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Original Research

Overproduction of efflux pumps caused reduced susceptibility to carbapenem under consecutive imipenem-selected stress in Acinetobacter baumannii

, , , , , , & show all
Pages 457-467 | Published online: 19 Oct 2023

Figures & data

Table 1 DNA sequence of primers and amplicon size

Table 2 MICs of Acinetobacter baumannii SZE strain (G1) and its imipenem-selected derivatives

Figure 1 Constant monitoring of imipenem susceptibility pattern of SZE strain using Kirby–Bauer agar diffusion method in 58 subcultivations. The white triangle dotted line shows diameter with an efflux pump inhibitor, and the black triangle dotted line indicates diameter without an efflux pump inhibitor. The smooth line indicates diameter of the zone of 13 mm, which is the breakpoint of imipenem resistance according to the guidelines of the CLSI.

Abbreviations: EI, efflux pump inhibitor; AST, antimicrobial susceptibility testing; CLSI, Clinical Laboratory Standards Institute.

Figure 1 Constant monitoring of imipenem susceptibility pattern of SZE strain using Kirby–Bauer agar diffusion method in 58 subcultivations. The white triangle dotted line shows diameter with an efflux pump inhibitor, and the black triangle dotted line indicates diameter without an efflux pump inhibitor. The smooth line indicates diameter of the zone of 13 mm, which is the breakpoint of imipenem resistance according to the guidelines of the CLSI.Abbreviations: EI, efflux pump inhibitor; AST, antimicrobial susceptibility testing; CLSI, Clinical Laboratory Standards Institute.

Figure 2 Changes in the relative expression of genes of efflux pump families, outer membrane proteins, and blaOXA-51 under the stress of imipenem resistance between G1, G10, G20, and G45 strains. (A) Genes of the RND family of efflux pumps (adeB, adeG, and adeJ) in G1, G10, G20, and G45; (B) genes of the MATE family of efflux pumps (abeM), SMR family of efflux pumps (abeS), genes of the MFS family of efflux pumps (craA, amvA, and tetB); and (C) outer membrane protein genes (ompA, ompW, omp33, oprD, and carO) and blaOXA-51. *p<0.01, **p<0.001; the change of expression between G1 and G45 was not significant.

Abbreviation: NS, not significant.

Figure 2 Changes in the relative expression of genes of efflux pump families, outer membrane proteins, and blaOXA-51 under the stress of imipenem resistance between G1, G10, G20, and G45 strains. (A) Genes of the RND family of efflux pumps (adeB, adeG, and adeJ) in G1, G10, G20, and G45; (B) genes of the MATE family of efflux pumps (abeM), SMR family of efflux pumps (abeS), genes of the MFS family of efflux pumps (craA, amvA, and tetB); and (C) outer membrane protein genes (ompA, ompW, omp33, oprD, and carO) and blaOXA-51. *p<0.01, **p<0.001; the change of expression between G1 and G45 was not significant.Abbreviation: NS, not significant.