{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T12:57:14Z","timestamp":1790773034580,"version":"4.1.0"},"reference-count":20,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2017,3,1]],"date-time":"2017-03-01T00:00:00Z","timestamp":1488326400000},"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":[[2017,3]]},"abstract":"\n Trimethoprim\u2013sulfamethoxazole is the first-line antimicrobial combination for\n Stenotrophomonas maltophilia<\/jats:italic>\n infections. However, allergy or intolerance and increasing resistance limit the use of trimethoprim\u2013sulfamethoxazole. Quinolones can be used as an alternative therapeutic option, but resistance can emerge rapidly during therapy. We analyzed the contribution of SmeABC and SmeDEF efflux pumps to levofloxacin resistance in clinical isolates of\n S. maltophilia<\/jats:italic>\n . Nonduplicate clinical isolates of\n S. maltophilia<\/jats:italic>\n were collected in 2010 from 11 university hospitals (\n n<\/jats:italic>\n \u2009=\u2009102). Fifty-five levofloxacin nonsusceptible (minimum inhibitory concentration [MIC] \u22654\u2009\u03bcg\/ml) and 47 susceptible (MIC \u22642\u2009\u03bcg\/ml) isolates were tested for efflux pump overexpression. Real-time reverse transcription-PCR was performed for amplification and quantification of\n smeB<\/jats:italic>\n ,\n smeC<\/jats:italic>\n ,\n smeD<\/jats:italic>\n , and\n smeF<\/jats:italic>\n mRNA. To determine which antimicrobials were affected by\n smeD<\/jats:italic>\n overexpression, the growth rates of a levofloxacin-susceptible\n S. maltophilia<\/jats:italic>\n isolate were compared by measuring absorbance of antimicrobial-supplemented Luria-Bertani broth (LB) cultures with or without triclosan. Significant relationships between\n sme<\/jats:italic>\n gene overexpression and resistance were observed for\n smeD<\/jats:italic>\n against levofloxacin,\n smeC<\/jats:italic>\n and\n smeF<\/jats:italic>\n against ceftazidime, and\n smeC<\/jats:italic>\n against ticarcillin\u2013clavulanate. The mean MICs of moxifloxacin and tigecycline did not significantly differ for isolates with or without overexpression of\n smeB<\/jats:italic>\n ,\n smeC<\/jats:italic>\n , and\n smeF<\/jats:italic>\n , but were significantly higher for isolates with\n smeD<\/jats:italic>\n overexpression. The mean MICs of amikacin were significantly higher for\n smeC<\/jats:italic>\n or\n smeF<\/jats:italic>\n overexpressing isolates. Increased growth of a levofloxacin-susceptible isolate was observed in LB with 1\/2 MIC levofloxacin in the presence of triclosan. These data suggest that the expression of\n smeD<\/jats:italic>\n plays a role in levofloxacin resistance in\n S. maltophilia<\/jats:italic>\n .\n <\/jats:p>","DOI":"10.1089\/mdr.2015.0228","type":"journal-article","created":{"date-parts":[[2016,6,13]],"date-time":"2016-06-13T18:57:40Z","timestamp":1465844260000},"page":"163-168","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":18,"title":["Levofloxacin Efflux and\n smeD<\/i>\n in Clinical Isolates of\n Stenotrophomonas maltophilia<\/i>"],"prefix":"10.1177","volume":"23","author":[{"given":"So Young","family":"Chong","sequence":"first","affiliation":[{"name":"CHA University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyungwon","family":"Lee","sequence":"additional","affiliation":[{"name":"Yonsei University College of Medicine"},{"name":"Yonsei University College of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hae-Sun","family":"Chung","sequence":"additional","affiliation":[{"name":"Yonsei University College of Medicine"},{"name":"Ewha Womans University School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seong Geun","family":"Hong","sequence":"additional","affiliation":[{"name":"Yonsei University College of Medicine"},{"name":"CHA University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Younghee","family":"Suh","sequence":"additional","affiliation":[{"name":"Yonsei University College of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yunsop","family":"Chong","sequence":"additional","affiliation":[{"name":"Yonsei University College of Medicine"},{"name":"Yonsei University College