Drug Information

Drug (ID: DG00037) and It's Reported Resistant Information

• Name: Cefoxitin
• Synonyms: Mefoxin; Mefoxitin; CEFOXITIN SODIUM; Cefoxitin sodium salt; Mefoxin (TN); Cefoxitin (USAN/INN); Cefoxitin sodium (JAN/USP); (6R,7S)-3-(carbamoyloxymethyl)-7-methoxy-8-oxo-7-[(2-thiophen-2-ylacetyl)amino]-5-thia-1-azabicyclo[4.2.0]oct-2-ene-2-carboxylate; (6R,7S)-3-(carbamoyloxymethyl)-7-methoxy-8-oxo-7-[(2-thiophen-2-ylacetyl)amino]-5-thia-1-azabicyclo[4.2.0]oct-2-ene-2-carboxylic acid; (6R,7S)-3-[(carbamoyloxy)methyl]-7-methoxy-8-oxo-7-[(2-thienylacetyl)amino]-5-thia-1-azabicyclo[4.2.0]oct-2-ene-2-carboxylate; (6R,7S)-3-{[(aminocarbonyl)oxy]methyl}-7-(methyloxy)-8-oxo-7-[(2-thienylacetyl)amino]-5-thia-1-azabicyclo[4.2.0]oct-2-ene-2-carboxylic acid; 3-[(carbamoyloxy)methyl]-7alpha-methoxy-7beta-[(2-thienylacetyl)amino]-3,4-didehydrocepham-4-carboxylate; 3-[(carbamoyloxy)methyl]-7alpha-methoxy-7beta-[(thiophen-2-yl)acetamido]-3,4-didehydrocepham-4-carboxylic acid
• Indication:
  In total 1 Indication(s)
  Bacterial infection [ICD-11: 1A00-1C4Z]; Approved; [1]
• Drug Resistance Disease(s):
  Disease(s) with Clinically Reported Resistance for This Drug (5 diseases)
  Bacillus infection [ICD-11: 1C4Y]; [2]
  Bacterial infection [ICD-11: 1A00-1C4Z]; [3]
  Malaria [ICD-11: 1F45]; [1]
  Melioidosis [ICD-11: 1C42]; [4], [5]
  Pneumonia [ICD-11: CA40]; [6]
  Disease(s) with Resistance Information Validated by in-vivo Model for This Drug (1 diseases)
  Bacillus infection [ICD-11: 1C4Y]; [7]
• Target: Bacterial Penicillin binding protein (Bact PBP); NOUNIPROTAC; [1]
• Formula: C16H17N3O7S2
• IsoSMILES: CO[C@@]1([C@@H]2N(C1=O)C(=C(CS2)COC(=O)N)C(=O)O)NC(=O)CC3=CC=CS3
• InChI: 1S/C16H17N3O7S2/c1-25-16(18-10(20)5-9-3-2-4-27-9)13(23)19-11(12(21)22)8(6-26-15(17)24)7-28-14(16)19/h2-4,14H,5-7H2,1H3,(H2,17,24)(H,18,20)(H,21,22)/t14-,16+/m1/s1
• InChIKey: WZOZEZRFJCJXNZ-ZBFHGGJFSA-N
• PubChem CID: 441199
• ChEBI ID: CHEBI:209807
• TTD Drug ID: D02VFC
• VARIDT ID: DR00828
• INTEDE ID: DR2492
• DrugBank ID: DB01331

Type(s) of Resistant Mechanism of This Drug

  ADTT: Aberration of the Drug's Therapeutic Target

  DISM: Drug Inactivation by Structure Modification

  IDUE: Irregularity in Drug Uptake and Drug Efflux

Drug Resistance Data Categorized by Their Corresponding Diseases

ICD-01: Infectious/parasitic diseases

Bacterial infection [ICD-11: 1A00-1C4Z]

Drug Resistance Data Categorized by Their Corresponding Mechanisms

Drug Inactivation by Structure Modification (DISM)

Key Molecule: Beta-lactamase (BLA) [8], [9]

• Molecule Alteration: Expression; Up-regulation
• Resistant Disease: Bacterial infection [ICD-11: 1A00-1C4Z]
• Experimental Note: Identified from the Human Clinical Data
• In Vitro Model: Escherichia coli strain DH5a; 668369
• In Vitro Model: Klebsiella pneumoniae strain HEL-1; 573
• Experiment for Molecule Alteration: Whole genome sequence assay
• Experiment for Drug Resistance: Agar dilution method assay
• Mechanism Description: The phenotype of Klebsiella pneumoniae HEL-1 indicates a plasmidic cephamycinase gene (blaCMY-2),which is responsible for cephamycin resistance.

