{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T22:53:28Z","timestamp":1793746408020,"version":"4.6.1"},"reference-count":46,"publisher":"SAGE Publications","issue":"10","license":[{"start":{"date-parts":[[2021,10,1]],"date-time":"2021-10-01T00:00:00Z","timestamp":1633046400000},"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":[[2021,10]]},"abstract":"<jats:p>\n                    A clinically isolated pan-resistant\n                    <jats:italic toggle=\"yes\">Klebsiella pneumoniae<\/jats:italic>\n                    strain (ST11), KPN142 was subjected to whole-genome sequencing. Genomic sequence of KPN142 showed that limited antibiotic resistances (\u03b2-lactams [\n                    <jats:italic toggle=\"yes\">\n                      bla\n                      <jats:sub>shv-11<\/jats:sub>\n                    <\/jats:italic>\n                    ], sulfonamides [\n                    <jats:italic toggle=\"yes\">sul1<\/jats:italic>\n                    and\n                    <jats:italic toggle=\"yes\">dfrA22<\/jats:italic>\n                    ], bacitracin [\n                    <jats:italic toggle=\"yes\">bacA<\/jats:italic>\n                    ], tetracycline [\n                    <jats:italic toggle=\"yes\">tet34<\/jats:italic>\n                    ], aminoglycosides [\n                    <jats:italic toggle=\"yes\">ksgA<\/jats:italic>\n                    ,\n                    <jats:italic toggle=\"yes\">kdpE<\/jats:italic>\n                    ,\n                    <jats:italic toggle=\"yes\">aph(3)Ia<\/jats:italic>\n                    ,\n                    <jats:italic toggle=\"yes\">aac(3)III<\/jats:italic>\n                    , and\n                    <jats:italic toggle=\"yes\">ant(3)Ia<\/jats:italic>\n                    ], and chloramphenicol [\n                    <jats:italic toggle=\"yes\">catA1<\/jats:italic>\n                    ]) were mediated by enzymes, and efflux pumps contributed most to pan resistance. Five types of multidrug resistance efflux pump families were identified, including the resistance nodulation division superfamily (AcrAB-TolC, AcrD, MdtABC, and KexD), the ATP-binding cascade superfamily (MacAB), the small multidrug resistance family (KpnEF), the multidrug and toxic compound extrusion family (KdeA), and the major facilitator superfamily (EmrAB). There was an AcrAB-TolC efflux pump system, and inhibitory regulatory gene\n                    <jats:italic toggle=\"yes\">acrR<\/jats:italic>\n                    and\n                    <jats:italic toggle=\"yes\">ramR<\/jats:italic>\n                    of system carried deletion mutation, which lead to overexpression of AcrAB-TolC efflux pump, and in turn plays key role in the pan resistance of KPN142. Moreover, we did not find\n                    <jats:italic toggle=\"yes\">mgrb<\/jats:italic>\n                    , a suppressor in the expression of\n                    <jats:italic toggle=\"yes\">phoPQ<\/jats:italic>\n                    , overexpression of which may confer the resistance of KPN142 to colistin B. In addition,\n                    <jats:italic toggle=\"yes\">K. pneumoniae<\/jats:italic>\n                    KPN142 carries IS1, IS3, and\n                    <jats:italic toggle=\"yes\">IntI1<\/jats:italic>\n                    , which means that KPN142 is able to transfer drug-resistance genes. Of note, we detected the overexpression of\n                    <jats:italic toggle=\"yes\">acrB<\/jats:italic>\n                    ,\n                    <jats:italic toggle=\"yes\">ramA<\/jats:italic>\n                    ,\n                    <jats:italic toggle=\"yes\">phoP<\/jats:italic>\n                    , and\n                    <jats:italic toggle=\"yes\">phoQ<\/jats:italic>\n                    by real-time quantitative reverse transcription\u2013polymerase chain reaction, and carbonyl cyanide chlorophenylhydrazone was able to reverse the resistance patterns of\n                    <jats:italic toggle=\"yes\">K. pneumoniae<\/jats:italic>\n                    KPN142. In conclusion, we consider that the overexpression of AcrAB-TolC efflux pump mediates the resistance to most common clinical antimicrobial agents, and the overexpression of\n                    <jats:italic toggle=\"yes\">phoPQ<\/jats:italic>\n                    mediates the resistance to colistin B in\n                    <jats:italic toggle=\"yes\">K. pneumoniae<\/jats:italic>\n                    KPN142.\n                  <\/jats:p>","DOI":"10.1089\/mdr.2020.0395","type":"journal-article","created":{"date-parts":[[2021,4,9]],"date-time":"2021-04-09T15:33:30Z","timestamp":1617982410000},"page":"1405-1411","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":42,"title":["Overexpression of Efflux Pumps Mediate Pan Resistance of\n                    <i>Klebsiella pneumoniae<\/i>\n                    Sequence Type 11"],"prefix":"10.1177","volume":"27","author":[{"given":"Fei","family":"Lv","sequence":"first","affiliation":[{"name":"Department of Microbiology and Immunology, College of Basic Medicine, Guangdong Medical University, Zhanjiang, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingjing","family":"Cai","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Affiliated Hospital of Guangdong Medical University, Zhanjiang, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qixia","family":"He","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Affiliated Hospital of Guangdong Medical University, Zhanjiang, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"WeiQi","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Microbiology and Immunology, College of Basic Medicine, Guangdong Medical University, Zhanjiang, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi","family":"Luo","sequence":"additional","affiliation":[{"name":"Department of Microbiology and Immunology, College of Basic Medicine, Guangdong Medical University, Zhanjiang, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Microbiology and Immunology, College of Basic Medicine, Guangdong Medical University, Zhanjiang, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Na","family":"Mi","sequence":"additional","affiliation":[{"name":"Department of Microbiology and Immunology, College of Basic Medicine, Guangdong Medical University, Zhanjiang, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zuguo","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Microbiology and Immunology, College of Basic Medicine, Guangdong Medical University, Zhanjiang, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guoming","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Microbiology and Immunology, College of Basic Medicine, Guangdong Medical University, Zhanjiang, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenying","family":"Luo","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2021,10,14]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"crossref","first-page":"1811","DOI":"10.1086\/430381","article-title":"Efflux pumps and nosocomial antibiotic resistance: a primer for hospital epidemiologists","volume":"40","author":"Hooper, D.C","year":"2005","unstructured":"Hooper, D.C. 2005. 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