{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T12:57:10Z","timestamp":1790773030150,"version":"4.1.0"},"reference-count":35,"publisher":"SAGE Publications","issue":"8","license":[{"start":{"date-parts":[[2019,10,1]],"date-time":"2019-10-01T00:00:00Z","timestamp":1569888000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2019,10,1]],"date-time":"2019-10-01T00:00:00Z","timestamp":1569888000000},"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":[[2019,10,1]]},"abstract":"<jats:p>\n                    Nosocomial infections caused by\n                    <jats:italic toggle=\"yes\">Klebsiella pneumoniae<\/jats:italic>\n                    are primarily characterized by a high prevalence of extended-spectrum \u03b2-lactamases (ESBL's) and a soaring pace of carbapenemase dissemination. Availability of limited antimicrobial agents as a therapeutic option for multidrug-resistant bacteria raises an alarming concern. This study aimed at the molecular characterization of multidrug-resistant\n                    <jats:italic toggle=\"yes\">K. pneumoniae<\/jats:italic>\n                    clinical isolates and studied the role of efflux pumps in \u03b2-lactam resistance. Thirty-three isolates confirmed as ESBL-positive\n                    <jats:italic toggle=\"yes\">K. pneumoniae<\/jats:italic>\n                    that harbored resistance genes to major classes of antibiotics. The results showed that CTX-M15 was the preeminent \u03b2-lactamase along with carbapenemases in ESBL-positive isolates. However, the efficacy of different antibiotics varied in the presence of lactamase inhibitors and efflux pump inhibitors (EPIs). Those showing increased efficacy of antibiotics with EPI were further explored for the expression of efflux pump genes and expressed a significantly different level of efflux pumps. We found that an isolate had higher expression of\n                    <jats:italic toggle=\"yes\">kpnF<\/jats:italic>\n                    (SMR family) and\n                    <jats:italic toggle=\"yes\">kdeA<\/jats:italic>\n                    (MATE family) pump genes relative to RND family pump genes. No mutations were observed in the genes for porins. Together, the findings suggest that \u03b2-lactamases are not the only single factor responsible for providing resistance against the existing \u03b2-lactam drugs. Resistance may increase many folds by simultaneous expression of RND family (the most prominent family in Gram-negative bacteria) and other efflux pump family.\n                  <\/jats:p>","DOI":"10.1089\/mdr.2018.0414","type":"journal-article","created":{"date-parts":[[2019,10,15]],"date-time":"2019-10-15T13:19:45Z","timestamp":1571145585000},"page":"1155-1163","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":51,"title":["Alliance of Efflux Pumps with \u03b2-Lactamases in Multidrug-Resistant\n                    <i>Klebsiella pneumoniae<\/i>\n                    Isolates"],"prefix":"10.1177","volume":"25","author":[{"given":"Navdezda","family":"Maurya","sequence":"first","affiliation":[{"name":"Bioactive Screening &amp; Clinical Microbiology Laboratory, CSIR-Institute of Microbial Technology, Chandigarh, India."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manoj","family":"Jangra","sequence":"additional","affiliation":[{"name":"Bioactive Screening &amp; Clinical Microbiology Laboratory, CSIR-Institute of Microbial Technology, Chandigarh, India."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rushikesh","family":"Tambat","sequence":"additional","affiliation":[{"name":"Bioactive Screening &amp; Clinical Microbiology Laboratory, CSIR-Institute of Microbial Technology, Chandigarh, India."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hemraj","family":"Nandanwar","sequence":"additional","affiliation":[{"name":"Bioactive Screening &amp; Clinical Microbiology Laboratory, CSIR-Institute of Microbial Technology, Chandigarh, India."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2019,10,11]]},"reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0115185"},{"key":"e_1_3_5_3_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00715-09"},{"key":"e_1_3_5_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(14)70780-7"},{"key":"e_1_3_5_5_2","unstructured":"CDDEP Center for Disease Dynamics Economics & Policy. 