Key Molecule: Beta-lactamase (BLA) [10]

• Molecule Alteration: Missense mutation; p.V88L+p.M154L
• Resistant Disease: Bacterial infection [ICD-11: 1A00-1C4Z]
• Experimental Note: Identified from the Human Clinical Data
• In Vitro Model: Escherichia coli TOP10; 83333
• In Vitro Model: Escherichia coli ST648; 562
• Experiment for Molecule Alteration: Whole genome sequence assay; Allelic frequency measurement assay
• Experiment for Drug Resistance: Etest assay
• Mechanism Description: NDM-5 differed from existing enzymes due to substitutions at positions 88 (Val - Leu) and 154 (Met - Leu) and reduced the susceptibility of Escherichia coli TOP10 transformants to expanded-spectrum cephalosporins and carbapenems when expressed under its native promoter.

Key Molecule: Penicillin binding protein PBP 2 (PBP2) [11]

• Molecule Alteration: Expression; Up-regulation
• Resistant Disease: Bacterial infection [ICD-11: 1A00-1C4Z]
• Experimental Note: Identified from the Human Clinical Data
• In Vitro Model: Staphylococcus aureus RN4220; 1280
• In Vitro Model: Staphylococcus aureus M10/0061; 1280
• In Vitro Model: Staphylococcus aureus M10/0148; 1280
• In Vitro Model: Staphylococcus aureus WGB8404; 1280
• Experiment for Molecule Alteration: Whole genome sequence assay; Allelic frequency measurement assay
• Experiment for Drug Resistance: Disk diffusion test assay; Etest assay
• Mechanism Description: Methicillin resistance in staphylococci is mediated by penicillin binding protein 2a (PBP 2a), encoded by mecA on mobile staphylococcal cassette chromosome mec (SCCmec) elements.Whole-genome sequencing of one isolate (M10/0061) revealed a 30-kb SCCmec element encoding a class E mec complex with highly divergent blaZ-mecA-mecR1-mecI, a type 8 cassette chromosome recombinase (ccr) complex consisting of ccrA1-ccrB3, an arsenic resistance operon, and flanking direct repeats (DRs).

Key Molecule: Beta-lactamase (BLA) [3]

• Molecule Alteration: Mutantion; p.V231S
• Resistant Disease: Bacterial infection [ICD-11: 1A00-1C4Z]
• Experimental Note: Identified from the Human Clinical Data
• In Vitro Model: Escherichia coli DH10B; 316385
• In Vitro Model: Escherichia coli VA1171/10; 562
• Experiment for Molecule Alteration: Whole genome sequence assay; Allelic frequency measurement assay
• Experiment for Drug Resistance: Quadruple disc test assay
• Mechanism Description: Molecular methods revealed a novel, plasmid-localized variant of CMY-2 with a substitution of valine 231 for serine (V231S), which was designated CMY-42. Like the CMY-2-like AmpC beta-lactamase CMY-30, carrying the substitution V231G, CMY-42 displayed increased activity toward expanded spectrum cephalosporins.

Key Molecule: Beta-lactamase (BLA) [8], [12]

• Molecule Alteration: Missense mutation; p.V77A+p.D114N+p.S140A+p.N288D
• Resistant Disease: Bacterial infection [ICD-11: 1A00-1C4Z]
• Experimental Note: Identified from the Human Clinical Data
• In Vitro Model: Citrobacter freundii strain 2524/96; 546
• In Vitro Model: Citrobacter freundii strain 2525/96; 546
• In Vitro Model: Citrobacter freundii strain 2526/96; 546
• In Vitro Model: Escherichia coli strain 2527/96; 562
• Experiment for Drug Resistance: Agar dilution method assay
• Mechanism Description: Sequencing has revealed that C. freundii isolates produced a new CTX-M-3 enzyme which is very closely related to the CTX-M-1/MEN-1 Beta-lactamase.

