ArticlePloS one2017
Tigecycline resistance among carbapenem-resistant Klebsiella Pneumoniae: Clinical characteristics and expression levels of efflux pump genes.
Article in PloS one, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 34 papers.
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Who cites it
34 citing papers in PubMed, 54 citations in OpenAlex.
- Molecular characterization and transmission pattern of tetracycline resistance determinants in tigecycline and carbapenem resistant Klebsiella pneumoniae isolates at a tertiary care hospital in India.Access microbiology · 2026Article
- Mechanisms, Significance, Detection and Emerging Therapies for Carbapenem-Resistant Enterobacterales: A Scoping Review.Journal of tropical medicine · 2026Review
- Article
- Recent Advances in Understanding the Clinical Implications of Heterogeneous Drug Resistance inInfection and drug resistance · 2025Review
- Distribution of Pathogenic Bacteria in Health Care Associated Sepsis in Preterm Infants and Ten Years Variation in Their Drug Resistance.Infection and drug resistance · 2025Article
- Dual role ofiMetaOmics · 2024Article
- AcrAB-TolC efflux pump overexpression and tet(A) gene mutation increase tigecycline resistance in Klebsiella pneumoniae.World journal of microbiology & biotechnology · 2024Article
- Occurrence and mechanisms of tigecycline resistance in carbapenem- and colistin-resistant Klebsiella pneumoniae in Thailand.Scientific reports · 2024Article
- Genomic features and comparative analysis of a multidrug-resistant Acinetobacter bereziniae strain infecting an animal: a novel emerging one health pathogen?World journal of microbiology & biotechnology · 2024Article
- Mechanisms of Antibiotic Resistance and Developments in Therapeutic Strategies to CombatInfection and drug resistance · 2024Review
- Synergistic Role of Biofilm-Associated Genes and Efflux Pump Genes in Tigecycline Resistance of Acinetobacter baumannii.Medical science monitor : international medical journal of experimental and clinical research · 2023Article
- Predicting tigecycline susceptibility in multidrug-resistant Klebsiella species and Escherichia coli strains of environmental origin.Brazilian journal of microbiology : [publication of the Brazilian Society for Microbiology] · 2023Article
- Intravenous Polymyxin B as Adjunctive Therapy to High-Dose Tigecycline for the Treatment of Nosocomial Pneumonia Due to Carbapenem-ResistantAntibiotics (Basel, Switzerland) · 2023Article
- Molecular epidemiology, risk factors, and outcomes of carbapenem-resistantFrontiers in microbiology · 2023Article
- 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
- Functional and phylogenetic analysis of TetX variants to design a new classification system.Communications biology · 2022Article
- Article
- Antibiotic Resistance, Molecular Characteristics and Risk Factors of Carbapenem-ResistantInfection and drug resistance · 2022Article
- Intrathecal or Intraventricular Tigecycline Therapy for Central Nervous System Infection Associated with Carbapenem-ResistantInfection and drug resistance · 2022Article
- Resistance evolution of hypervirulent carbapenem-resistantEmerging microbes & infections · 2021Article
Corrections and comments
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Authors and funding
9 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTigecycline is a treatment option for infections caused by carbapenem-resistant Klebsiella pneumoniae (CRKP). Emerging tigecycline resistance in CRKP represents a growing threat. Knowledge of the clinical, microbiological, and molecular characteristics of tigecycline- and carbapenem-resistant Klebsiella pneumoniae (TCRKP) is limited.
methodsPatients infected with TCRKP were identified from a Taiwanese national surveillance study. Clinical data were collected from medical records. We performed susceptibility tests, carbapenemase gene detection, pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST). Furthermore, we performed quantitative real-time polymerase chain reaction (qRT-PCR) analyses to assess the expression levels of the efflux pump genes acrB and oqxB.
resultsWe identified 16 patients infected with TCRKP, with urinary tract infection (UTI) being the most common type of infection (63%). The all-cause 30-day mortality rate was 44% in patients with TCRKP infection. Patients with a site of infection other than the urinary tract had a significantly higher mortality rate than patients with UTIs (83% vs. 20%, p = 0.035). PFGE and MLST revealed no dominant clone or sequence type. Using qRT-PCR, overexpression of both the acrB and oqxB genes was identified in seven isolates, and overexpression of the oqxB gene was observed in another seven. There was poor correlation between acrB or oqxB expression and tigecycline MICs (r = -0.038 and -0.166, respectively).
conclusionsThe mortality rate in patients infected with TCRKP in this study was 44% and this is an important subset of patients. The absence of a linear relationship between efflux pump genes expression and MICs indicates that tigecycline resistance may be mediated by other factors. Continuous monitoring of tigecycline resistance among CRKP isolates and resistance mechanisms are necessary.
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