{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T12:56:36Z","timestamp":1789131396417,"version":"build-2803163510"},"reference-count":36,"publisher":"American Society for Microbiology","issue":"10","license":[{"start":{"date-parts":[[2024,10,3]],"date-time":"2024-10-03T00:00:00Z","timestamp":1727913600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2024,10,3]],"date-time":"2024-10-03T00:00:00Z","timestamp":1727913600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"funder":[{"DOI":"10.13039\/501100012659","name":"Foundation for Innovative Research Groups of the National Natural Science Foundation of China","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100012659","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100002858","name":"China Postdoctoral Science Foundation","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100002858","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["Microbiol Spectr"],"published-print":{"date-parts":[[2024,10,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n          <jats:sec>\n            <jats:title\/>\n            <jats:p>\n              Background emergence of multidrug-resistant (MDR) bacterial strains is a public health concern that threatens global and regional security. Efflux pump-overexpressing MDR strains from clinical isolates are the best subjects for studying the mechanisms of MDR caused by bacterial efflux pumps. A\n              <jats:italic>Klebsiella pneumoniae<\/jats:italic>\n              strain overexpressing the OqxB-only efflux pump was screened from a clinical strain library to explore reverse OqxB-mediated bacterial resistance strategies. We identified non-repetitive clinical isolated\n              <jats:italic>K. pneumoniae<\/jats:italic>\n              strains using a matrix-assisted laser desorption\/ionization time-of-flight (TOF) mass spectrometry clinical TOF-II (Clin-TOF-II) and susceptibility test screening against levofloxacin and ciprofloxacin. And the polymorphism analysis was conducted using pulsed-field gel electrophoresis. Efflux pump function of resistant strains is obtained by combined drug sensitivity test of phenylalanine-arginine beta-naphthylamide (Pa\u03b2N, an efflux pump inhibitor) and detection with ethidium bromide as an indicator. The quantitative reverse transcription PCR was performed to assess whether the\n              <jats:italic>oqxB<\/jats:italic>\n              gene was overexpressed in\n              <jats:italic>K. pneumoniae<\/jats:italic>\n              isolates. Additional analyses assessed whether the\n              <jats:italic>oqxB<\/jats:italic>\n              gene was overexpressed in\n              <jats:italic>K. pneumoniae<\/jats:italic>\n              isolates and gene knockout and complementation strains were constructed. The binding mode of Pa\u03b2N with OqxB was determined using molecular docking modeling. Among the clinical quinolone-resistant\n              <jats:italic>K. pneumoniae<\/jats:italic>\n              strains, one mediates resistance almost exclusively through the overexpression of the resistance\u2013nodulation\u2013division efflux pump, OqxB. Crystal structure of OqxB has been reported recently by N. Bharatham, P. Bhowmik, M. Aoki, U. Okada et al. (Nat Commun 12:5400, 2021,\n              <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/doi.org\/10.1038\/s41467-021-25679-0\" xlink:type=\"simple\">https:\/\/doi.org\/10.1038\/s41467-021-25679-0<\/jats:ext-link>\n              ). The discovery of this strain will contribute to a better understanding of the role of the OqxB transporter in\n              <jats:italic>K. pneumoniae<\/jats:italic>\n              and builds on the foundation for addressing the threat posed by quinolone resistance.\n            <\/jats:p>\n            <jats:sec>\n              <jats:title>IMPORTANCE<\/jats:title>\n              <jats:p>\n                The emergence of antimicrobial resistance is a growing and significant health concern, particularly in the context of\n                <jats:italic>K. pneumoniae<\/jats:italic>\n                infections. The upregulation of efflux pump systems is a key factor that contributes to this resistance. Our results indicated that the\n                <jats:italic>K. pneumoniae<\/jats:italic>\n                strain GN 172867 exhibited a higher\n                <jats:italic>oqxB<\/jats:italic>\n                gene expression compared to the reference strain ATCC 43816. Deletion of\n                <jats:italic>oqxB<\/jats:italic>\n                led a decrease in the minimum inhibitory concentration of levofloxacin. Complementation with\n                <jats:italic>oqxB<\/jats:italic>\n                rescued antibiotic resistance in the\n                <jats:italic>oqxB<\/jats:italic>\n                mutant strain. We demonstrated that the overexpression of the OqxB efflux pump plays an important role in quinolone resistance. The discovery of strain GN 172867 will contribute to a better understanding of the role of the OqxB transporter in\n                <jats:italic>K. pneumoniae<\/jats:italic>\n                and promotes further study of antimicrobial resistance.