{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T13:13:39Z","timestamp":1791465219377,"version":"4.3.4"},"reference-count":29,"publisher":"American Society for Microbiology","issue":"3","license":[{"start":{"date-parts":[[2012,3,1]],"date-time":"2012-03-01T00:00:00Z","timestamp":1330560000000},"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":[[2012,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n          <jats:p>\n            Heteroresistance to antimicrobial agents may affect susceptibility test results and therapeutic success. In this study, we investigated heteroresistance to cephalosporins and penicillins in\n            <jats:named-content content-type=\"genus-species\">Acinetobacter baumannii<\/jats:named-content>\n            , a major pathogen causing nosocomial infections. Two\n            <jats:named-content content-type=\"genus-species\">A. baumannii<\/jats:named-content>\n            isolates exhibited heteroresistance to ampicillin-sulbactam, ticarcillin-clavulanic acid, cefepime, and cefpirome, showing a distinct colony morphology of circular rings within the inhibition halos. Pulsed-field gel electrophoresis (PFGE) and outer membrane protein (OMP) analysis demonstrated that subpopulations around the disks\/Etest strips and the original strains all belonged to the same PFGE type and OMP profile. Population analysis profile (PAP) showed the presence of heteroresistant subpopulations with high cefepime resistance levels in two isolates (008 and 328). Interestingly,\n            <jats:named-content content-type=\"genus-species\">A. baumannii<\/jats:named-content>\n            008 contained two peaks: one was grown in the presence of up to 1 \u03bcg of cefepime\/ml, the other apparently occurred when the concentration of cefepime was raised to 256 \u03bcg\/ml. After serial passages without exposure to cefepime, the PAP curve maintained the same trend observed for the original strain of\n            <jats:named-content content-type=\"genus-species\">A. baumannii<\/jats:named-content>\n            008. However, the PAP curve showed a shift to relatively lower cefepime resistance (from 256 to 64 \u03bcg\/ml) in\n            <jats:named-content content-type=\"genus-species\">A. baumannii<\/jats:named-content>\n            328 after 10 passages in antibiotic-free Mueller-Hinton agar plates. Convergence to a monotypic resistance phenotype did not occur. Growth rate analysis revealed that slower growth in resistant subpopulations may provide a strategy against antibiotic challenge. To our knowledge, this is the first report of heteroresistance to cephalosporins and penicillins in\n            <jats:named-content content-type=\"genus-species\">A. baumannii<\/jats:named-content>\n            .\n          <\/jats:p>","DOI":"10.1128\/jcm.05085-11","type":"journal-article","created":{"date-parts":[[2011,12,22]],"date-time":"2011-12-22T02:24:53Z","timestamp":1324520693000},"page":"721-726","update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":41,"title":["Heteroresistance to Cephalosporins and Penicillins in Acinetobacter baumannii"],"prefix":"10.1128","volume":"50","author":[{"given":"Kuei-Hsiang","family":"Hung","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, National Cheng Kung University Hospital, Tainan, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ming-Cheng","family":"Wang","sequence":"additional","affiliation":[{"name":"Division of Nephrology, National Cheng Kung University Hospital, National Cheng Kung University Hospital, Tainan, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ay-Huey","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Pathology, 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":"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, 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, National Cheng Kung University Hospital, Tainan, Taiwan"},{"name":"Center of Infectious Disease and Signaling Research, National Cheng Kung University, National Cheng Kung University Hospital, 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\/JCM.39.9.3379-3381.2001"},{"key":"e_1_3_2_3_2","unstructured":"Clinical and Laboratory Standards Institute. 2009. Performance standards for antimicrobial disk susceptibility tests; M02\u2013A10 approved standard-10th ed. CLSI Wayne PA."},{"key":"e_1_3_2_4_2","unstructured":"Clinical and Laboratory Standards Institute. 2009. Methods for dilution antimicrobial susceptibility tests for bacteria that grow aerobically; M07\u2013A8 approved standard-8th ed. CLSI Wayne PA."},{"key":"e_1_3_2_5_2","unstructured":"Clinical and Laboratory Standards Institute. 2011. Performance standards for antimicrobial susceptibility testing 21st informational supplement M100\u2013S21. CLSI Wayne PA."},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00437-10"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-0691.2007.01912.x"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkg097"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1086\/653120"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-121-1-199407010-00004"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1097\/QCO.0b013e32833ae38b"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijantimicag.2009.10.024"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.00959-09"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00103-06"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkr007"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1128\/jb.54.4.467-481.1947"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.0702377104"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1128\/jb.56.2.207-218.1948"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dki115"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkm528"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1099\/jmm.0.46816-0"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.02134-09"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1099\/0022-1317-50-12-1018"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.38.4.724"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.01130-10"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.33.9.2233-2239.1995"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.35.1.124"},{"key":"e_1_3_2_28_2","first-page":"130","article-title":"OXA-type beta-lactamases among extended-spectrum cephalosporin-resistant Pseudomonas aeruginosa isolates in a university hospital in southern Taiwan","volume":"39","author":"Yan JJ","year":"2006","unstructured":"YanJJ TsaiSH ChuangCL WuJJ. 2006. OXA-type beta-lactamases among extended-spectrum cephalosporin-resistant Pseudomonas aeruginosa isolates in a university hospital in southern Taiwan. J. Microbiol. Immunol. Infect. 39:130\u2013134.","journal-title":"J. Microbiol. Immunol. Infect."},{"key":"e_1_3_2_29_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10096-010-1020-1"},{"key":"e_1_3_2_30_2","doi-asserted-by":"publisher","DOI":"10.1128\/jb.55.4.459-461.1948"}],"container-title":["Journal of Clinical Microbiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.asm.org\/doi\/pdf\/10.1128\/JCM.05085-11","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.asm.org\/doi\/pdf\/10.1128\/JCM.05085-11","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,3,5]],"date-time":"2022-03-05T11:21:02Z","timestamp":1646479262000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.asm.org\/doi\/10.1128\/JCM.05085-11"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2012,3]]},"references-count":29,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2012,3]]}},"alternative-id":["10.1128\/JCM.05085-11"],"URL":"https:\/\/doi.org\/10.1128\/jcm.05085-11","relation":{},"ISSN":["0095-1137","1098-660X"],"issn-type":[{"value":"0095-1137","type":"print"},{"value":"1098-660X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2012,3]]},"assertion":[{"value":"2011-07-12","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2011-12-09","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2012-02-16","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}