title: In vivo development of ertapenem resistance in a patient with pneumonia caused by Klebsiella pneumoniae with an extended-spectrum beta-lactamase.
abstract: Four sequential extended-spectrum beta -lactamase-producing isolates of Klebsiella pneumoniae were obtained from a patient after treatment with ertapenem and cultured. The first and fourth isolates were susceptible to ertapenem, whereas the second and third were resistant. All 4 isolates belonged to the same strain and produced a group 1 CTX-M enzyme; additionally, the resistant isolates had lost a porin.
authors.affiliation: Department of Clinical Microbiology, Ampath Laboratories, Milpark Hospital, Johannesburg, South Africa. elliottg@ampath.co.za
authors.forename: Eugenne
authors.initials: E
authors.lastname: Elliott
authors.forename: Adrian J
authors.initials: AJ
authors.lastname: Brink
authors.forename: Johan
authors.initials: J
authors.lastname: van Greune
authors.forename: Zia
authors.initials: Z
authors.lastname: Els
authors.forename: Neil
authors.initials: N
authors.lastname: Woodford
authors.forename: Jane
authors.initials: J
authors.lastname: Turton
authors.forename: Marina
authors.initials: M
authors.lastname: Warner
authors.forename: David M
authors.initials: DM
authors.lastname: Livermore
mesh_terms: D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D000077727:Ertapenem; D006801:Humans; D007710:Klebsiella Infections / Q000382:microbiology; D007711:Klebsiella pneumoniae / Q000187:drug effects* / Q000201:enzymology*; D008297:Male; D008826:Microbial Sensitivity Tests; D018410:Pneumonia, Bacterial / Q000188:drug therapy / Q000382:microbiology*; D018440:beta-Lactam Resistance; D001618:beta-Lactamases / Q000378:metabolism*; D047090:beta-Lactams / Q000494:pharmacology*
chemical_list: D000900:Anti-Bacterial Agents; D047090:beta-Lactams; D001618:beta-Lactamases; D000077727:Ertapenem