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Article summary:
1. Klebsiella pneumoniae is a common opportunistic pathogen that causes various hospital-acquired infections, and the emergence of extensively drug-resistant K. pneumoniae (XDR-KP) severely limits the effective use of antimicrobial agents.
2. Colistin and tigecycline are last-resort antibiotics used to treat XDR-KP infection, but resistance to these drugs can be mediated by chromosomal mutations or plasmid-related mcr genes.
3. This study characterized the whole genome structure of an ST656 XDR K. pneumoniae strain harboring mcr-1.1, mcr-8.2, and crrB mutations and the tet(A), tet(M), and tmexCD1-toprJ1 gene cluster located on chromosome or several distinct plasmids, as well as performed transformation/conjugation tests and plasmid curing assays to explore the transferability of corresponding resistance determinants.
Article analysis:
This article provides a comprehensive overview of the emergence of high-level colistin resistance mediated by multiple determinants in an ST656 Klebsiella pneumoniae strain, including mcr-1.1, mcr-8.2 and crrB mutations combined with tigecycline resistance. The authors provide detailed information on the methods used for bacterial isolation and identification, antimicrobial susceptibility testing, whole genome sequencing and analysis, transformation/conjugation assay, and plasmid curing assay to characterize this strain's genetic structure characteristics related to its multidrug resistance phenotype.
The article is generally reliable in terms of its content accuracy; however, there are some potential biases that should be noted when evaluating its trustworthiness and reliability. First, there is no discussion about possible risks associated with using colistin or tigecycline as last resort antibiotics for treating XDR-KP infection; thus it is unclear whether these drugs may have any adverse effects on patients' health or not. Second, while the authors provide detailed information on their methods used for characterizing this strain's genetic structure characteristics related to its multidrug resistance phenotype, they do not discuss any potential limitations associated with these methods that could affect their results or conclusions drawn from them; thus it is unclear how reliable their results actually are in practice. Thirdly, while the authors provide a comprehensive overview of this strain's genetic