Spandidos Publications Logo
  • About
    • About Spandidos
    • Aims and Scopes
    • Abstracting and Indexing
    • Editorial Policies
    • Reprints and Permissions
    • Job Opportunities
    • Terms and Conditions
    • Contact
  • Journals
    • All Journals
    • Oncology Letters
      • Oncology Letters
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Oncology
      • International Journal of Oncology
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Molecular and Clinical Oncology
      • Molecular and Clinical Oncology
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Experimental and Therapeutic Medicine
      • Experimental and Therapeutic Medicine
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Molecular Medicine
      • International Journal of Molecular Medicine
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Biomedical Reports
      • Biomedical Reports
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Oncology Reports
      • Oncology Reports
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Molecular Medicine Reports
      • Molecular Medicine Reports
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • World Academy of Sciences Journal
      • World Academy of Sciences Journal
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Functional Nutrition
      • International Journal of Functional Nutrition
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Epigenetics
      • International Journal of Epigenetics
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Medicine International
      • Medicine International
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
  • Articles
  • Information
    • Information for Authors
    • Information for Reviewers
    • Information for Librarians
    • Information for Advertisers
    • Conferences
  • Language Editing
Spandidos Publications Logo
  • About
    • About Spandidos
    • Aims and Scopes
    • Abstracting and Indexing
    • Editorial Policies
    • Reprints and Permissions
    • Job Opportunities
    • Terms and Conditions
    • Contact
  • Journals
    • All Journals
    • Biomedical Reports
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Experimental and Therapeutic Medicine
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Epigenetics
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Functional Nutrition
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Molecular Medicine
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • International Journal of Oncology
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Medicine International
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Molecular and Clinical Oncology
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Molecular Medicine Reports
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Oncology Letters
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • Oncology Reports
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
    • World Academy of Sciences Journal
      • Information for Authors
      • Editorial Policies
      • Editorial Board
      • Aims and Scope
      • Abstracting and Indexing
      • Bibliographic Information
      • Archive
  • Articles
  • Information
    • For Authors
    • For Reviewers
    • For Librarians
    • For Advertisers
    • Conferences
  • Language Editing
Login Register Submit
  • This site uses cookies
  • You can change your cookie settings at any time by following the instructions in our Cookie Policy. To find out more, you may read our Privacy Policy.

    I agree
Search articles by DOI, keyword, author or affiliation
Search
Advanced Search
presentation
Experimental and Therapeutic Medicine
Join Editorial Board Propose a Special Issue
Print ISSN: 1792-0981 Online ISSN: 1792-1015
Journal Cover
April-2020 Volume 19 Issue 4

Full Size Image

Sign up for eToc alerts
Recommend to Library

Journals

International Journal of Molecular Medicine

International Journal of Molecular Medicine

International Journal of Molecular Medicine is an international journal devoted to molecular mechanisms of human disease.

International Journal of Oncology

International Journal of Oncology

International Journal of Oncology is an international journal devoted to oncology research and cancer treatment.

Molecular Medicine Reports

Molecular Medicine Reports

Covers molecular medicine topics such as pharmacology, pathology, genetics, neuroscience, infectious diseases, molecular cardiology, and molecular surgery.

Oncology Reports

Oncology Reports

Oncology Reports is an international journal devoted to fundamental and applied research in Oncology.

Experimental and Therapeutic Medicine

Experimental and Therapeutic Medicine

Experimental and Therapeutic Medicine is an international journal devoted to laboratory and clinical medicine.

Oncology Letters

Oncology Letters

Oncology Letters is an international journal devoted to Experimental and Clinical Oncology.

Biomedical Reports

Biomedical Reports

Explores a wide range of biological and medical fields, including pharmacology, genetics, microbiology, neuroscience, and molecular cardiology.

Molecular and Clinical Oncology

Molecular and Clinical Oncology

International journal addressing all aspects of oncology research, from tumorigenesis and oncogenes to chemotherapy and metastasis.

World Academy of Sciences Journal

World Academy of Sciences Journal

Multidisciplinary open-access journal spanning biochemistry, genetics, neuroscience, environmental health, and synthetic biology.

