Up and down regulation of PhoE modulate the carbapenem resistance of Klebsiella pneumoniae clinical isolates with inactivated OmpK porins

The complete genomic sequence was determined for 3 Klebsiella pneumoniae urinary tract isolates consecutively obtained over a 3-week period from a hospitalized patient because of their antibiotic resistant phenotypes. The first isolate (strain BJ-STC-a) was resistant to cefoxitin and ertapenem, intermediate susceptible to imipenem and susceptible to tigecycline whereas the second one (strain BJ-STC-b) was susceptible to the four antibiotics and the third one (strain BJ-STC-c) was susceptible to imipenem and resistant to cefoxitin, ertapenem and tigecycline. We demonstrated that these phenotypes were related to the association of extended-spectrum β-lactamase production and modification of different influx and efflux systems.