\n              <\/jats:p>\n            <\/jats:sec>\n          <\/jats:sec>","DOI":"10.1128\/spectrum.00122-24","type":"journal-article","created":{"date-parts":[[2024,8,16]],"date-time":"2024-08-16T13:00:23Z","timestamp":1723813223000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":6,"title":["Discovery of clinical isolation of drug-resistant\n            <i>Klebsiella pneumoniae<\/i>\n            with overexpression of OqxB efflux pump as the decisive drug resistance factor"],"prefix":"10.1128","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-5887-4266","authenticated-orcid":false,"given":"Ping","family":"Tian","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases, The First Affiliated Hospital of Anhui Medical University, Hefei, China"},{"name":"Anhui Province Key Laboratory of Infectious Diseases, Anhui Medical University, Hefei, China"},{"name":"Anhui Center for Surveillance of Bacterial Resistance, The First Affiliated Hospital of Anhui Medical University, Hefei, China"},{"name":"Institute of Bacterial Resistance, Anhui Medical University, Hefei, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ming-Juan","family":"Guo","sequence":"additional","affiliation":[{"name":"Department of Hepatology, The First Affiliated Hospital of Jilin University, Changchun, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qing-Qing","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, The First Affiliated Hospital of Anhui Medical University, Hefei, China"},{"name":"Anhui Province Key Laboratory of Infectious Diseases, Anhui Medical University, Hefei, China"},{"name":"Anhui Center for Surveillance of Bacterial Resistance, The First Affiliated Hospital of Anhui Medical University, Hefei, China"},{"name":"Institute of Bacterial Resistance, Anhui Medical University, Hefei, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xu-Feng","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, The First Affiliated Hospital of Anhui Medical University, Hefei, China"},{"name":"Anhui Province Key Laboratory of Infectious Diseases, Anhui Medical University, Hefei, China"},{"name":"Anhui Center for Surveillance of Bacterial Resistance, The First Affiliated Hospital of Anhui Medical University, Hefei, China"},{"name":"Institute of Bacterial Resistance, Anhui Medical University, Hefei, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao-Qiang","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, The First Affiliated Hospital of Anhui Medical University, Hefei, China"},{"name":"Anhui Province Key Laboratory of Infectious Diseases, Anhui Medical University, Hefei, China"},{"name":"Anhui Center for Surveillance of Bacterial Resistance, The First Affiliated Hospital of Anhui Medical University, Hefei, China"},{"name":"Institute of Bacterial Resistance, Anhui Medical University, Hefei, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qin-Xiang","family":"Kong","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Chaohu Hospital of Anhui Medical University, Hefei, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, The First Affiliated Hospital of Anhui Medical University, Hefei, China"},{"name":"Anhui Province Key Laboratory of Infectious Diseases, Anhui Medical University, Hefei, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, The First Affiliated Hospital of Anhui Medical University, Hefei, China"},{"name":"Anhui Province Key Laboratory of Infectious Diseases, Anhui Medical University, Hefei, China"},{"name":"Anhui Center for Surveillance of Bacterial Resistance, The First Affiliated Hospital of Anhui Medical University, Hefei, China"},{"name":"Institute of Bacterial Resistance, Anhui Medical University, Hefei, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan-Yan","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, The First Affiliated Hospital of Anhui Medical University, Hefei, China"},{"name":"Anhui Province Key Laboratory of Infectious Diseases, Anhui Medical University, Hefei, China"},{"name":"Anhui Center for Surveillance of Bacterial Resistance, The First Affiliated Hospital of Anhui Medical University, Hefei, China"},{"name":"Institute of Bacterial Resistance, Anhui Medical University, Hefei, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liang","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, The First Affiliated Hospital of Anhui Medical University, Hefei, China"},{"name":"Anhui Province Key Laboratory of Infectious Diseases, Anhui Medical University, Hefei, China"},{"name":"Anhui Center for Surveillance of Bacterial Resistance, The First 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China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-5703-6445","authenticated-orcid":false,"given":"Ya-Sheng","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, The First Affiliated Hospital of Anhui Medical University, Hefei, China"},{"name":"Anhui Province Key Laboratory of Infectious Diseases, Anhui Medical University, Hefei, China"},{"name":"Anhui Center for Surveillance of Bacterial Resistance, The First Affiliated Hospital of Anhui Medical University, Hefei, China"},{"name":"Institute of Bacterial Resistance, Anhui Medical University, Hefei, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_5_3_2","doi-asserted-by":"publisher","DOI":"10.3390\/molecules24173152"},{"key":"e_1_3_5_4_2","unstructured":"World Health Organization. 2019. 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