title: Emergence of bacterial resistance to cefamandole in vivo due to outer membrane protein deficiency.
abstract: Cefamandole therapy in a patient with suppurative thrombophlebitis failed due to selection of a resistant variant of the causative organism Klebsiella pneumoniae. Analysis of the resistance mechanism revealed that in the resistant variant one of the major outer membrane proteins, OmpF, was missing. Resistance of this type has implications for therapy with other antibiotics including non-beta-lactam antibiotics. This report demonstrates the role of outer membrane permeation in the emergence of bacterial resistance during antibiotic therapy.
authors.affiliation: Department of Medical Microbiology, University Hospital Leiden, The Netherlands.
authors.forename: J A
authors.initials: JA
authors.lastname: van de Klundert
authors.forename: M H
authors.initials: MH
authors.lastname: van Gestel
authors.forename: G
authors.initials: G
authors.lastname: Meerdink
authors.forename: S
authors.initials: S
authors.lastname: de Marie
mesh_terms: D000328:Adult; D001425:Bacterial Outer Membrane Proteins / Q000032:analysis*; D002435:Cefamandole / Q000494:pharmacology*; D004352:Drug Resistance, Microbial; D005260:Female; D006801:Humans; D007711:Klebsiella pneumoniae / Q000187:drug effects*
chemical_list: D001425:Bacterial Outer Membrane Proteins; D002435:Cefamandole