International Journal of Functional Nutrition

International Journal of Functional Nutrition

Open-access journal combining biochemistry, pharmacology, immunology, and genetics to advance health through functional nutrition.

International Journal of Epigenetics

International Journal of Epigenetics

Publishes open-access research on using epigenetics to advance understanding and treatment of human disease.

Medicine International

Medicine International

An International Open Access Journal Devoted to General Medicine.

Journal Cover
April-2020 Volume 19 Issue 4

Full Size Image

Sign up for eToc alerts
Recommend to Library

  • Article
  • Citations
    • Cite This Article
    • Download Citation
    • Create Citation Alert
    • Remove Citation Alert
    • Cited By
  • Similar Articles
    • Related Articles (in Spandidos Publications)
    • Similar Articles (Google Scholar)
    • Similar Articles (PubMed)
  • Download PDF
  • Download XML
  • View XML
Article Open Access

Klebsiella pneumoniae presents antimicrobial drug resistance for β‑lactam through the ESBL/PBP signaling pathway

  • Authors:
    • Wei Jiang
    • Wenjie Yang
    • Xuequn Zhao
    • Na Wang
    • Haixia Ren
  • View Affiliations / Copyright

    Affiliations: Department of Infectious Disease, Tianjin First Central Hospital, Tianjin 300000, P.R. China, Department of Transplantation, Tianjin First Central Hospital, Tianjin 300000, P.R. China, Department of Pharmaceutical Preparation, Tianjin First Central Hospital, Tianjin 300000, P.R. China
    Copyright: © Jiang et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
  • Pages: 2449-2456
    |
    Published online on: February 7, 2020
       https://doi.org/10.3892/etm.2020.8498
  • Expand metrics +
Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )
Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )
Cited By (CrossRef): 0 citations Loading Articles...

This article is mentioned in:



Abstract

Overuse and misuse of antibiotics leads to antibiotic resistance which has become a significant public health concern. Klebsiella pneumoniae is the most common pathogenic bacteria underlying nosocomial infections due to the expression of virulence factors and occurrence of antibiotic resistance. Evidence indicates that β‑lactamase is involved in the antibiotic resistance of Klebsiella pneumoniae to β‑lactam antibiotics. The aim of the present study was to investigate the association between the molecular biological mechanisms of antibiotic resistance of Klebsiella pneumoniae and extended‑spectrum β‑lactamase (ESBL). In order to assess temporal trends in prevalence and antimicrobial susceptibility, Klebsiella pneumoniae bacteria were isolated and the ESBL expression level was analyzed. Susceptibility tests were performed using automated systems. The β‑lactam‑resistance in Klebsiella pneumoniae was assessed by the β‑lactam agar screen plate and respective MIC values were evaluated using E‑test strips. The confirmatory disk diffusion methods were applied for phenotypic identification of the ESBL production of Klebsiella pneumoniae. The results showed that Klebsiella pneumoniae bacteria exhibited higher ESBL production after treatment with β‑lactam compared to the control. The ESBL gene expression was upregulated in Klebsiella pneumoniae after treatment with β‑lactam. Results identified that penicillin‑binding proteins (PBPs) were associated with the growth and resistance to β‑lactams. Zinc finger nuclease markedly inhibited the antibiotic resistance of Klebsiella pneumoniae to β‑lactam. PBP knockdown abolished the inhibitory effects of zinc finger nuclease on the growth of Klebsiella pneumoniae induced by β‑lactam antibiotic treatment. In conclusion, these results suggest that the resistance of Klebsiella pneumoniae bacteria to antimicrobial drugs is through the ESBL signaling pathway, which indicates that ESBL may be a potential target for abolishing resistance to β‑lactam.
View Figures

Figure 1

Figure 2

Figure 3

Figure 4

View References

1 

Lim MK, Lai PS, Ponnampalavanar SS, Syed Omar SF, Taib NA, Yusof MY, Italiano CM, Kong DC and Kamarulzaman A: Antibiotics in surgical wards: Use or misuse? A newly industrialized country's perspective. J Infect Dev Countries. 9:1264–1271. 2015.PubMed/NCBI View Article : Google Scholar