Melioidosis [ICD-11: 1C42]

Drug Resistance Data Categorized by Their Corresponding Mechanisms

Irregularity in Drug Uptake and Drug Efflux (IDUE)

Key Molecule: Outer membrane porin (OMP38) [4], [5]

• Molecule Alteration: Expression; Up-regulation
• Resistant Disease: Melioidosis [ICD-11: 1C42.0]
• Experimental Note: Identified from the Human Clinical Data
• In Vitro Model: Escherichia coli; 668369
• In Vitro Model: Escherichia coli BL21(DE3); 469008
• In Vitro Model: Burkholderia pseudomallei isolates; 28450
• Experiment for Molecule Alteration: Whole genome sequence assay
• Experiment for Drug Resistance: Broth microdilution method assay
• Mechanism Description: Bps is highly resistant to many antimicrobial agents and this resistance may result from the low drug permeability of outer membrane proteins, known as porins.An Escherichia coli strain defective in most porins, but expressing BpsOmp38, exhibited considerably lower antimicrobial susceptibility than the control strain. In addition, mutation of Tyr119, the most prominent pore-lining residue in BpsOmp38, markedly altered membrane permeability, substitution with Ala (mutant BpsOmp38Y119A) enhanced uptake of the antimicrobial agents, while substitution with Phe (mutant BpsOmp38Y119F) inhibited uptake.

Bacillus infection [ICD-11: 1C4Y]

Drug Resistance Data Categorized by Their Corresponding Mechanisms

Aberration of the Drug's Therapeutic Target (ADTT)

Key Molecule: ErmR rRNA adenine N6-methyltransferase (ERMR) [7]

• Molecule Alteration: Expression; Inherence
• Resistant Disease: Bacteroides fragilis infection [ICD-11: 1C4Y.6]
• Experimental Note: Discovered Using In-vivo Testing Model
• In Vitro Model: Bacteroides distasonis strains; 823
• In Vitro Model: Bacteroides distasonis strains V2002; 823
• In Vitro Model: Bacteroides distasonis strains V2003; 823
• In Vitro Model: Bacteroides distasonis strains V2004; 823
• In Vitro Model: Bacteroides fragilis strain; 817
• In Vitro Model: Bacteroides fragilis strain V503; 817
• In Vitro Model: Bacteroides ovatus strains; 28116
• In Vitro Model: Bacteroides ovatus strains V2008; 28116
• In Vitro Model: Bacteroides thetaiotaomicron strain; 818
• In Vitro Model: Bacteroides thetaiotaomicron strain V2005; 818
• In Vitro Model: Bacteroides thetaiotaomicron strain V2006; 818
• In Vitro Model: Bacteroides thetaiotaomicron strain V2007; 818
• In Vitro Model: Bacteroides uniformis strain; 820
• In Vitro Model: Bacteroides uniformis strain V1760; 820
• In Vitro Model: Bacteroides uniformis strain V1761; 820
• In Vitro Model: Bacteroides uniformis strain V1918; 820
• In Vitro Model: Bacteroides uniformis strain V1921; 820
• In Vitro Model: Bacteroides uniformis strain V2000; 820
• In Vitro Model: Bacteroides uniformis strain V2001; 820
• In Vitro Model: Bacteroides uniformis strain V528; 820
• In Vitro Model: Bacteroides uniformis strain V844; 820
• Experiment for Molecule Alteration: Southern blotting assay
• Mechanism Description: Clindamycin resistance in Bacteroides spp. is usually macrolide-lincosamide-streptogramin B (MLS) resistance conferred by erm genes which are similar to those seen in gram-positive, facultative anaerobes. Of 13 clinical isolates of the Bacteroides group, all were resistant to tetracycline (>10,ug/ml).

