{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,9]],"date-time":"2026-05-09T13:59:39Z","timestamp":1778335179393,"version":"3.51.4"},"reference-count":35,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2018,7,1]],"date-time":"2018-07-01T00:00:00Z","timestamp":1530403200000},"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":[[2018,7]]},"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>\n                      The current investigation explores whether extended-spectrum \u03b2-lactamase (ESBL) genes exist in clinical non-ESBL\u2013producing\n                      <jats:italic toggle=\"yes\">Klebsiella pneumoniae<\/jats:italic>\n                      isolates.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      A total of 202 clinical isolates with non-ESBL\u2013producing\n                      <jats:italic toggle=\"yes\">K. pneumoniae<\/jats:italic>\n                      were collected from southern and middle of China. Thirteen \u03b2-lactamase genes (\n                      <jats:italic toggle=\"yes\">bla<\/jats:italic>\n                      <jats:sub>SHV<\/jats:sub>\n                      ,\n                      <jats:sub>CTX-M<\/jats:sub>\n                      ,\n                      <jats:sub>TEM<\/jats:sub>\n                      ,\n                      <jats:sub>OXA-2<\/jats:sub>\n                      ,\n                      <jats:sub>OXA-10<\/jats:sub>\n                      ,\n                      <jats:sub>VEB<\/jats:sub>\n                      ,\n                      <jats:sub>PER<\/jats:sub>\n                      ,\n                      <jats:sub>SFO<\/jats:sub>\n                      ,\n                      <jats:sub>GES<\/jats:sub>\n                      ,\n                      <jats:sub>CSP<\/jats:sub>\n                      ,\n                      <jats:sub>TLA<\/jats:sub>\n                      ,\n                      <jats:sub>BEL<\/jats:sub>\n                      ,\n                      <jats:sub>and IBC<\/jats:sub>\n                      ) were screened by PCR and their identity confirmed by sequencing of PCR products. The ESBL-producing phenotype of the isolates that carried ESBL genes was tested and confirmed in 9 of the 18 isolates by a double-disc synergy test. The sequences upstream of ESBL genes of isolates with ESBL-producing genotype (+)\/phenotype (\u2212) were also subjected to PCR and sequencing. The ESBL genes and their upstream regions were cloned into\n                      <jats:italic toggle=\"yes\">Escherichia coli<\/jats:italic>\n                      DH5\u03b1 for functional evaluation.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      A total of 8.9% (18\/202) isolates carried ESBL genes. All of them harbored only one ESBL gene, including 33.3% (6\/18)\n                      <jats:italic toggle=\"yes\">bla<\/jats:italic>\n                      <jats:sub>SHV<\/jats:sub>\n                      and 66.7% (12\/18)\n                      <jats:italic toggle=\"yes\">bla<\/jats:italic>\n                      <jats:sub>CTX-M<\/jats:sub>\n                      . Among the isolates carrying ESBL genes, nine isolates were confirmed as ESBL phenotype (\u2212). The ESBL genotype (+)\/phenotype (\u2212) isolates had\n                      <jats:italic toggle=\"yes\">bla<\/jats:italic>\n                      <jats:sub>SHV-27,38,41,42<\/jats:sub>\n                      (66.7%, 6\/9) and\n                      <jats:italic toggle=\"yes\">bla<\/jats:italic>\n                      <jats:sub>CTX-M-3,15,24<\/jats:sub>\n                      (33.3%, 3\/9). The upstream gene sequences, including promoters of these unexpressed ESBL genes, were intact without any mutations or spacers and effective among eight strains. The IS\n                      <jats:italic toggle=\"yes\">Ecp1<\/jats:italic>\n                      element in the upstream region was not found in one isolate carrying an unexpressed\n                      <jats:italic toggle=\"yes\">bla<\/jats:italic>\n                      <jats:sub>CTX-M-15<\/jats:sub>\n                      gene.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>\n                      Clinical non-ESBL\u2013producing\n                      <jats:italic toggle=\"yes\">K. pneumoniae<\/jats:italic>\n                      isolates could carry ESBL genes with intact promoter, but without the correlated phenotype. Specific silencing mechanisms may play an important role in regulating ESBL gene expression. This kind of isolates has the potential to transfer their ESBL genes to other bacteria with effective promoters, resulting in ESBL phenotype.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/mdr.2017.0018","type":"journal-article","created":{"date-parts":[[2017,11,1]],"date-time":"2017-11-01T16:04:57Z","timestamp":1509552297000},"page":"799-806","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":18,"title":["Characterization of Unexpressed Extended-Spectrum Beta-Lactamase Genes in Antibiotic\u2013Sensitive\n                    <i>Klebsiella pneumoniae<\/i>\n                    Isolates"],"prefix":"10.1177","volume":"24","author":[{"given":"Zhao","family":"Zhang","sequence":"first","affiliation":[{"name":"Peking University People's Hospital","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yao","family":"Zhai","sequence":"additional","affiliation":[{"name":"Peking University People's Hospital","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yatao","family":"Guo","sequence":"additional","affiliation":[{"name":"Peking University People's Hospital","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daixi","family":"Li","sequence":"additional","affiliation":[{"name":"Peking University People's Hospital","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhanwei","family":"Wang","sequence":"additional","affiliation":[{"name":"Peking University People's Hospital","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jing","family":"Wang","sequence":"additional","affiliation":[{"name":"The First Affiliated Hospital of Zhengzhou University","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yusheng","family":"Chen","sequence":"additional","affiliation":[{"name":"Fujian Provincial Hospital","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qi","family":"Wang","sequence":"additional","affiliation":[{"name":"The Second Affiliated Hospital to Dalian Medical University","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhancheng","family":"Gao","sequence":"additional","affiliation":[{"name":"Peking University People's Hospital","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2018,7]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"crossref","first-page":"64","DOI":"10.12703\/P6-64","article-title":"Klebsiella: a long way to go towards understanding this enigmatic jet-setter","volume":"6","author":"Broberg C.A.","year":"2014","unstructured":"Broberg C.A., , Palacios M., , and Miller V.L., 2014. 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