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We have previously shown that the presence or absence of transmissible antibiotic resistance genes has excellent predictive power for phenotype. In this study, we analyzed the distribution of six \u03b2-lactam antibiotic susceptibility phenotypes associated with commonly acquired resistance genes in\n            <jats:named-content content-type=\"genus-species\">Enterobacteriaceae<\/jats:named-content>\n            in Sydney, Australia.\n            <jats:named-content content-type=\"genus-species\">Escherichia coli<\/jats:named-content>\n            (\n            <jats:italic>n<\/jats:italic>\n            = 200) and\n            <jats:named-content content-type=\"genus-species\">Klebsiella pneumoniae<\/jats:named-content>\n            (\n            <jats:italic>n<\/jats:italic>\n            = 178) clinical isolates, with relevant transmissible resistance genes (\n            <jats:italic>bla<\/jats:italic>\n            <jats:sub>TEM<\/jats:sub>\n            ,\n            <jats:italic>n<\/jats:italic>\n            = 33; plasmid AmpC,\n            <jats:italic>n<\/jats:italic>\n            = 69; extended-spectrum \u03b2-lactamase [ESBL],\n            <jats:italic>n<\/jats:italic>\n            = 116; and carbapenemase,\n            <jats:italic>n<\/jats:italic>\n            = 100), were characterized. A group of 60 isolates with no phenotypic resistance to any antibiotics tested and carrying none of the important \u03b2-lactamase genes served as comparators. The MICs for all drug-bacterium combinations had a normal distribution, varying only in the presence of additional genes relevant to the phenotype or, for ertapenem resistance in\n            <jats:named-content content-type=\"genus-species\">K. pneumoniae<\/jats:named-content>\n            , with a loss or change in the outer membrane porin protein OmpK36. We demonstrated mutations in\n            <jats:italic>ompK36<\/jats:italic>\n            or absence of OmpK36 in all isolates in which reduced susceptibility to ertapenem (MIC, &gt;1 mg\/liter) was evident. Ertapenem nonsusceptibility in\n            <jats:named-content content-type=\"genus-species\">K. pneumoniae<\/jats:named-content>\n            was most common in the context of an OmpK36 variant with an ESBL or AmpC gene. Surveillance strategies to define appropriate antimicrobial therapies should include genotype-phenotype relationships for all major transmissible resistance genes and the characterization of mutations in relevant porins in organisms, like\n            <jats:named-content content-type=\"genus-species\">K. pneumoniae<\/jats:named-content>\n            .\n          <\/jats:p>","DOI":"10.1128\/jcm.02153-15","type":"journal-article","created":{"date-parts":[[2016,2,25]],"date-time":"2016-02-25T04:36:33Z","timestamp":1456374993000},"page":"1243-1250","update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":27,"title":["Predictability of Phenotype in Relation to Common \u03b2-Lactam Resistance Mechanisms in Escherichia coli and Klebsiella pneumoniae"],"prefix":"10.1128","volume":"54","author":[{"given":"Alex","family":"Agyekum","sequence":"first","affiliation":[{"name":"Centre for Infectious Diseases and Microbiology, The Westmead 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