2 

Kardas P, Devine S, Golembesky A and Roberts C: A systematic review and meta-analysis of misuse of antibiotic therapies in the community. Int J Antimicrob Agents. 26:106–113. 2005.PubMed/NCBI View Article : Google Scholar

3 

Heineman HS and Watt VS: All-inclusive concurrent antibiotic usage review: A way to reduce misuse without formal controls. Infect Control. 7:168–171. 1986.PubMed/NCBI View Article : Google Scholar

4 

Nõlvak H, Truu M, Kanger K, Tampere M, Espenberg M, Loit E, Raave H and Truu J: Inorganic and organic fertilizers impact the abundance and proportion of antibiotic resistance and integron-integrase genes in agricultural grassland soil. Sci Total Environ. 562:678–689. 2016.PubMed/NCBI View Article : Google Scholar

5 

Stogios PJ, Cox G, Spanogiannopoulos P, Pillon MC, Waglechner N, Skarina T, Koteva K, Guarné A, Savchenko A and Wright GD: Rifampin phosphotransferase is an unusual antibiotic resistance kinase. Nat Commun. 7(11343)2016.PubMed/NCBI View Article : Google Scholar

6 

Ferro G, Guarino F, Castiglione S and Rizzo L: Antibiotic resistance spread potential in urban wastewater effluents disinfected by UV/H2O2 process. Sci Total Environ. 560-561:29–35. 2016.PubMed/NCBI View Article : Google Scholar

7 

Ouwehand AC, Forssten S, Hibberd AA, Lyra A and Stahl B: Probiotic approach to prevent antibiotic resistance. Ann Med. 48:246–255. 2016.PubMed/NCBI View Article : Google Scholar

8 

Date KA, Newton AE, Medalla F, Blackstock A, Richardson L, McCullough A, Mintz ED and Mahon BE: Changing patterns in enteric fever incidence and increasing antibiotic resistance of enteric fever isolates in the United States, 2008-2012. Clin Infect Dis. 63:322–329. 2016.PubMed/NCBI View Article : Google Scholar

9 

Çöl A, Dedeić-Ljubović A, Salimović-Bešić I and Hukic M: Antibiotic resistance profiles and genetic similarities within a new generation of carbapenem-resistant Acinetobacter calcoaceticus-A. baumannii complex resistotypes in Bosnia and Herzegovina. Microb Drug Resist. 22:655–661. 2016.PubMed/NCBI View Article : Google Scholar

10 

Barger A, Schaade L, Krause G and Kramer M: Strategies for recognition, prevention and control of antimicrobial resistances in Germany-a draft from the federal german ministry of health. Gesundheitswesen. 70:631–635. 2008.(In German). PubMed/NCBI View Article : Google Scholar

11 

Oliva A, Gizzi F, Mascellino MT, Cipolla A, D'Abramo A, D'Agostino C, Trinchieri V, Russo G, Tierno F, Iannetta M, et al: Bactericidal and synergistic activity of double-carbapenem regimen for infections caused by carbapenemase-producing Klebsiella pneumoniae. Clin Microbiol Infect. 22:147–153. 2016.PubMed/NCBI View Article : Google Scholar

12 

Gajul SV, Mohite ST, Mangalgi SS, Wavare SM and Kakade SV: Klebsiella pneumoniae in septicemic neonates with special reference to extended spectrum β-lactamase, AmpC, metallo β-lactamase production and multiple drug resistance in tertiary care hospital. J Lab Physicians. 7:32–37. 2015.PubMed/NCBI View Article : Google Scholar

13 

Rastogi V, Nirwan PS, Jain S and Kapil A: Nosocomial outbreak of septicaemia in neonatal intensive care unit due to extended spectrum β-lactamase producing Klebsiella pneumoniae showing multiple mechanisms of drug resistance. Indian J Med Microbiol. 28:380–384. 2010.PubMed/NCBI View Article : Google Scholar

14 

Babálová M, Blahová J, Králiková K, Krcméry V Sr, Menkyna R, Bartoníková N and Skalicková R: Unexpected reservoir of Klebsiella pneumoniae strains with transferable multiple drug resistance causing clinical sepsis in newborns. J Chemother. 17:454–455. 2005.PubMed/NCBI View Article : Google Scholar

