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

Abstract
We investigated ertapenem-susceptible and -resistant extended-spectrum β-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.

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