{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T11:58:12Z","timestamp":1789905492459,"version":"4.0.1"},"reference-count":42,"publisher":"American Society for Microbiology","issue":"6","license":[{"start":{"date-parts":[[2015,6,1]],"date-time":"2015-06-01T00:00:00Z","timestamp":1433116800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["Antimicrob Agents Chemother"],"published-print":{"date-parts":[[2015,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n          <jats:p>\n            A 22-year-old male developed a recurrent sacral abscess associated with embedded shrapnel following a blast injury. Cultures grew extended-spectrum \u03b2-lactamase (ESBL)-producing, carbapenem-susceptible\n            <jats:named-content xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" content-type=\"genus-species\" xlink:type=\"simple\">Escherichia coli<\/jats:named-content>\n            . Ertapenem was administered, but the infection recurred after each course of antibiotics. Initial surgical interventions were unsuccessful, and subsequent cultures yielded\n            <jats:named-content xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" content-type=\"genus-species\" xlink:type=\"simple\">E. coli<\/jats:named-content>\n            and\n            <jats:named-content xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" content-type=\"genus-species\" xlink:type=\"simple\">Morganella morganii<\/jats:named-content>\n            , both nonsusceptible to carbapenems. The isolates were Carba NP test negative, gave ambiguous results with the modified Hodge test, and amplified the\n            <jats:italic>bla<\/jats:italic>\n            <jats:sub>OXA48<\/jats:sub>\n            -like gene by real-time PCR. All\n            <jats:named-content xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" content-type=\"genus-species\" xlink:type=\"simple\">E. coli<\/jats:named-content>\n            isolates were sequence type 131 (ST131), carried nine resistance genes (including\n            <jats:italic>bla<\/jats:italic>\n            <jats:sub>CTX-M-27<\/jats:sub>\n            ) on an IncF plasmid, and were identical by genome sequencing, except for 150 kb of plasmid DNA in carbapenem-nonsusceptible isolates only. Sixty kilobases of this was shared by\n            <jats:named-content xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" content-type=\"genus-species\" xlink:type=\"simple\">M. morganii<\/jats:named-content>\n            and represented an IncN plasmid harboring\n            <jats:italic>bla<\/jats:italic>\n            <jats:sub>OXA-181<\/jats:sub>\n            . In\n            <jats:named-content xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" content-type=\"genus-species\" xlink:type=\"simple\">M. morganii<\/jats:named-content>\n            , the gene was flanked by IS\n            <jats:italic>3000<\/jats:italic>\n            and IS\n            <jats:italic>Kpn19<\/jats:italic>\n            , but in all but one of the\n            <jats:named-content xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" content-type=\"genus-species\" xlink:type=\"simple\">E. coli<\/jats:named-content>\n            isolates containing\n            <jats:italic>bla<\/jats:italic>\n            <jats:sub>OXA-181<\/jats:sub>\n            , a second copy of IS\n            <jats:italic>Kpn19<\/jats:italic>\n            had inserted adjacent to IS\n            <jats:italic>3000<\/jats:italic>\n            . To the best of our knowledge, this is the first report of\n            <jats:italic>bla<\/jats:italic>\n            <jats:sub>OXA-181<\/jats:sub>\n            in the virulent ST131 clonal group and carried by the promiscuous IncN family of plasmids. The tendency of\n            <jats:named-content xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" content-type=\"genus-species\" xlink:type=\"simple\">M. morganii<\/jats:named-content>\n            to have high MICs of imipenem, a\n            <jats:italic>bla<\/jats:italic>\n            <jats:sub>OXA-181<\/jats:sub>\n            substrate profile that includes penicillins but not extended-spectrum cephalosporins, and weak carbapenemase activity almost resulted in the presence of\n            <jats:italic>bla<\/jats:italic>\n            <jats:sub>OXA-181<\/jats:sub>\n            being overlooked. We highlight the importance of surveillance for carbapenem resistance in all species, even those with intrinsic resistances, and the value of advanced molecular techniques in detecting subtle genetic changes.\n          <\/jats:p>","DOI":"10.1128\/aac.04442-14","type":"journal-article","created":{"date-parts":[[2015,4,14]],"date-time":"2015-04-14T02:22:21Z","timestamp":1428978141000},"page":"3556-3562","update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":45,"title":["War Wound Treatment Complications Due to Transfer of an IncN Plasmid Harboring\n            <i>bla<\/i>\n            <sub>OXA-181<\/sub>\n            from Morganella morganii to CTX-M-27-Producing Sequence Type 131 Escherichia coli"],"prefix":"10.1128","volume":"59","author":[{"given":"Patrick","family":"McGann","sequence":"first","affiliation":[{"name":"Multidrug-Resistant Organism Repository and Surveillance Network, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erik","family":"Snesrud","sequence":"additional","affiliation":[{"name":"Multidrug-Resistant Organism Repository and Surveillance Network, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana C.","family":"Ong","sequence":"additional","affiliation":[{"name":"Multidrug-Resistant Organism Repository and Surveillance Network, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lakshmi","family":"Appalla","sequence":"additional","affiliation":[{"name":"Multidrug-Resistant Organism Repository and Surveillance Network, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Koren","sequence":"additional","affiliation":[{"name":"Infectious Diseases Service, Walter Reed National Military Medical Center, Bethesda, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoon I.","family":"Kwak","sequence":"additional","affiliation":[{"name":"Multidrug-Resistant Organism Repository and Surveillance Network, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paige E.","family":"Waterman","sequence":"additional","affiliation":[{"name":"Multidrug-Resistant Organism Repository and Surveillance Network, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emil P.","family":"Lesho","sequence":"additional","affiliation":[{"name":"Multidrug-Resistant Organism Repository and Surveillance Network, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0b013e31829a0970"},{"key":"e_1_3_3_3_2","unstructured":"Dismounted Complex Blast Injury Task Force. 2011. 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