{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T09:36:55Z","timestamp":1790674615719,"version":"4.1.0"},"reference-count":28,"publisher":"American Society for Microbiology","issue":"2","license":[{"start":{"date-parts":[[2012,2,1]],"date-time":"2012-02-01T00:00:00Z","timestamp":1328054400000},"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":["J Clin Microbiol"],"published-print":{"date-parts":[[2012,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n          <jats:p>\n            The emergence of carbapenem resistance in\n            <jats:named-content content-type=\"genus-species\">Enterobacteriaceae<\/jats:named-content>\n            has become a great concern. The aim of this study was to characterize ertapenem-resistant\n            <jats:named-content content-type=\"genus-species\">Enterobacter cloacae<\/jats:named-content>\n            isolates from a Taiwanese university hospital. A total of 355 nonduplicated\n            <jats:named-content content-type=\"genus-species\">E. cloacae<\/jats:named-content>\n            isolates collected in 2007 were analyzed by antimicrobial susceptibility testing with and without an inhibitor of efflux pumps and AmpC \u03b2-lactamase. The phenotype of extended-spectrum \u03b2-lactamase (ESBL), profile of outer membrane proteins (OMPs), and clonal relatedness were investigated by the double-disk synergy test, urea\/SDS-PAGE, and pulsed-field gel electrophoresis (PFGE), respectively. \u03b2-Lactamase genes were examined by PCR and sequencing, and the expression of efflux pump gene\n            <jats:italic>acrB<\/jats:italic>\n            was evaluated by reverse transcription-PCR. The contribution of porin deficiency to resistance was investigated by restoring functional porin genes on plasmids. We demonstrated that ertapenem resistance was prevalent (53\/355; 14.9%) in\n            <jats:named-content content-type=\"genus-species\">E. cloacae<\/jats:named-content>\n            . Among the strains, IMP-8, SHV-12, and TEM-1 \u03b2-lactamases were identified in 3 (5.7%), 40 (75.5%), and 46 (86.8%) isolates, respectively. PFGE showed clonal diversity among these isolates. Phenotypes of ESBL, AmpC \u03b2-lactamase overproduction, an active efflux pump, and change in the expression of OMPs were found in 18 (34%), 11 (20.8%), 51 (96.2%), and 23 (43.4%) of ertapenem-resistant strains, respectively. Ertapenem MICs were restored in strains with OmpC and OmpF expression plasmids. This study suggests that ESBL, AmpC \u03b2-lactamase overproduction, and decreased OMP expression combined with an active efflux pump contribute to the ertapenem resistance of\n            <jats:named-content content-type=\"genus-species\">E. cloacae<\/jats:named-content>\n            . The presence of IMP-8 may also play a partial role in ertapenem resistance in Taiwan.\n          <\/jats:p>","DOI":"10.1128\/jcm.01263-11","type":"journal-article","created":{"date-parts":[[2011,12,2]],"date-time":"2011-12-02T13:55:54Z","timestamp":1322834154000},"page":"223-226","update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":66,"title":["Characterization of Ertapenem-Resistant Enterobacter cloacae in a Taiwanese University Hospital"],"prefix":"10.1128","volume":"50","author":[{"given":"Fu-Chen","family":"Yang","sequence":"first","affiliation":[{"name":"Department of Medical Laboratory Science and Biotechnology, College of Medicine, National Cheng Kung University, National Cheng Kung University, National Cheng Kung University Hospital, Tainan, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing-Jou","family":"Yan","sequence":"additional","affiliation":[{"name":"Department of Pathology, National Cheng Kung University Hospital, Tainan, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kuei-Hsiang","family":"Hung","sequence":"additional","affiliation":[{"name":"Department of Medical Laboratory Science and Biotechnology, College of Medicine, National Cheng Kung University, National Cheng Kung University, National Cheng Kung University Hospital, Tainan, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiunn-Jong","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Medical Laboratory Science and Biotechnology, College of Medicine, National Cheng Kung University, National Cheng Kung University, National Cheng Kung University Hospital, Tainan, Taiwan"},{"name":"Research Center for Medical Laboratory Biotechnology, College of Medicine, National Cheng Kung University, National Cheng Kung University, National Cheng Kung University Hospital, Tainan, Taiwan"},{"name":"Center for Infectious Disease and Signaling Research, National Cheng Kung University, National Cheng Kung University Hospital, Tainan, Taiwan"},{"name":"Department of Pathology, National Cheng Kung University Hospital, Tainan, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.47.12.3989-3993.2003"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00931-08"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.resmic.2008.09.003"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.00197-07"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.01497-10"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jinf.2011.02.009"},{"key":"e_1_3_2_8_2","unstructured":"Clinical and Laboratory Standards Institute. \n2009. \nPerformance standards for antimicrobial disk susceptibility tests; M02-A10 approved standard 10th ed. \nClinical and Laboratory Standards Institute Wayne PA."},{"key":"e_1_3_2_9_2","unstructured":"Clinical and Laboratory Standards Institute. \n2009. \nMethods for dilution antimicrobial susceptibility tests for bacteria that grow aerobically; M07-A8 approved standard 8th ed. \nClinical and Laboratory Standards Institute Wayne PA."},{"key":"e_1_3_2_10_2","unstructured":"Clinical and Laboratory Standards Institute. \n2011. \nPerformance standards for antimicrobial susceptibility testing 21st informational supplement M100-S21. \nClinical and Laboratory Standards Institute Wayne PA."},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.39.2.350"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkp029"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.01193-09"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00055-10"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.molmed.2005.06.006"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1038\/nrmicro1464"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dki296"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.00001-07"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00574-09"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkq388"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.10.2.220"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.01591-05"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.33.9.2233-2239.1995"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.38.2.542-546.2000"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijantimicag.2006.11.020"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkf170"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.diagmicrobio.2004.01.002"},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijantimicag.2010.09.001"},{"key":"e_1_3_2_29_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-0691.2006.01384.x"}],"container-title":["Journal of Clinical Microbiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.asm.org\/doi\/pdf\/10.1128\/JCM.01263-11","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.asm.org\/doi\/pdf\/10.1128\/JCM.01263-11","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,3,5]],"date-time":"2022-03-05T11:01:54Z","timestamp":1646478114000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.asm.org\/doi\/10.1128\/JCM.01263-11"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2012,2]]},"references-count":28,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2012,2]]}},"alternative-id":["10.1128\/JCM.01263-11"],"URL":"https:\/\/doi.org\/10.1128\/jcm.01263-11","relation":{},"ISSN":["0095-1137","1098-660X"],"issn-type":[{"value":"0095-1137","type":"print"},{"value":"1098-660X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2012,2]]},"assertion":[{"value":"2011-06-27","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2011-11-22","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2012-01-20","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}