cephalosporins and penicillins in A. baumannii.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.