of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2017,3]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1586\/eri.11.24"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.00019-11"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(09)70083-0"},{"key":"e_1_3_3_5_2","doi-asserted-by":"crossref","first-page":"391","DOI":"10.1016\/j.jinf.2012.01.001","article-title":"Stenotrophomonas maltophilia\u2014the most worrisome threat among unusual non-fermentative gram-negative bacilli from hospitalized patients: A prospective multicenter study","volume":"64","author":"Fihman V.","year":"2012","unstructured":"Fihman V., , Monnier A.L., , Corvec S., , Jaureguy F., , Tankovic J., , Jacquier H., , Carbonnelle E., , Bille E., , Illiaquer M., , Cattoir V., , and Zahar JR. 2012. Stenotrophomonas maltophilia\u2014the most worrisome threat among unusual non-fermentative gram-negative bacilli from hospitalized patients: A prospective multicenter study. J. Infect., 64:391\u2013398.","journal-title":"J. Infect."},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijantimicag.2004.10.002"},{"key":"e_1_3_3_7_2","doi-asserted-by":"crossref","first-page":"1769","DOI":"10.1124\/mol.107.043273","article-title":"Covalent binding of the nitroso metabolite of sulfamethoxazole is important in induction of drug-specific T-cell responses in vivo","volume":"73","author":"Cheng L.","year":"2008","unstructured":"Cheng L., , Stewart B.J., , You Q., , Petersen D.R., , Ware J.A., , Piccotti J.R., , Kawabata T.T., , and Ju C. 2008. Covalent binding of the nitroso metabolite of sulfamethoxazole is important in induction of drug-specific T-cell responses in vivo. Mol. Pharmacol., 73:1769\u20131775.","journal-title":"Mol. Pharmacol."},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11882-002-0033-y"},{"key":"e_1_3_3_9_2","doi-asserted-by":"crossref","first-page":"518","DOI":"10.1093\/jac\/dkh094","article-title":"Contribution of integrons, and SmeABC and SmeDEF efflux pumps to multidrug resistance in clinical isolates of Stenotrophomonas maltophilia","volume":"53","author":"Chang L.L.","year":"2004","unstructured":"Chang L.L., , Chen H.F., , Chang C.Y., , Lee T.M., , and Wu W.J. 2004. Contribution of integrons, and SmeABC and SmeDEF efflux pumps to multidrug resistance in clinical isolates of Stenotrophomonas maltophilia. J. Antimicrob. Chemother., 53:518\u2013521.","journal-title":"J. Antimicrob. Chemother."},{"key":"e_1_3_3_10_2","doi-asserted-by":"crossref","first-page":"62","DOI":"10.3346\/jkms.2013.28.1.62","article-title":"Antimicrobial susceptibility of stenotrophomonas maltophilia isolates from Korea, and the activity of antimicrobial combinations against the isolates","volume":"28","author":"Chung H.S.","year":"2013","unstructured":"Chung H.S., , Hong S.G., , Kim Y.R., , Shin K.S., , Whang D.H., , Ahn J.Y., , Park Y.J., , Uh Y., , Chang C.L., , Shin J.H., , Lee H.S., , Lee K., , and Chong Y. 2013. Antimicrobial susceptibility of stenotrophomonas maltophilia isolates from Korea, and the activity of antimicrobial combinations against the isolates. J. Korean Med. Sci., 28:62\u201366.","journal-title":"J. Korean Med. Sci."},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10096-007-0279-3"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/45.3.363"},{"key":"e_1_3_3_13_2","doi-asserted-by":"crossref","first-page":"3079","DOI":"10.1128\/AAC.44.11.3079-3086.2000","article-title":"Cloning and characterization of SmeDEF, a novel multidrug efflux pump from Stenotrophomonas maltophilia","volume":"44","author":"Alonso A.","year":"2000","unstructured":"Alonso A., , and Martinez J.L. 2000. Cloning and characterization of SmeDEF, a novel multidrug efflux pump from Stenotrophomonas maltophilia. Antimicrob. Agents Chemother., 44:3079\u20133086.","journal-title":"Antimicrob. Agents Chemother."},{"key":"e_1_3_3_14_2","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1128\/AAC.46.2.333-343.2002","article-title":"SmeC, an outer membrane multidrug efflux protein of Stenotrophomonas maltophilia","volume":"46","author":"Li X.Z.","year":"2002","unstructured":"Li X.Z., , Zhang L., , and Poole K. 2002. SmeC, an outer membrane multidrug efflux protein of Stenotrophomonas maltophilia. Antimicrob. Agents Chemother., 46:333\u2013343.","journal-title":"Antimicrob. Agents Chemother."