ArticleMolecular microbiology2019
Colistin heteroresistance in Enterobacter cloacae is regulated by PhoPQ-dependent 4-amino-4-deoxy-l-arabinose addition to lipid A.
Article in Molecular microbiology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 63 papers.
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Who cites it
63 citing papers in PubMed, 97 citations in OpenAlex.
- Combinatorial action of regulatory systems generates colistin heteroresistance.Science advances · 2026Article
- Negative-Ion Mode MALDI-TOF MS Combined with Machine Learning for the Rapid Identification of Colistin-ResistantACS omega · 2026Article
- Distinct proteomic profiles of clinical isolates show diversity of Pseudomonas aeruginosa colistin-resistance.Clinical proteomics · 2026Article
- Polymyxin heteroresistance inJournal of medical microbiology · 2026Article
- Synergistic chemodynamic-photothermal therapy of super-resistant Enterobacter asburiae-infected sepsis using multifunctional mesoporous nanocomposite.Journal of nanobiotechnology · 2026Article
- Resistance, heteroresistance, and fitness costs drive colistin treatment failure duringProceedings of the National Academy of Sciences of the United States of America · 2026Article
- MexS mediated heteroresistance ofFrontiers in microbiology · 2026Article
- Cell-to-Cell and Patient-to-Patient Variability in Antimicrobial Resistance.Microorganisms · 2025Review
- Resistance, heteroresistance and fitness costs drive colistin treatment failure duringbioRxiv : the preprint server for biology · 2025Article
- Colistin heteroresistance inAntimicrobial agents and chemotherapy · 2025Article
- Molecular interplay between peptidoglycan integrity and outer membrane asymmetry in maintaining cell envelope homeostasis.Journal of bacteriology · 2025Article
- Article
- Broad Host Range Peptide Nucleic Acids Prevent Gram-Negative Biofilms Implicated in Catheter-Associated Urinary Tract Infections.Microorganisms · 2025Article
- Colistin heteroresistance, mechanisms, diagnostic methods, and therapeutic options: A review.Germs · 2025Review
- Heteroresistance in Enterobacter cloacae complex caused by variation in transient gene amplification events.npj antimicrobials and resistance · 2025Article
- Alternative lipid synthesis in response to phosphate limitation promotes antibiotic tolerance in Gram-negative ESKAPE pathogens.PLoS pathogens · 2025Article
- Clinical characteristics, molecular epidemiology and mechanisms of colistin heteroresistance inFrontiers in cellular and infection microbiology · 2025Article
- Alternative lipid synthesis in response to phosphate limitation promotes antibiotic tolerance in Gram-negative ESKAPE pathogens.bioRxiv : the preprint server for biology · 2024Article
- Aminoglycoside heteroresistance inmBio · 2024Article
- Polymyxin resistance in Enterobacter cloacae complex in Brazil: phenotypic and molecular characterization.Brazilian journal of microbiology : [publication of the Brazilian Society for Microbiology] · 2024Article
3 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
7 authors at 4 institutions in 2 countries.
Funding
Abstract
The Enterobacter cloacae complex (ECC) consists of closely related bacteria commonly associated with the human microbiota. ECC are increasingly isolated from healthcare-associated infections, demonstrating that these Enterobacteriaceae are emerging nosocomial pathogens. ECC can rapidly acquire multidrug resistance to conventional antibiotics. Cationic antimicrobial peptides (CAMPs) have served as therapeutic alternatives because they target the highly conserved lipid A component of the Gram-negative outer membrane. Many Enterobacteriaceae fortify their outer membrane with cationic amine-containing moieties to prevent CAMP binding, which can lead to cell lysis. The PmrAB two-component system (TCS) directly activates 4-amino-4-deoxy-l-arabinose (l-Ara4N) biosynthesis to result in cationic amine moiety addition to lipid A in many Enterobacteriaceae such as E. coli and Salmonella. In contrast, PmrAB is dispensable for CAMP resistance in E. cloacae. Interestingly, some ECC clusters exhibit colistin heteroresistance, where a subpopulation of cells exhibit clinically significant resistance levels compared to the majority population. We demonstrate that E. cloacae lipid A is modified with l-Ara4N to induce CAMP heteroresistance and the regulatory mechanism is independent of the PmrAB
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