Key Molecule: ErmR rRNA adenine N6-methyltransferase (ERMR) [7]

• Molecule Alteration: Expression; Inherence
• Resistant Disease: Bacteroides uniformis infection [ICD-11: 1C4Y.11]
• Experimental Note: Discovered Using In-vivo Testing Model
• In Vitro Model: Bacteroides distasonis strains; 823
• In Vitro Model: Bacteroides distasonis strains V2002; 823
• In Vitro Model: Bacteroides distasonis strains V2003; 823
• In Vitro Model: Bacteroides distasonis strains V2004; 823
• In Vitro Model: Bacteroides fragilis strain; 817
• In Vitro Model: Bacteroides fragilis strain V503; 817
• In Vitro Model: Bacteroides ovatus strains; 28116
• In Vitro Model: Bacteroides ovatus strains V2008; 28116
• In Vitro Model: Bacteroides thetaiotaomicron strain; 818
• In Vitro Model: Bacteroides thetaiotaomicron strain V2005; 818
• In Vitro Model: Bacteroides thetaiotaomicron strain V2006; 818
• In Vitro Model: Bacteroides thetaiotaomicron strain V2007; 818
• In Vitro Model: Bacteroides uniformis strain; 820
• In Vitro Model: Bacteroides uniformis strain V1760; 820
• In Vitro Model: Bacteroides uniformis strain V1761; 820
• In Vitro Model: Bacteroides uniformis strain V1918; 820
• In Vitro Model: Bacteroides uniformis strain V1921; 820
• In Vitro Model: Bacteroides uniformis strain V2000; 820
• In Vitro Model: Bacteroides uniformis strain V2001; 820
• In Vitro Model: Bacteroides uniformis strain V528; 820
• In Vitro Model: Bacteroides uniformis strain V844; 820
• Experiment for Molecule Alteration: Southern blotting assay
• Mechanism Description: Clindamycin resistance in Bacteroides spp. is usually macrolide-lincosamide-streptogramin B (MLS) resistance conferred by erm genes which are similar to those seen in gram-positive, facultative anaerobes. Of 13 clinical isolates of the Bacteroides group, all were resistant to tetracycline (>10,ug/ml).

Key Molecule: ErmR rRNA adenine N6-methyltransferase (ERMR) [7]

• Molecule Alteration: Expression; Inherence
• Resistant Disease: Bacteroides thetaiotaomicron infection [ICD-11: 1C4Y.10]
• Experimental Note: Discovered Using In-vivo Testing Model
• In Vitro Model: Bacteroides distasonis strains; 823
• In Vitro Model: Bacteroides distasonis strains V2002; 823
• In Vitro Model: Bacteroides distasonis strains V2003; 823
• In Vitro Model: Bacteroides distasonis strains V2004; 823
• In Vitro Model: Bacteroides fragilis strain; 817
• In Vitro Model: Bacteroides fragilis strain V503; 817
• In Vitro Model: Bacteroides ovatus strains; 28116
• In Vitro Model: Bacteroides ovatus strains V2008; 28116
• In Vitro Model: Bacteroides thetaiotaomicron strain; 818
• In Vitro Model: Bacteroides thetaiotaomicron strain V2005; 818
• In Vitro Model: Bacteroides thetaiotaomicron strain V2006; 818
• In Vitro Model: Bacteroides thetaiotaomicron strain V2007; 818
• In Vitro Model: Bacteroides uniformis strain; 820
• In Vitro Model: Bacteroides uniformis strain V1760; 820
• In Vitro Model: Bacteroides uniformis strain V1761; 820
• In Vitro Model: Bacteroides uniformis strain V1918; 820
• In Vitro Model: Bacteroides uniformis strain V1921; 820
• In Vitro Model: Bacteroides uniformis strain V2000; 820
• In Vitro Model: Bacteroides uniformis strain V2001; 820
• In Vitro Model: Bacteroides uniformis strain V528; 820
• In Vitro Model: Bacteroides uniformis strain V844; 820
• Experiment for Molecule Alteration: Southern blotting assay
• Mechanism Description: Clindamycin resistance in Bacteroides spp. is usually macrolide-lincosamide-streptogramin B (MLS) resistance conferred by erm genes which are similar to those seen in gram-positive, facultative anaerobes. Of 13 clinical isolates of the Bacteroides group, all were resistant to tetracycline (>10,ug/ml).