15 

Sanchez GV, Master RN, Clark RB, Fyyaz M, Duvvuri P, Ekta G and Bordon J: Klebsiellapneumoniae antimicrobial drug resistance, United States, 1998-2010. Emerg Infect Dis. 19:133–136. 2013.PubMed/NCBI View Article : Google Scholar

16 

Neupane S, Pant ND, Khatiwada S, Chaudhary R and Banjara MR: Correlation between biofilm formation and resistance toward different commonly used antibiotics along with extended spectrum beta lactamase production in uropathogenic Escherichia coli isolated from the patients suspected of urinary tract infections visiting Shree Birendra Hospital, Chhauni, Kathmandu, Nepal. Antimicrob Resist Infect Control. 5(5)2016.PubMed/NCBI View Article : Google Scholar

17 

Chen X, Che J, Zhao XF, Zhang LF and Li J: Dissemination of insertion sequence common regions 1 and int1 gene and drug resistance of 483 Escherichia coli and Klebsiella pneumonia broiler isolates. Zhonghua Yu Fang Yi Xue Za Zhi. 51:886–889. 2017.(In Chinese). PubMed/NCBI View Article : Google Scholar

18 

Sekowska A, Janicka G, Klyszejko C, Wojda M, Wroblewski M and Szymankiewicz M: Resistance of Klebsiella pneumoniae strains producing and not producing ESBL (extended-spectrum beta-lactamase) type enzymes to selected non-beta-lactam antibiotics. Med Sci Monit. 8:BR100–BR104. 2002.PubMed/NCBI

19 

Sanguinetti CM, De Benedetto F and Miragliotta G: Bacterial agents of lower respiratory tract infections (LRTIs), beta-lactamase production, and resistance to antibiotics in elderly people. DEDALO study group. Int J Antimicrob Agents. 16:467–471. 2000.PubMed/NCBI View Article : Google Scholar

20 

Boggio SB and Roveri OA: Catalytic properties of an endogenous beta-lactamase responsible for the resistance of Azospirillum lipoferum to beta-lactam antibiotics. Microbiology. 149:445–450. 2003.PubMed/NCBI View Article : Google Scholar

21 

Uraz G, Simsek H and Celik B: Beta-Lactamase activities and resistance to antibiotics of Haemophilus influenzae, H. parainfluenzae and H. aphrophilus strains identified in throat cultures from children. Drug Metabol Drug Interact. 16:217–228. 2000.PubMed/NCBI View Article : Google Scholar

22 

Macheboeuf P, Contreras-Martel C, Job V, Dideberg O and Dessen A: Penicillin binding proteins: Key players in bacterial cell cycle and drug resistance processes. FEMS Microbiol Rev. 30:673–691. 2006.PubMed/NCBI View Article : Google Scholar

23 

Shahbazi Dastjerdeh M, Kouhpayeh S, Sabzehei F, Khanahmad H, Salehi M, Mohammadi Z, Shariati L, Hejazi Z, Rabiei P and Manian M: Zinc finger nuclease: A new approach to overcome beta-lactam antibiotic resistance. Jundishapur J Microbiol. 9(e29384)2016.PubMed/NCBI View Article : Google Scholar

24 

Zscheppang K, Kurth I, Wachtel N, Dubrovska A, Kunz-Schughart LA and Cordes N: Efficacy of beta1 integrin and EGFR targeting in sphere-forming human head and neck cancer cells. J Cancer. 7:736–745. 2016.PubMed/NCBI View Article : Google Scholar

25 

Hsueh PR, Ko WC, Wu JJ, Lu JJ, Wang FD, Wu HY, Wu TL and Teng LJ: Consensus statement on the adherence to clinical and laboratory standards institute (CLSI) antimicrobial susceptibility testing guidelines (CLSI-2010 and CLSI-2010-update) for enterobacteriaceae in clinical microbiology laboratories in Taiwan. J Microbiol Immunol Infect. 43:452–455. 2010.PubMed/NCBI View Article : Google Scholar