},{"key":"e_1_3_3_15_2","doi-asserted-by":"crossref","first-page":"3386","DOI":"10.1128\/AAC.46.11.3386-3393.2002","article-title":"Cloning and characterization of SmeT, a repressor of the Stenotrophomonas maltophilia multidrug efflux pump SmeDEF","volume":"46","author":"Sanchez P.","year":"2002","unstructured":"Sanchez P., , Alonso A., , and Martinez J.L. 2002. Cloning and characterization of SmeT, a repressor of the Stenotrophomonas maltophilia multidrug efflux pump SmeDEF. Antimicrob. Agents Chemother., 46:3386\u20133393.","journal-title":"Antimicrob. Agents Chemother."},{"key":"e_1_3_3_16_2","doi-asserted-by":"crossref","first-page":"2274","DOI":"10.1128\/AAC.48.6.2274-2276.2004","article-title":"Regulatory regions of smeDEF in Stenotrophomonas maltophilia strains expressing different amounts of the multidrug efflux pump SmeDEF","volume":"48","author":"Sanchez P.","year":"2004","unstructured":"Sanchez P., , Alonso A., , and Martinez J.L. 2004. Regulatory regions of smeDEF in Stenotrophomonas maltophilia strains expressing different amounts of the multidrug efflux pump SmeDEF. Antimicrob. Agents Chemother., 48:2274\u20132276.","journal-title":"Antimicrob. Agents Chemother."},{"key":"e_1_3_3_17_2","doi-asserted-by":"crossref","first-page":"e1002103","DOI":"10.1371\/journal.ppat.1002103","article-title":"The binding of triclosan to SmeT, the repressor of the multidrug efflux pump SmeDEF, induces antibiotic resistance in Stenotrophomonas maltophilia","volume":"7","author":"Hernandez A.","year":"2011","unstructured":"Hernandez A., , Ruiz F.M., , Romero A., , and Martinez J.L. 2011. The binding of triclosan to SmeT, the repressor of the multidrug efflux pump SmeDEF, induces antibiotic resistance in Stenotrophomonas maltophilia. PLoS Pathog., 7:e1002103.","journal-title":"PLoS Pathog."},{"key":"e_1_3_3_18_2","unstructured":"CLSI. 2011. Performance standards for antimicrobial susceptibility testing; 21st informational supplement M100-S21. Clinical and Laboratory Standards Institute Wayne PA."},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.45.6.1879-1881.2001"},{"key":"e_1_3_3_20_2","doi-asserted-by":"crossref","first-page":"3497","DOI":"10.1128\/AAC.45.12.3497-3503.2001","article-title":"SmeDEF multidrug efflux pump contributes to intrinsic multidrug resistance in Stenotrophomonas maltophilia","volume":"45","author":"Zhang L.","year":"2001","unstructured":"Zhang L., , Li X.Z., , and Poole K. 2001. SmeDEF multidrug efflux pump contributes to intrinsic multidrug resistance in Stenotrophomonas maltophilia. Antimicrob. Agents Chemother., 45:3497\u20133503.","journal-title":"Antimicrob. Agents Chemother."},{"key":"e_1_3_3_21_2","doi-asserted-by":"crossref","first-page":"38","DOI":"10.3343\/alm.2012.32.1.38","article-title":"Expression of Sme efflux pumps and multilocus sequence typing in clinical isolates of Stenotrophomonas maltophilia","volume":"32","author":"Cho H.H.","year":"2012","unstructured":"Cho H.H., , Sung J.Y., , Kwon K.C., , and Koo S.H. 2012. Expression of Sme efflux pumps and multilocus sequence typing in clinical isolates of Stenotrophomonas maltophilia. Ann. Lab. Med., 32:38\u201343.","journal-title":"Ann. Lab. Med."}],"container-title":["Microbial Drug Resistance"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1089\/mdr.2015.0228","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/mdr.2015.0228","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/mdr.2015.0228","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T20:29:53Z","timestamp":1777667393000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/full\/10.1089\/mdr.2015.0228"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,3]]},"references-count":20,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2017,3]]}},"alternative-id":["10.1089\/mdr.2015.0228"],"URL":"https:\/\/doi.org\/10.1089\/mdr.2015.0228","relation":{},"ISSN":["1076-6294","1931-8448"],"issn-type":[{"value":"1076-6294","type":"print"},{"value":"1931-8448","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,3]]}}}