ArticlePloS one2015
Tigecycline susceptibility and the role of efflux pumps in tigecycline resistance in KPC-producing Klebsiella pneumoniae.
Article in PloS one, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 53 papers.
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Who cites it
53 citing papers in PubMed, 90 citations in OpenAlex.
- Bacterial strategies for surviving antibiotics during urinary tract infection: could uropathogenic Escherichia coli be persisters?Nature reviews. Urology · 2026Review
- Effect of sub-inhibitory tigecycline (½-MIC) on AcrAB-TolC andFrontiers in cellular and infection microbiology · 2026Article
- Whole-Genome Insights Into Tigecycline-ResistantTransboundary and emerging diseases · 2026Article
- Heteroresistance is associated with mutations during low concentration of tigecycline therapy in multiple-resistant Klebsiella pneumoniae.Annals of clinical microbiology and antimicrobials · 2025Article
- RND/HAE-1 members in the Pseudomonadota phylum: exploring multidrug resistance.Biophysical reviews · 2025Review
- Phenotypic Profiling of Tigecycline-resistant Klebsiella pneumoniae Strains Induced In vitro.Current microbiology · 2024Article
- Dual role ofiMetaOmics · 2024Article
- Establishment of epidemiological cut-off values for eravacycline, against Escherichia coli, Klebsiella pneumoniae, Enterobacter cloacae, Acinetobacter baumannii and Staphylococcus aureus.The Journal of antimicrobial chemotherapy · 2024Article
- Mechanisms of tigecycline resistance in Gram-negative bacteria: A narrative review.Engineering microbiology · 2024Review
- Occurrence and mechanisms of tigecycline resistance in carbapenem- and colistin-resistant Klebsiella pneumoniae in Thailand.Scientific reports · 2024Article
- Characterization of a Highly VirulentInfection and drug resistance · 2024Article
- Efflux Pumps and Different Genetic Contexts ofInternational journal of molecular sciences · 2023Article
- Virulence Characteristics and Molecular Typing of Carbapenem-Resistant ST15Antibiotics (Basel, Switzerland) · 2023Article
- Characterization of two multidrug-resistantFrontiers in microbiology · 2023Article
- Genomic characterization of tigecycline-resistantFrontiers in microbiology · 2023Article
- Review
- Molecular epidemiology and genomic insights into the transmission of carbapenem-resistant NDM-producingComputational and structural biotechnology journal · 2023Article
- Sodium Malonate Inhibits the AcrAB-TolC Multidrug Efflux Pump ofPathogens (Basel, Switzerland) · 2022Article
- Progressive Development of Cefiderocol Resistance in Escherichia coli During Therapy is Associated With an Increase in blaNDM-5 Copy Number and Gene Expression.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2022Article
- Tigecycline antibacterial activity, clinical effectiveness, and mechanisms and epidemiology of resistance: narrative review.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2022Review
Corrections and comments
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Authors and funding
7 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
KPC-producing Klebsiella pneumoniae isolates have emerged as important pathogens of nosocomial infections, and tigecycline is one of the antibiotics recommended for severe infections caused by KPC-producing K. pneumoniae. To identify the susceptibility profile of KPC-producing K. pneumoniae to tigecycline and investigate the role of efflux pumps in tigecycline resistance, a total of 215 KPC-producing K. pneumoniae isolates were collected. The minimum inhibitory concentration (MIC) of tigecycline was determined by standard broth microdilution tests. Isolates showing resistance to tigecycline underwent susceptibility test with efflux pump inhibitors. Expression levels of efflux pump genes (acrB and oqxB) and their regulators (ramA, marA, soxS and rarA) were examined by real-time PCR, and the correlation between tigecycline MICs and gene expression levels were analysed. Our results show that the tigecycline resistance rate in these isolates was 11.2%. Exposure of the tigecycline-resistant isolates to the efflux pump inhibitor NMP resulted in an obvious decrease in MICs and restored susceptibility to tigecycline in 91.7% of the isolates. A statistically significant association between acrB expression and tigecycline MICs was observed, and overexpression of ramA was found in three tigecycline-resistant isolates, further analysis confirmed ramR mutations existed in these isolates. Transformation of one mutant with wild-type ramR restored susceptibility to tigecycline and repressed overexpression of ramA and acrB. These data indicate that efflux pump AcrAB, which can be up-regulated by ramR mutations and subsequent ramA activation, contributed to tigecycline resistance in K. pneumoniae clinical isolates.
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