S. Hernandez-alles et al., Development of resistance during antimicrobial therapy caused by insertionsequence interruption of porin genes, ANTIM AG CH, 43(4), 1999, pp. 937-939
We have demonstrated by using an in vitro approach that interruption of the
OmpK36 porin gene by insertion sequences (ISs) is a common type of mutatio
n that causes toss of porin expression and increased resistance to cefoxiti
n in Klebsiella pneumoniae. This mechanism also operates in vivo: of 13 por
in-deficient cefoxitin-resistant clinical isolates of K. pneumoniae, 4 pres
ented ISs in their ompK36 gene.