ArticleAntimicrobial agents and chemotherapy2015
Genomic and transcriptomic analyses of colistin-resistant clinical isolates of Klebsiella pneumoniae reveal multiple pathways of resistance.
Article in Antimicrobial agents and chemotherapy, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 120 papers, 2 of them syntheses that pooled it.
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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
120 citing papers in PubMed, 2 syntheses or guidelines pooled it, 213 citations in OpenAlex.
- Global prevalence of mutation in theFrontiers in microbiology · 2024Pooled it
- Mcr colistin resistance gene: a systematic review of current diagnostics and detection methods.MicrobiologyOpen · 2019Pooled it
- A posttranslational modification of fimbriae drives pathogenicity inProceedings of the National Academy of Sciences of the United States of America · 2026Article
- Overview of Colistin Resistance in the Middle East and North Africa (MENA) Region.Microorganisms · 2026Review
- Rapid Adaptive Evolution under Combination Therapy inACS infectious diseases · 2026Article
- Emergence and dissemination of extensively drug-resistant ST307Microbial genomics · 2026Article
- Carbapenem and colistin-resistantJAC-antimicrobial resistance · 2026Article
- Emergence of Polymyxin Resistance Driven by a PhoQ Mutation in KPC-2-ProducingAntibiotics (Basel, Switzerland) · 2026Article
- Proteome-wide remodelling in Klebsiella pneumoniae during step-wise adaptive evolution against colistin.PloS one · 2026Article
- Colistin Resistance in Bacteria: Current Updates on Mechanism of Action and Combating Strategies.The Canadian journal of infectious diseases & medical microbiology = Journal canadien des maladies infectieuses et de la microbiologie medicale · 2026Review
- Antibiotic Resistance inAntibiotics (Basel, Switzerland) · 2026Review
- A systematic analysis of various clonal lineages of colistin-resistant Klebsiella pneumoniae with mgrB mutations.Molecular biology reports · 2025Review
- A novel post-translational modification of fimbriae drives pathogenicity inbioRxiv : the preprint server for biology · 2025Article
- Challenges in the management of multidrug-resistant Gram-negative bacterial meningitis in children: a decade of clinical insights.BMC pediatrics · 2025Article
- Emergence of concurrently transmissibleMicrobiology spectrum · 2025Article
- Unseen Enemy: Mechanisms of Multidrug Antimicrobial Resistance in Gram-Negative ESKAPE Pathogens.Antibiotics (Basel, Switzerland) · 2025Review
- Article
- ESKAPE in China: epidemiology and characteristics of antibiotic resistance.Emerging microbes & infections · 2024Review
- Colistin: Lights and Shadows of an Older Antibiotic.Molecules (Basel, Switzerland) · 2024Review
- Colistin Resistance Mechanisms and Molecular Epidemiology ofInfection and drug resistance · 2024Article
60 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
10 authors at 6 institutions in 1 country.
Funding
Abstract
The emergence of multidrug-resistant (MDR) Klebsiella pneumoniae has resulted in a more frequent reliance on treatment using colistin. However, resistance to colistin (Col(r)) is increasingly reported from clinical settings. The genetic mechanisms that lead to Col(r) in K. pneumoniae are not fully characterized. Using a combination of genome sequencing and transcriptional profiling by RNA sequencing (RNA-Seq) analysis, distinct genetic mechanisms were found among nine Col(r) clinical isolates. Col(r) was related to mutations in three different genes in K. pneumoniae strains, with distinct impacts on gene expression. Upregulation of the pmrH operon encoding 4-amino-4-deoxy-L-arabinose (Ara4N) modification of lipid A was found in all Col(r) strains. Alteration of the mgrB gene was observed in six strains. One strain had a mutation in phoQ. Common among these seven strains was elevated expression of phoPQ and unaltered expression of pmrCAB, which is involved in phosphoethanolamine addition to lipopolysaccharide (LPS). In two strains, separate mutations were found in a previously uncharacterized histidine kinase gene that is part of a two-component regulatory system (TCRS) now designated crrAB. In these strains, expression of pmrCAB, crrAB, and an adjacent glycosyltransferase gene, but not that of phoPQ, was elevated. Complementation with the wild-type allele restored colistin susceptibility in both strains. The crrAB genes are present in most K. pneumoniae genomes, but not in Escherichia coli. Additional upregulated genes in all strains include those involved in cation transport and maintenance of membrane integrity. Because the crrAB genes are present in only some strains, Col(r) mechanisms may be dependent on the genetic background.
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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.