Key Molecule: ErmR rRNA adenine N6-methyltransferase (ERMR) [7]

• Molecule Alteration: Expression; Inherence
• Resistant Disease: Bacteroides ovatus infection [ICD-11: 1C4Y.8]
• Experimental Note: Discovered Using In-vivo Testing Model
• In Vitro Model: Bacteroides distasonis strains; 823
• In Vitro Model: Bacteroides distasonis strains V2002; 823
• In Vitro Model: Bacteroides distasonis strains V2003; 823
• In Vitro Model: Bacteroides distasonis strains V2004; 823
• In Vitro Model: Bacteroides fragilis strain; 817
• In Vitro Model: Bacteroides fragilis strain V503; 817
• In Vitro Model: Bacteroides ovatus strains; 28116
• In Vitro Model: Bacteroides ovatus strains V2008; 28116
• In Vitro Model: Bacteroides thetaiotaomicron strain; 818
• In Vitro Model: Bacteroides thetaiotaomicron strain V2005; 818
• In Vitro Model: Bacteroides thetaiotaomicron strain V2006; 818
• In Vitro Model: Bacteroides thetaiotaomicron strain V2007; 818
• In Vitro Model: Bacteroides uniformis strain; 820
• In Vitro Model: Bacteroides uniformis strain V1760; 820
• In Vitro Model: Bacteroides uniformis strain V1761; 820
• In Vitro Model: Bacteroides uniformis strain V1918; 820
• In Vitro Model: Bacteroides uniformis strain V1921; 820
• In Vitro Model: Bacteroides uniformis strain V2000; 820
• In Vitro Model: Bacteroides uniformis strain V2001; 820
• In Vitro Model: Bacteroides uniformis strain V528; 820
• In Vitro Model: Bacteroides uniformis strain V844; 820
• Experiment for Molecule Alteration: Southern blotting assay
• Mechanism Description: Clindamycin resistance in Bacteroides spp. is usually macrolide-lincosamide-streptogramin B (MLS) resistance conferred by erm genes which are similar to those seen in gram-positive, facultative anaerobes. Of 13 clinical isolates of the Bacteroides group, all were resistant to tetracycline (>10,ug/ml). Seven of the eight clindamycin-resistant clinical isolates constitutively expressed erythromycin resistance and had a high level of resistance to clindamycin (> 10ug/ml). V2002 was susceptible to erythromycin.

Drug Inactivation by Structure Modification (DISM)

Key Molecule: Beta-lactamase (BLA) [2]

• Molecule Alteration: Expression; Inherence
• Resistant Disease: Bacteroides infection [ICD-11: 1C4Y.7]
• Experimental Note: Identified from the Human Clinical Data
• In Vitro Model: Escherichia coli strain HB101; 634468
• In Vitro Model: Escherichia coli strain DH5a; 668369
• In Vitro Model: Bacteroides uniformis strain V528; 820
• In Vitro Model: Bacteroides fragilis strain 638; 862962
• In Vitro Model: Bacteroides fragilis strain IB246; 817
• In Vitro Model: Bacteroides fragilis strain IB246flpSUC2C; 817
• In Vitro Model: Bacteroides fragilis strain IB247; 817
• In Vitro Model: Bacteroides vulgatus strain CLA341; 821
• Experiment for Molecule Alteration: Nucleotide sequence assay
• Experiment for Drug Resistance: Standard broth microdilution method assay
• Mechanism Description: The beta-lactamase gene (cfxA) was subcloned on a 2.2-kb DraI-HindIII fragment, and the nucleotide sequence was determined. These results showed that cfxA encoded a protein of 321 amino acids and 35,375 molecular weight. Mutant strains in which the cfxA structural gene was disrupted by insertional inactivation lost both Fxr and beta-lactamase activity.

