{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T11:39:17Z","timestamp":1790768357547,"version":"4.1.0"},"reference-count":34,"publisher":"American Society for Microbiology","issue":"9","license":[{"start":{"date-parts":[[2004,9,1]],"date-time":"2004-09-01T00:00:00Z","timestamp":1093996800000},"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":[[2004,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n          <jats:p>\n            The aim of this study was to determine whether there is an association between serum resistance, O serotypes, and the production of extended-spectrum \u03b2-lactamases (ESBLs) in\n            <jats:italic>Klebsiella pneumoniae<\/jats:italic>\n            . Ninety ESBL-producing and 178 non-ESBL-producing\n            <jats:italic>K. pneumoniae<\/jats:italic>\n            isolates gathered in five European countries were O serotyped and tested for sensitivity to the serum's bactericidal effect. The frequency of serum-resistant isolates was higher among ESBL-producing strains (30%; 27\/90 isolates) than among non-ESBL-producing strains (17.9%; 32\/178 isolates) (\n            <jats:italic>P<\/jats:italic>\n            = 0.037; odds ratio [OR] = 1.96; 95% confidence interval [95% CI] = 1.08 to 3.53). Although O1 was the most common O serotype in both\n            <jats:italic>Klebsiella<\/jats:italic>\n            groups, its frequency among ESBL-producing strains was significantly higher (59%; 53\/90 isolates) than among non-ESBL producers (36%; 64\/178 isolates) (\n            <jats:italic>P<\/jats:italic>\n            = 0.0006; OR = 2.5; 95% CI = 1.52 to 4.29). Furthermore, the prevalence of the O1 serotype was higher among serum-resistant strains of both ESBL-producing (74%; 20\/27isolates) and non-ESBL producers (75%; 24\/32 isolates) than among serum-sensitive ESBL producers (52.4%; 33\/63 isolates) and non-ESBL producers (27.4%; 40\/146 isolates). Serum resistance among ESBL-producing strains (36%; 17\/47 isolates) versus non-ESBL-producing strains (16%; 27\/166 isolates) was also significantly higher after the exclusion of clonal strains (\n            <jats:italic>P<\/jats:italic>\n            = 0.0056; OR = 2.9; 95% CI = 1.41 to 6.01). Sixteen ESBL types were detected, among which the frequency of serum resistance was significantly lower among the SHV-producing strains (9\/48 isolates) than among the TEM producers (16\/35 isolates) (\n            <jats:italic>P<\/jats:italic>\n            = 0.016; OR = 3.65; CI = 1.3 to 9.7). Curing ESBL-coding plasmids did not influence the serum resistance of the bacteria; all six plasmid-cured derivatives maintained serum resistance. The present findings suggest that ESBL-producing strains have a greater pathogenic potential than non-ESBL-producing strains, but the linkage between O serotypes, serum resistance, and ESBL production remains unclear at this stage.\n          <\/jats:p>","DOI":"10.1128\/aac.48.9.3477-3482.2004","type":"journal-article","created":{"date-parts":[[2004,8,24]],"date-time":"2004-08-24T19:12:57Z","timestamp":1093374777000},"page":"3477-3482","update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":45,"title":["Increased Serum Resistance in\n            <i>Klebsiella pneumoniae<\/i>\n            Strains Producing Extended-Spectrum \u03b2-Lactamases"],"prefix":"10.1128","volume":"48","author":[{"given":"H.","family":"Sahly","sequence":"first","affiliation":[{"name":"Department of Medical Microbiology and Virology, University of Kiel, Kiel, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H.","family":"Aucken","sequence":"additional","affiliation":[{"name":"Central Public Health Laboratory, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V. J.","family":"Benedi\u0301","sequence":"additional","affiliation":[{"name":"Area de Microbiologia, Departmento de Biologia, Universidad de las Islas Baleares, Palma de Mallorca"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Forestier","sequence":"additional","affiliation":[{"name":"Laboratoire de Bacte\u0301riologie, Faculte\u0301s de Me\u0301decine-Pharmacie, Clermont-Ferrand, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V.","family":"Fussing","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal Infections, Statens Serum Institut, Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D. S.","family":"Hansen","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal Infections, Statens Serum Institut, Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I.","family":"Ofek","sequence":"additional","affiliation":[{"name":"Department of Human Microbiology, University of Tel Aviv, Tel Aviv, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Podschun","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology and Virology, University of Kiel, Kiel, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.","family":"Sirot","sequence":"additional","affiliation":[{"name":"Laboratoire de Bacte\u0301riologie, Faculte\u0301s de Me\u0301decine-Pharmacie, Clermont-Ferrand, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. 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