2015. ResistanceMap. Available at https:\/\/resistancemap.cddep.org\/AntibioticResistance.php."},{"key":"e_1_3_5_6_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1574-6976.2011.00290.x"},{"key":"e_1_3_5_7_2","doi-asserted-by":"publisher","DOI":"10.1128\/MMBR.67.4.593-656.2003"},{"key":"e_1_3_5_8_2","doi-asserted-by":"publisher","DOI":"10.1038\/nrmicro1994"},{"key":"e_1_3_5_9_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0004817"},{"key":"e_1_3_5_10_2","doi-asserted-by":"publisher","DOI":"10.2165\/11317030-000000000-00000"},{"key":"e_1_3_5_11_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00725-13"},{"key":"e_1_3_5_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.gene.2012.02.008"},{"key":"e_1_3_5_13_2","doi-asserted-by":"publisher","DOI":"10.1248\/bpb.30.1962"},{"key":"e_1_3_5_14_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.02284-12"},{"key":"e_1_3_5_15_2","doi-asserted-by":"publisher","DOI":"10.1128\/AEM.02869-05"},{"key":"e_1_3_5_16_2","doi-asserted-by":"publisher","DOI":"10.1093\/ajcp\/45.4_ts.493"},{"key":"e_1_3_5_17_2","unstructured":"CLSI. 2019. Performance Standards for Antimicrobial Susceptibility Testing. 29th ed. CLSI supplement M100. Wayne PA."},{"key":"e_1_3_5_18_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.43.8.4178-4182.2005"},{"key":"e_1_3_5_19_2","doi-asserted-by":"publisher","DOI":"10.1128\/jcm.24.3.330-332.1986"},{"key":"e_1_3_5_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbapap.2008.12.011"},{"key":"e_1_3_5_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(10)70143-2"},{"key":"e_1_3_5_22_2","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkl422"},{"key":"e_1_3_5_23_2","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkf240"},{"key":"e_1_3_5_24_2","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.00001-07"},{"key":"e_1_3_5_25_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.01497-10"},{"key":"e_1_3_5_26_2","doi-asserted-by":"publisher","DOI":"10.3201\/eid0705.010528"},{"key":"e_1_3_5_27_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1574-6976.2008.00157.x"},{"key":"e_1_3_5_28_2","doi-asserted-by":"publisher","DOI":"10.1099\/jmm.0.000299"},{"key":"e_1_3_5_29_2","doi-asserted-by":"publisher","DOI":"10.1002\/cem.867"},{"key":"e_1_3_5_30_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.38.3.1048-1052.2000"},{"key":"e_1_3_5_31_2","doi-asserted-by":"publisher","DOI":"10.1128\/JB.181.9.2726-2732.1999"},{"key":"e_1_3_5_32_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.02045-12"},{"key":"e_1_3_5_33_2","first-page":"759","article-title":"TEM & SHV genes in extended spectrum [beta]-lactamase producing Klebsiella species & their antimicrobial resistance pattern","volume":"128","author":"Jain A.","year":"2008","unstructured":"Jain A., , and Mondal R. 2008. TEM & SHV genes in extended spectrum [beta]-lactamase producing Klebsiella species & their antimicrobial resistance pattern. Indian J. Med. Res. 128:759.","journal-title":"Indian J. Med. Res"},{"key":"e_1_3_5_34_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.42.12.5715-5721.2004"},{"key":"e_1_3_5_35_2","doi-asserted-by":"publisher","DOI":"10.3855\/jidc.2268"},{"key":"e_1_3_5_36_2","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkp029"}],"container-title":["Microbial Drug Resistance"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1089\/mdr.2018.0414","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/mdr.2018.0414","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/mdr.2018.0414","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T20:34:33Z","timestamp":1777667673000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1089\/mdr.2018.0414"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,10,1]]},"references-count":35,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2019,10,1]]}},"alternative-id":["10.1089\/mdr.2018.0414"],"URL":"https:\/\/doi.org\/10.1089\/mdr.2018.0414","relation":{},"ISSN":["1076-6294","1931-8448"],"issn-type":[{"value":"1076-6294","type":"print"},{"value":"1931-8448","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,10,1]]}}}