{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T16:21:21Z","timestamp":1781886081300,"version":"3.54.5"},"reference-count":44,"publisher":"Microbiology Society","issue":"7","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2009,7,1]]},"abstract":"<jats:p>The spread of Gram-negative bacteria with plasmid-borne extended-spectrum<jats:italic>\u03b2<\/jats:italic>-lactamases (ESBLs) has become a worldwide problem. This study analysed a total of 366 ESBL-producing<jats:italic>Enterobacteriaceae<\/jats:italic>strains isolated from non-selected patient specimens at the university hospital of T\u00fcbingen in the period January 2003 to December 2007. Although the overall ESBL rate was comparatively low (1.6\u200a%), the percentages of ESBL-producing<jats:italic>Enterobacter<\/jats:italic>spp. and<jats:italic>Escherichia coli<\/jats:italic>increased from 0.8 and 0.5\u200a%, respectively, in 2003 to 4.6 and 3.8\u200a% in 2007. In particular, the emergence was observed of one carbapenem-resistant ESBL-producing<jats:italic>E. coli<\/jats:italic>isolate and five carbapenem-non-susceptible ESBL-positive<jats:italic>Klebsiella pneumoniae<\/jats:italic>isolates, in two of which carbapenem resistance development was documented<jats:italic>in vivo<\/jats:italic>under a meropenem-containing antibiotic regime. The possible underlying mechanism for this carbapenem resistance in three of the<jats:italic>K. pneumoniae<\/jats:italic>isolates was loss of the<jats:italic>Klebsiella<\/jats:italic>porin channel protein OmpK36 as shown by PCR analysis. The remaining two<jats:italic>K. pneumoniae<\/jats:italic>isolates exhibited increased expression of a tripartite AcrAB\u2013TolC efflux pump as demonstrated by SDS-PAGE and mass spectrometry analysis of bacterial outer-membrane extracts, which, in addition to other unknown mechanisms, may contribute towards increasing the carbapenem MIC values further. Carbapenem-non-susceptible ESBL isolates may pose a new problem in the future due to possible outbreak situations and limited antibiotic treatment options. Therefore, a systematic exploration of intestinal colonization with ESBL isolates should be reconsidered, at least for haemato-oncological departments from where four of the five carbapenem-non-susceptible ESBL isolates originated.<\/jats:p>","DOI":"10.1099\/jmm.0.005850-0","type":"journal-article","created":{"date-parts":[[2009,6,11]],"date-time":"2009-06-11T17:47:00Z","timestamp":1244742420000},"page":"912-922","source":"Crossref","is-referenced-by-count":166,"title":["Emergence of carbapenem-non-susceptible extended-spectrum \u03b2-lactamase-producing Klebsiella pneumoniae isolates at the university hospital of T\u00fcbingen, Germany"],"prefix":"10.1099","volume":"58","author":[{"given":"Sabine","family":"Gr\u00f6bner","sequence":"first","affiliation":[{"name":"Institute of Medical Microbiology and Hygiene, Eberhard Karls University of T\u00fcbingen, Elfriede-Aulhorn-Str. 6, D-72076 T\u00fcbingen, 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