Malaria [ICD-11: 1F45]

Drug Resistance Data Categorized by Their Corresponding Mechanisms

Drug Inactivation by Structure Modification (DISM)

Key Molecule: CAM-1 carbapenemase (CAM1) [1]

• Molecule Alteration: Expression; Up-regulation
• Resistant Disease: Pseudomonas infection [ICD-11: 1F45.1]
• Experimental Note: Identified from the Human Clinical Data
• In Vitro Model: Escherichia coli TOP10; 83333
• In Vitro Model: Pseudomonas aeruginosa N17-01167; 287
• In Vitro Model: Pseudomonas aeruginosa N17-01173; 287
• In Vitro Model: Pseudomonas aeruginosa N17-02436; 287
• In Vitro Model: Pseudomonas aeruginosa N17-02437; 287
• Experiment for Molecule Alteration: Whole genome sequencing assay
• Experiment for Drug Resistance: Vitek 2 assay; Etest assay
• Mechanism Description: A novel class B Beta-lactamase gene, blaCAM-1, exhibited resistance to imipenem, meropenem, doripenem, cefotaxime, ceftazidime, cefoxitin, piperacillin/tazobactam, ceftazidime/avibactam and ceftolozane/tazobactam.

ICD-12: Respiratory system diseases

Pneumonia [ICD-11: CA40]

Drug Resistance Data Categorized by Their Corresponding Mechanisms

Irregularity in Drug Uptake and Drug Efflux (IDUE)

Key Molecule: Bcr/CflA family efflux transporter (BCML) [6]

• Molecule Alteration: Expression; Inherence
• Resistant Disease: Klebsiella pneumoniae infection [ICD-11: CA40.1]
• Experimental Note: Identified from the Human Clinical Data
• In Vitro Model: Escherichia coli DH10B; 316385
• In Vitro Model: Escherichia coli strain NCTC 50192; 562
• In Vitro Model: Klebsiella pneumoniae strain ORI-1; 573
• Experiment for Molecule Alteration: PCR and hybridization experiments assay
• Experiment for Drug Resistance: Agar dilution technique assay
• Mechanism Description: Klebsiella pneumoniae ORI-1 strain harbored a ca. 140-kb nontransferable plasmid, pTk1, that conferred an extended-spectrum cephalosporin resistance profile antagonized by the addition of clavulanic acid, tazobactam, or imipenem. The gene for GES-1 (Guiana extended-spectrum beta-lactamase) was cloned, and its protein was expressed in Escherichia coli DH10B, where this pI-5. 8 beta-lactamase of a ca. 31-kDa molecular mass conferred resistance to oxyimino cephalosporins (mostly to ceftazidime). GES-1 is weakly related to the other plasmid-located Ambler class A extended-spectrum beta-lactamases (ESBLs).

Drug Sensitivity Data Categorized by Their Corresponding Mechanisms

Irregularity in Drug Uptake and Drug Efflux (IDUE)

Key Molecule: Bcr/CflA family efflux transporter (BCML) [6]

• Molecule Alteration: Expression; Antagonism
• Sensitive Disease: Klebsiella pneumoniae infection [ICD-11: CA40.1]
• Experimental Note: Identified from the Human Clinical Data
• In Vitro Model: Escherichia coli DH10B; 316385
• In Vitro Model: Escherichia coli strain NCTC 50192; 562
• In Vitro Model: Klebsiella pneumoniae strain ORI-1; 573
• Experiment for Molecule Alteration: PCR and hybridization experiments assay
• Experiment for Drug Resistance: Agar dilution technique assay
• Mechanism Description: Inhibition studies, as measured by IC50 values with benzylpenicillin as the substrate, showed that GES-1 was inhibited by clavulanic acid (5 uM) and tazobactam (2.5 uM) and strongly inhibited by imipenem (0.1 uM). Beta-Lactam MICs were always lowered by the addition of clavulanic acid or tazobactam, less so by sulbactam, and uncommonly by imipenem.