26 

Baruah FK, Hussain AN, Kausalya   and Grover RK: Antibiotic resistance profile of non-fermenting Gram-negative bacilli isolated from the blood cultures of cancer patients. J Glob Infect Dis. 7:46–47. 2015.PubMed/NCBI View Article : Google Scholar

27 

Hill JT, Tran KD, Barton KL, Labreche MJ and Sharp SE: Evaluation of the nanosphere Verigene BC-GN assay for direct identification of gram-negative bacilli and antibiotic resistance markers from positive blood cultures and potential impact for more-rapid antibiotic interventions. J Clin Microbiol. 52:3805–3807. 2014.PubMed/NCBI View Article : Google Scholar

28 

Ares MA, Alcantar-Curiel MD, Jimenez-Galicia C, Rios-Sarabia N, Pacheco S and De la Cruz MA: Antibiotic resistance of gram-negative bacilli isolated from pediatric patients with nosocomial bloodstream infections in a mexican tertiary care hospital. Chemotherapy. 59:361–368. 2013.PubMed/NCBI View Article : Google Scholar

29 

Patel SJ, O'Toole D and Larson E: A new metric of antibiotic class resistance in gram-negative bacilli isolated from hospitalized children. Infect Control Hosp Epidemiol. 33:602–607. 2012.PubMed/NCBI View Article : Google Scholar

30 

Sasirekha B and Shivakumar S: Occurrence of plasmid-mediated AmpC β-lactamases among Escherichia coli and Klebsiella pneumoniae clinical isolates in a tertiary care hospital in Bangalore. Indian J Microbiol. 52:174–179. 2012.PubMed/NCBI View Article : Google Scholar

31 

Koczura R, Mokracka J, Krzyminska S and Kaznowski A: Virulence properties and integron-associated antibiotic resistance of Klebsiella mobilis strains isolated from clinical specimens. J Med Microbiol. 60:281–288. 2011.PubMed/NCBI View Article : Google Scholar

32 

Lee M, Dhar S, De Benedetti S, Hesek D, Boggess B, Blázquez B, Mathee K and Mobashery S: Muropeptides in pseudomonas aeruginosa and their role as elicitors of β-lactam-antibiotic resistance. Angew Chem Int Ed Engl. 55:6882–6886. 2016.PubMed/NCBI View Article : Google Scholar

33 

Lee YD and Park JH: Phage conversion for β-lactam antibiotic resistance of staphylococcus aureus from foods. J Microbiol Biotechnol. 26:263–269. 2016.PubMed/NCBI View Article : Google Scholar

34 

Shafiq M, Rahman H, Qasim M, Ayub N, Hussain S, Khan J and Naeem M: Prevalence of plasmid-mediated AmpC β-lactamases in Escherichia coli and Klebsiella pneumonia at tertiary care hospital of Islamabad, Pakistan. Eur J Microbiol Immunol (Bp). 3:267–271. 2013.PubMed/NCBI View Article : Google Scholar

35 

Goessens WH, Mouton JW, Ten Kate MT, Sorgel F, Kinzig M and Bakker-Woudenberg IA: The therapeutic effect of tigecycline, unlike that of Ceftazidime, is not influenced by whether the Klebsiella pneumoniae strain produces extended-spectrum beta-lactamases in experimental pneumonia in rats. Antimicrob Agents Chemother. 57:643–646. 2013.PubMed/NCBI View Article : Google Scholar

36 

Rivera A, Larrosa N, Mirelis B and Navarro F: Importance of quality control for the detection of β-lactam antibiotic resistance in enterobacteriaceae. Enferm Infecc Microbiol Clin. 32 (Suppl 1):S30–S36. 2014.(In Spanish). PubMed/NCBI View Article : Google Scholar

37 

Padilla E, Alonso D, Domenech-Sanchez A, Gomez C, Pérez JL, Albertí S and Borrell N: Effect of porins and plasmid-mediated AmpC beta-lactamases on the efficacy of beta-lactams in rat pneumonia caused by Klebsiella pneumoniae. Antimicrob Agents Chemother. 50:2258–2260. 2006.PubMed/NCBI View Article : Google Scholar

