ArticleEmerging microbes & infections2019
Detection and characterization of tigecycline heteroresistance in E. cloacae: clinical and microbiological findings.
Article in Emerging microbes & infections, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers.
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Who cites it
21 citing papers in PubMed, 34 citations in OpenAlex.
- Clinical characteristics and temporal trends of meropenem and piperacillin/tazobactam heteroresistance in Pseudomonas aeruginosa isolates.Annals of clinical microbiology and antimicrobials · 2026Article
- Transcriptomic analysis of tigecycline-induced colistin collateral sensitivity in carbapenem-resistantmSphere · 2026Article
- Phenotypic and genomic characterization of tigecycline heteroresistance in carbapenem-resistantMicrobiology spectrum · 2026Article
- Current progress in antibacterial agents for carbapenem-resistant enterobacterales.Frontiers in pharmacology · 2026Review
- A nomogram for predicting the risk of tigecycline-associated drug-induced liver injury in a Chinese population.Scientific reports · 2025Article
- Study on collateral sensitivity of tigecycline to colistin-resistantMicrobiology spectrum · 2025Article
- Overview of heteroresistance to multiple antibiotics in clinicalJAC-antimicrobial resistance · 2025Article
- Heteroresistance in Enterobacter cloacae complex caused by variation in transient gene amplification events.npj antimicrobials and resistance · 2025Article
- Epidemiology, mechanisms, and clinical impact of bacterial heteroresistance.npj antimicrobials and resistance · 2025Review
- The tigecycline resistance mechanisms in Gram-negative bacilli.Frontiers in cellular and infection microbiology · 2024Review
- Intra-abdominal infection after tumor surgery: tigecycline combined with β-lactam antibiotics versus tigecycline alone.BMC cancer · 2023Article
- Dissemination and characteristics of carbapenem-resistantFrontiers in microbiology · 2023Article
- Risk Factors for Cefoperazone/Sulbactam-Induced Coagulation Disorder.Infection and drug resistance · 2023Article
- Comparison of bleeding risk and hypofibrinogenemia-associated risk factors between tigecycline with cefoperazone/sulbactam therapy and other tigecycline-based combination therapies.Frontiers in pharmacology · 2023Article
- Relationships between Efflux Pumps and Emergence of Heteroresistance: A Comprehensive Study on the Current Findings.The Canadian journal of infectious diseases & medical microbiology = Journal canadien des maladies infectieuses et de la microbiologie medicale · 2022Review
- Combined effect of Polymyxin B and Tigecycline to overcome Heteroresistance in Carbapenem-Resistant Klebsiella pneumoniae.Microbiology spectrum · 2021Article
- Tigecycline Heteroresistance and Resistance Mechanism in Clinical Isolates of Acinetobacter baumannii.Microbiology spectrum · 2021Article
- Clinical Status of Efflux Resistance Mechanisms in Gram-Negative Bacteria.Antibiotics (Basel, Switzerland) · 2021Review
- Characterization of Tigecycline-HeteroresistantFrontiers in microbiology · 2021Article
- RAntimicrobial agents and chemotherapy · 2020Article
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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
Tigecycline is regarded as a last-resort treatment for carbapenem-resistant Enterobacteriaceae (CRE), however, the emergence of tigecycline heteroresistance has posted the therapeutic challenge to combat this "nightmare bacteria". The primary purpose of this study was to demonstrate the existence of tigecycline heteroresistance in carbapenem-resistant E. cloacae (TH-CRECL) and further to explore the epidemiological characteristics and underlying molecular mechanisms. Our study identified a relative low prevalence of carbapenem-resistant E. cloacae (CRECL) isolates, about 20.0% (28/140), as heteroresistance to tigecycline. Molecular genetic relatedness of these heteroresistant isolates were characterized epidemiologically sporadic. In addition, mechanistic analysis revealed that Phe-Arg-β-naphthylamide (PAβN) significantly reversed tigecycline MIC levels of resistant colonies in heteroresistant strains, as primarily related to the marked overproduction of efflux pump genes acrAB and oqxAB, as well as overexpression of transcriptional regulators (soxS and ramA). Moreover, logistic regression analysis showed that previous fluoroquinolone therapy was identified as the only potential independent risk factor for the acquisition of TH-CRECL. Most importantly, our data indicated that patients with TH-CRECL infection might lead to a remarkably prolonged hospital stay and deterioration in functional status. These findings emphasized the necessity of timely detection and intervention of patients infected with TH-CRECL.
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