Key Molecule: OmpK37 (OMPK37) [13]

• Molecule Alteration: Expression; Inherence
• Sensitive Disease: Klebsiella pneumoniae infection [ICD-11: CA40.1]
• Experimental Note: Identified from the Human Clinical Data
• In Vitro Model: Escherichia coli; 668369
• In Vitro Model: Klebsiella pneumoniae strain CSUB10R; 573
• In Vitro Model: Klebsiella pneumoniae strain CSUB10S; 573
• In Vitro Model: Klebsiella pneumoniae strain LB4; 573
• In Vitro Model: Klebsiella pneumoniae strain LB66; 573
• In Vitro Model: Klebsiella pneumoniae strain SD8; 573
• Experiment for Molecule Alteration: Southern blotting assay
• Experiment for Drug Resistance: Microdilution method assay
• Mechanism Description: Due to its porin deficiency, strain CSUB10R is more resistant to Beta-lactams than is parental strain CSUB10S. As expected, for k. pneumoniae CSUB10R expressing Ompk36 or Ompk35, the MICs reverted to values similar to those observed for strain CSUB10S.

References

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• Ref 2: Genetic and biochemical analysis of a novel Ambler class A beta-lactamase responsible for cefoxitin resistance in Bacteroides species. Antimicrob Agents Chemother. 1993 May;37(5):1028-36. doi: 10.1128/AAC.37.5.1028.
• Ref 3: CMY-42, a novel plasmid-mediated CMY-2 variant AmpC beta-lactamase. Microb Drug Resist. 2011 Jun;17(2):165-9. doi: 10.1089/mdr.2010.0137. Epub 2011 Mar 9.
• Ref 4: Functional reconstitution, gene isolation and topology modelling of porins from Burkholderia pseudomallei and Burkholderia thailandensis. Biochem J. 2004 Feb 1;377(Pt 3):579-87. doi: 10.1042/BJ20031118.
• Ref 5: Porin involvement in cephalosporin and carbapenem resistance of Burkholderia pseudomallei. PLoS One. 2014 May 1;9(5):e95918. doi: 10.1371/journal.pone.0095918. eCollection 2014.
• Ref 6: Biochemical sequence analyses of GES-1, a novel class A extended-spectrum beta-lactamase, and the class 1 integron In52 from Klebsiella pneumoniae. Antimicrob Agents Chemother. 2000 Mar;44(3):622-32. doi: 10.1128/AAC.44.3.622-632.2000.
• Ref 7: Molecular survey of clindamycin and tetracycline resistance determinants in Bacteroides species. Antimicrob Agents Chemother. 1991 Nov;35(11):2415-8. doi: 10.1128/AAC.35.11.2415.
• Ref 8: Identifying novel Beta-lactamase substrate activity through in silico prediction of antimicrobial resistance. Microb Genom. 2021 Jan;7(1):mgen000500. doi: 10.1099/mgen.0.000500.
• Ref 9: Characterization of the plasmidic beta-lactamase CMY-2, which is responsible for cephamycin resistance. Antimicrob Agents Chemother. 1996 Jan;40(1):221-4. doi: 10.1128/AAC.40.1.221.
• Ref 10: A novel variant, NDM-5, of the New Delhi metallo-Beta-lactamase in a multidrug-resistant Escherichia coli ST648 isolate recovered from a patient in the United Kingdom. Antimicrob Agents Chemother. 2011 Dec;55(12):5952-4. doi: 10.1128/AAC.05108-11. Epub 2011 Sep 19.
• Ref 11: Detection of staphylococcal cassette chromosome mec type XI carrying highly divergent mecA, mecI, mecR1, blaZ, and ccr genes in human clinical isolates of clonal complex 130 methicillin-resistant Staphylococcus aureus. Antimicrob Agents Chemother. 2011 Aug;55(8):3765-73. doi: 10.1128/AAC.00187-11. Epub 2011 Jun 2.
• Ref 12: Cefotaxime-resistant Enterobacteriaceae isolates from a hospital in Warsaw, Poland: identification of a new CTX-M-3 cefotaxime-hydrolyzing beta-lactamase that is closely related to the CTX-M-1/MEN-1 enzyme. Antimicrob Agents Chemother. 1998 Apr;42(4):827-32. doi: 10.1128/AAC.42.4.827.
• Ref 13: Identification and characterization of a new porin gene of Klebsiella pneumoniae: its role in beta-lactam antibiotic resistance. J Bacteriol. 1999 May;181(9):2726-32. doi: 10.1128/JB.181.9.2726-2732.1999.