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Antimicrobial Agents and Chemotherapy, August 2006, p. 2833-2835, Vol. 50, No. 8
0066-4804/06/$08.00+0     doi:10.1128/AAC.01591-05
Copyright © 2006, American Society for Microbiology. All Rights Reserved.

Outer Membrane Protein Changes and Efflux Pump Expression Together May Confer Resistance to Ertapenem in Enterobacter cloacae

Dóra Szabó,1,2 Fernanda Silveira,1 Andrea M. Hujer,3 Robert A. Bonomo,3 Kristine M. Hujer,3 Jane W. Marsh,1 Christopher R. Bethel,3 Yohei Doi,1 Kathleen Deeley,1 and David L. Paterson1*

Division of Infectious Diseases, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania 15213,1 Institute of Medical Microbiology, Semmelweis University, Budapest, Hungary,2 Research Service, Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, Ohio 441063

Received 14 December 2005/ Returned for modification 16 February 2006/ Accepted 22 May 2006

We investigated ertapenem-susceptible and -resistant extended-spectrum ß-lactamase-producing Enterobacter cloacae isolates obtained from the same patient. Gene transcription of OmpD and OmpF was diminished in the ertapenem-resistant isolate. An efflux pump inhibitor decreased the MICs of ertapenem in the resistant strain, suggesting a potential role of efflux pumps in ertapenem resistance.

* Corresponding author. Mailing address: UPMC Division of Infectious Diseases, Suite 3A Falk Medical Building, 3601 5th Ave., Pittsburgh, PA 15213. Phone: (412) 648-6478. Fax: (412) 648-6399. E-mail: patersond{at}dom.pitt.edu.

Antimicrobial Agents and Chemotherapy, August 2006, p. 2833-2835, Vol. 50, No. 8
0066-4804/06/$08.00+0     doi:10.1128/AAC.01591-05
Copyright © 2006, American Society for Microbiology. All Rights Reserved.



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