title: Acquisition of Broad-Spectrum Cephalosporin Resistance Leading to Colistin Resistance in Klebsiella pneumoniae.
abstract: An extended-spectrum β-lactamase (ESBL)-producing and colistin-resistant Klebsiella pneumoniae clinical isolate was recovered from a patient who was treated with cefotaxime. This isolate harbored a blaCTX-M-15 ESBL gene that was associated with an ISEcp1 insertion sequence. Transposition of that tandem occurred within the chromosomal mgrB gene, leading to inactivation of the mgrB gene and consequently to acquired resistance to colistin. We showed here a coselection of colistin resistance as a result of a broad-spectrum cephalosporin selective pressure.
authors.affiliation: Medical and Molecular Microbiology, Emerging Antibiotic Resistance Unit, Department of Medicine, Faculty of Science, University of Fribourg, Fribourg, Switzerland.
authors.forename: Aurélie
authors.initials: A
authors.lastname: Jayol
authors.affiliation: Medical and Molecular Microbiology, Emerging Antibiotic Resistance Unit, Department of Medicine, Faculty of Science, University of Fribourg, Fribourg, Switzerland HFR - Hôpital Cantonal, Fribourg, Switzerland.
authors.forename: Patrice
authors.initials: P
authors.lastname: Nordmann
authors.affiliation: Department of Virology, Bacteriology-Infect Control, Parasitology-Mycology, Assistance Publique-Hôpitaux de Paris, University Hospital Henri Mondor, Créteil, France IAME, UMR 1137, INSERM, Paris, France.
authors.forename: Marine
authors.initials: M
authors.lastname: Desroches
authors.affiliation: Department of Virology, Bacteriology-Infect Control, Parasitology-Mycology, Assistance Publique-Hôpitaux de Paris, University Hospital Henri Mondor, Créteil, France IAME, UMR 1137, INSERM, Paris, France.
authors.forename: Jean-Winoc
authors.initials: JW
authors.lastname: Decousser
authors.affiliation: Medical and Molecular Microbiology, Emerging Antibiotic Resistance Unit, Department of Medicine, Faculty of Science, University of Fribourg, Fribourg, Switzerland laurent.poirel@unifr.ch.
authors.forename: Laurent
authors.initials: L
authors.lastname: Poirel
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D002439:Cefotaxime / Q000494:pharmacology; D018550:Cephalosporin Resistance / Q000235:genetics; D002511:Cephalosporins / Q000494:pharmacology*; D003091:Colistin / Q000494:pharmacology*; D024881:Drug Resistance, Bacterial / Q000235:genetics; D007711:Klebsiella pneumoniae / Q000187:drug effects* / Q000378:metabolism; D008826:Microbial Sensitivity Tests
chemical_list: D000900:Anti-Bacterial Agents; D002511:Cephalosporins; D002439:Cefotaxime; D003091:Colistin