ArticleBMC microbiology2022
Cefazolin and imipenem enhance AmpC expression and resistance in NagZ-dependent manner in Enterobacter cloacae complex.
Article in BMC microbiology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed, 8 citations in OpenAlex.
- Non canonical perspectives on AmpR mediated ampC expression in Gram negative bacteria, with particular emphasis on the potential regulatory purview of FtsZ.World journal of microbiology & biotechnology · 2026Review
- Changes in the Gut Microbiome Following Perioperative Prophylactic Cefazolin Administration in Patients Undergoing Orthopedic Surgery: A Longitudinal Prospective Study.Antibiotics (Basel, Switzerland) · 2026Article
- CoNS blood culture isolates from very preterm infants: antibiotic susceptibility, synergy testing andJAC-antimicrobial resistance · 2026Article
- Correlation between the mutation rates for ampC derepression and species or ampC genotypes in Enterobacter cloacae complex.BMC microbiology · 2025Article
- Exploring nagZ as a virulence biomarker and treatment target in Enterobacter cloacae.BMC microbiology · 2025Article
- Bloodstream infection with NDM-1/5Frontiers in cellular and infection microbiology · 2025Article
- Impact of overlapping fungal infection on the occurrence and prognosis of carbapenem-resistant gram-negative bacilli infection.Frontiers in cellular and infection microbiology · 2025Observational
- Distribution and Antimicrobial Resistance Analysis of Blood Culture Isolates at a Chinese National Cardiovascular Regional Medical Center: A 7-Year Retrospective Study.Infection and drug resistance · 2025Article
- Cefepime versus carbapenems for treatment of AmpC beta-lactamase-producing Enterobacterales bloodstream infections.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2024Article
- Filling knowledge gaps related to AmpC-dependent β-lactam resistance in Enterobacter cloacae.Scientific reports · 2024Article
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Authors and funding
7 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundEnterobacter cloacae complex (ECC) is a common opportunistic pathogen and is responsible for causing various infections in humans. Owing to its inducible chromosomal AmpC β-lactamase (AmpC), ECC is inherently resistant to the 1st- and 2nd- generation cephalosporins. However, whether β-lactams antibiotics enhance ECC resistance remains unclear.
resultsIn this study, we found that subinhibitory concentrations (SICs) of cefazolin (CFZ) and imipenem (IMP) can advance the expression of AmpC and enhance its resistance towards β-lactams through NagZ in Enterobacter cloacae (EC). Further, AmpC manifested a substantial upregulation in EC in response to SICs of CFZ and IMP. In nagZ knockout EC (ΔnagZ), the resistance to β-lactam antibiotics was rather weakened and the effect of CFZ and IMP on AmpC induction was completely abrogated. NagZ ectopic expression can rescue the induction effects of CFZ and IMP on AmpC and increase ΔnagZ resistance. More importantly, CFZ and IMP have the potential to induce the expression of AmpR's target genes in a NagZ-dependent manner.
conclusionsOur findings suggest that NagZ is a critical determinant for CFZ and IMP to promote AmpC expression and resistance and that CFZ and IMP should be used with caution since they may aggravate ECC resistance. At the same time, this study further improves our understanding of resistance mechanisms in ECC.
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