Evidence map›Paper›PMID 38743684›Full record

ArticlePloS one2024

Antimicrobial resistance and AmpC production in ESBL-producing Klebsiella pneumoniae and Klebsiella quasipneumoniae: A retrospective study in Japanese clinical isolates.

Naoki Watanabe, Tomohisa Watari, Yoshihito Otsuka, Masahiko Ito, Kazufumi Yamagata, Miyuki Fujioka

Abstract read
In one paragraph

Article in PloS one, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. Frontiers in cellular and infection microbiology · 2025
    Article
  3. Extended-Spectrum β-Lactamase-ProducingInfection and drug resistance · 2025
    Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Naoki WatanabeDepartment of Clinical Laboratory, Kameda Medical Center, Kamogawa, Chiba, Japan.ORCID 0000-0001-8609-4981
Tomohisa WatariDepartment of Clinical Laboratory, Kameda Medical Center, Kamogawa, Chiba, Japan.
Yoshihito OtsukaDepartment of Clinical Laboratory, Kameda Medical Center, Kamogawa, Chiba, Japan.
Masahiko ItoSapporo Clinical Laboratory Inc., Chuo-ku, Sapporo, Hokkaido, Japan.
Kazufumi YamagataGraduate School of Health Sciences, Hirosaki University, Hirosaki, Aomori, Japan.
Miyuki FujiokaGraduate School of Health Sciences, Hirosaki University, Hirosaki, Aomori, Japan.ORCID 0000-0002-6872-5943

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThe study of Klebsiella quasipneumoniae, Klebsiella variicola, and AmpC production in extended-spectrum β-lactamase (ESBL)-producing Klebsiella in Japan is limited, and existing data are insufficient. This study aims to characterize Klebsiella species, determine AmpC production rates, and analyze antimicrobial resistance patterns in ESBL-producing Klebsiella isolates in Japan.

methodsA total of 139 clinical isolates of ESBL-producing Klebsiella were collected in Japan, along with their corresponding antimicrobial susceptibility profiles. The isolates were identified using a web-based tool. ESBL genes within the isolates were identified using multiplex PCR. Screening for AmpC-producing isolates was performed using cefoxitin disks, followed by multiplex PCR to detect the presence of AmpC genes. Antimicrobial resistance patterns were analyzed across the predominant ESBL genotypes.

resultsThe web-based tool identified 135 isolates (97.1%) as Klebsiella pneumoniae and 4 (2.9%) as K. quasipneumoniae subsp. similipneumoniae, with no instances of K. variicola detected. Among K. pneumoniae, the CTX-M-1 group emerged as the predominant genotype (83/135, 61.5%), followed by K. quasipneumoniae subsp. similipneumoniae (3/4, 75.0%). The CTX-M-9 group was the second most prevalent genotype in K. pneumoniae (45/135, 33.3%). The high resistance rates were observed for quinolones (ranging from 46.7% to 63.0%) and trimethoprim/sulfamethoxazole (78.5%). The CTX-M-1 group exhibited higher resistance to ciprofloxacin (66/83, 79.5%) compared to the CTX-M-9 group (18/45, 40.0%), a trend also observed for levofloxacin and trimethoprim/sulfamethoxazole. Among the 16 isolates that tested positive during AmpC screening, only one K. pneumoniae isolates (0.7%) were confirmed to carry the AmpC gene.

conclusionKlebsiella pneumoniae with the CTX-M-1 group is the most common ESBL-producing Klebsiella in Japan and showed a low proportion of AmpC production. These isolates are resistant to quinolones and trimethoprim/sulfamethoxazole, highlighting the challenge of managing this pathogen. The findings underscore the importance of broader research and continuous monitoring to address the resistance patterns of ESBL-producing Klebsiella.

Indexed as

Anti-Bacterial AgentsBacterial Proteinsbeta-LactamasesDrug Resistance, BacterialKlebsiellaKlebsiella InfectionsEast Asian PeopleFemaleHumansJapanKlebsiella pneumoniaeMaleMicrobial Sensitivity TestsRetrospective StudiesAmpC beta-lactamasesAnti-Bacterial AgentsBacterial Proteinsbeta-Lactamases

Identifiers

PMID38743684
PMCPMC11093370

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.