title: Colistin heteroresistance in Enterobacter cloacae is associated with cross-resistance to the host antimicrobial lysozyme.
abstract: Here, we describe the first identification of colistin-heteroresistant Enterobacter cloacae in the United States. Treatment of this isolate with colistin increased the frequency of the resistant subpopulation and induced cross-resistance to the host antimicrobial lysozyme. This is the first description of heteroresistance conferring cross-resistance to a host antimicrobial and suggests that clinical treatment with colistin may inadvertently select for bacteria that are resistant to components of the host innate immune system.
authors: Department of Microbiology and Immunology, Emory University School of Medicine, Atlanta, Georgia, USA.
authors: Brooke A
authors: BA
authors: Napier
authors: Department of Microbiology and Immunology, Emory University School of Medicine, Atlanta, Georgia, USA.
authors: Victor
authors: V
authors: Band
authors: Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia, USA eburd@emory.edu david.weiss@emory.edu.
authors: Eileen M
authors: EM
authors: Burd
authors: Department of Microbiology and Immunology, Emory University School of Medicine, Atlanta, Georgia, USA Emory Vaccine Center, Emory University School of Medicine, Atlanta, Georgia, USA Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA eburd@emory.edu david.weiss@emory.edu.
authors: David S
authors: DS
authors: Weiss
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D003091:Colistin / Q000494:pharmacology*; D024881:Drug Resistance, Bacterial / Q000235:genetics*; D016972:Enterobacter cloacae / Q000187:drug effects* / Q000235:genetics / Q000276:immunology; D007113:Immunity, Innate; D008826:Microbial Sensitivity Tests; D009113:Muramidase / Q000378:metabolism*
chemical_list: D000900:Anti-Bacterial Agents; D009113:Muramidase; D003091:Colistin