{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T18:37:32Z","timestamp":1778870252909,"version":"3.51.4"},"reference-count":23,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2013,12,1]],"date-time":"2013-12-01T00:00:00Z","timestamp":1385856000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Microbial Drug Resistance"],"published-print":{"date-parts":[[2013,12]]},"abstract":"<jats:p>\n                    The aim of this study was to investigate, for the first time, the combinations of carbapenem resistance mechanisms in clinical isolates of extended-spectrum beta-lactamase (ESBL)-producing\n                    <jats:italic toggle=\"yes\">Pseudomonas aeruginosa<\/jats:italic>\n                    in a Chinese hospital. Pulsed-field gel electrophoresis revealed the presence of eight clonal types among the 15 ESBL producers. Multilocus sequence typing of two isolates harboured\n                    <jats:italic toggle=\"yes\">bla<\/jats:italic>\n                    <jats:sub>IMP-1<\/jats:sub>\n                    identified the clonal strain as ST325. All these genes were found either alone or simultaneously in the strains in the following five different arrangements:&lt;\n                    <jats:italic toggle=\"yes\">bla<\/jats:italic>\n                    <jats:sub>OXA-10<\/jats:sub>\n                    &gt;; &lt;\n                    <jats:italic toggle=\"yes\">bla<\/jats:italic>\n                    <jats:sub>OXA-10<\/jats:sub>\n                    ,\n                    <jats:italic toggle=\"yes\">bla<\/jats:italic>\n                    <jats:sub>IMP-1<\/jats:sub>\n                    &gt;; &lt;\n                    <jats:italic toggle=\"yes\">bla<\/jats:italic>\n                    <jats:sub>PER-1<\/jats:sub>\n                    ,\n                    <jats:italic toggle=\"yes\">bla<\/jats:italic>\n                    <jats:sub>OXA-10<\/jats:sub>\n                    &gt;; &lt;\n                    <jats:italic toggle=\"yes\">bla<\/jats:italic>\n                    <jats:sub>PER-1<\/jats:sub>\n                    ,\n                    <jats:italic toggle=\"yes\">bla<\/jats:italic>\n                    <jats:sub>PSE-1<\/jats:sub>\n                    &gt;; &lt;\n                    <jats:italic toggle=\"yes\">bla<\/jats:italic>\n                    <jats:sub>OXA-10<\/jats:sub>\n                    ,\n                    <jats:italic toggle=\"yes\">bla<\/jats:italic>\n                    <jats:sub>TEM-1<\/jats:sub>\n                    &gt;. Regarding mutation-driven resistance, all, but four of the isolates had a relevant decrease of\n                    <jats:italic toggle=\"yes\">oprD<\/jats:italic>\n                    expression. In addition, 73.3% of the isolates overexpressed\n                    <jats:italic toggle=\"yes\">mexB<\/jats:italic>\n                    , 40%\n                    <jats:italic toggle=\"yes\">mexD<\/jats:italic>\n                    , and 33.3%\n                    <jats:italic toggle=\"yes\">mexY<\/jats:italic>\n                    . A specific combination of overexpressed\n                    <jats:italic toggle=\"yes\">mexB<\/jats:italic>\n                    or\n                    <jats:italic toggle=\"yes\">mexY<\/jats:italic>\n                    and alteration in loop L7\n                    <jats:sub>10<\/jats:sub>\n                    of OprD were significantly associated with meropenem resistance. In conclusion, combination of several mutation-driven mechanisms leading to OprD inactivation and overexpression of efflux systems was the main carbapenem resistance mechanism among the ESBL-producing\n                    <jats:italic toggle=\"yes\">P. aeruginosa<\/jats:italic>\n                    isolates, but acquisition of a transferable resistance determinant such as metallo-\u03b2-lactamase could be problematic in clinical settings in China.\n                  <\/jats:p>","DOI":"10.1089\/mdr.2013.0010","type":"journal-article","created":{"date-parts":[[2013,7,18]],"date-time":"2013-07-18T09:42:12Z","timestamp":1374140532000},"page":"463-468","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":9,"title":["Efflux System Overexpression and Decreased OprD Contribute to the Carbapenem Resistance Among Extended-Spectrum Beta-Lactamase-Producing\n                    <i>Pseudomonas aeruginosa<\/i>\n                    Isolates from a Chinese University Hospital"],"prefix":"10.1177","volume":"19","author":[{"given":"Yang","family":"Liu","sequence":"first","affiliation":[{"name":"Nanchang University","place":["People's Republic of China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiang-Yang","family":"Li","sequence":"additional","affiliation":[{"name":"Wenzhou Medical College","place":["People's Republic of China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"La-Gen","family":"Wan","sequence":"additional","affiliation":[{"name":"Nanchang University","place":["People's Republic of China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wei-Yan","family":"Jiang","sequence":"additional","affiliation":[{"name":"Wenzhou Medical College","place":["People's Republic of China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fang-Qu","family":"Li","sequence":"additional","affiliation":[{"name":"Wenzhou Medical College","place":["People's Republic of China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jing-Hong","family":"Yang","sequence":"additional","affiliation":[{"name":"Wenzhou Medical College","place":["People's Republic of China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2013,12]]},"reference":[{"key":"e_1_3_2_2_2","volume-title":"Performance Standards for Antimicrobial Susceptibility Testing","author":"[CLSI] Clinical, Laboratory Standards Institute","year":"2011","unstructured":"[CLSI] Clinical, Laboratory Standards Institute. 2011. 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