38 

Wragg R, Harris A, Patel M, Robb A, Chandran H and McCarthy L: Extended spectrum beta lactamase (ESBL) producing bacteria urinary tract infections and complex pediatric urology. J Pediatr Surg. 52:286–288. 2017.PubMed/NCBI View Article : Google Scholar

39 

Charrouf FO, Hamze M, Mallat H, Achkar M and Dabboussia F: Characterization of resistance genes in 68 ESBL-producing Klebsiella pneumonia in Lebanon. Med Mal Infect. 44:535–538. 2014.PubMed/NCBI View Article : Google Scholar

40 

Ogawara H: Self-resistance in streptomyces, with special reference to beta-lactam antibiotics. Molecules. 21(E605)2016.PubMed/NCBI View Article : Google Scholar

41 

Navarro Jimenez C, Luque Marquez R, de Torres Solis I and Aguilar Guisado M: Changes in empiric therapy for nosocomial pneumonia due to the emergence of bacterial strains with broad spectrum beta-lactamases. Med Clin (Barc). 122(679)2004.(In Spanish). PubMed/NCBI View Article : Google Scholar

Related Articles

  • Abstract
  • View
  • Download
  • Twitter
Copy and paste a formatted citation
Spandidos Publications style
Jiang W, Yang W, Zhao X, Wang N and Ren H: Klebsiella pneumoniae presents antimicrobial drug resistance for β‑lactam through the ESBL/PBP signaling pathway. Exp Ther Med 19: 2449-2456, 2020.
APA
Jiang, W., Yang, W., Zhao, X., Wang, N., & Ren, H. (2020). Klebsiella pneumoniae presents antimicrobial drug resistance for β‑lactam through the ESBL/PBP signaling pathway. Experimental and Therapeutic Medicine, 19, 2449-2456. https://doi.org/10.3892/etm.2020.8498
MLA
Jiang, W., Yang, W., Zhao, X., Wang, N., Ren, H."Klebsiella pneumoniae presents antimicrobial drug resistance for β‑lactam through the ESBL/PBP signaling pathway". Experimental and Therapeutic Medicine 19.4 (2020): 2449-2456.
Chicago
Jiang, W., Yang, W., Zhao, X., Wang, N., Ren, H."Klebsiella pneumoniae presents antimicrobial drug resistance for β‑lactam through the ESBL/PBP signaling pathway". Experimental and Therapeutic Medicine 19, no. 4 (2020): 2449-2456. https://doi.org/10.3892/etm.2020.8498
Copy and paste a formatted citation
x
Spandidos Publications style
Jiang W, Yang W, Zhao X, Wang N and Ren H: Klebsiella pneumoniae presents antimicrobial drug resistance for β‑lactam through the ESBL/PBP signaling pathway. Exp Ther Med 19: 2449-2456, 2020.
APA
Jiang, W., Yang, W., Zhao, X., Wang, N., & Ren, H. (2020). Klebsiella pneumoniae presents antimicrobial drug resistance for β‑lactam through the ESBL/PBP signaling pathway. Experimental and Therapeutic Medicine, 19, 2449-2456. https://doi.org/10.3892/etm.2020.8498
MLA
Jiang, W., Yang, W., Zhao, X., Wang, N., Ren, H."Klebsiella pneumoniae presents antimicrobial drug resistance for β‑lactam through the ESBL/PBP signaling pathway". Experimental and Therapeutic Medicine 19.4 (2020): 2449-2456.
Chicago
Jiang, W., Yang, W., Zhao, X., Wang, N., Ren, H."Klebsiella pneumoniae presents antimicrobial drug resistance for β‑lactam through the ESBL/PBP signaling pathway". Experimental and Therapeutic Medicine 19, no. 4 (2020): 2449-2456. https://doi.org/10.3892/etm.2020.8498
Follow us
  • Twitter
  • LinkedIn
  • Facebook
About
  • Spandidos Publications
  • Careers
  • Cookie Policy
  • Privacy Policy
How can we help?
  • Help
  • Live Chat
  • Contact
  • Email to our Support Team