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3 Nature MRSA MRCNS VREVRSA PRSP BRNAR MDRP ESBL)MBL AmpC Qnr 20MRSA MRSA Extended-spectrum -lactamase: ESBL - --MBL - MBL MBL MRSA - PC MRSA SENTRY MRSA 70%MRSA VRSA VRE1997 VRE VER vanc Enterococcus faecalis, Enterococcus faecium

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7 ant pneumococci. Microb Drug Resist 1: Crook, D. W., and B. G. Spratt Multiple antibiotic resistance in Streptococcus pneumoniae. Br Med Bull 54: Feil, E. J., and B. G. Spratt Recombination and the population structures of bacterial pathogens. Annu Rev Microbiol 55: Spratt, B. G Resistance to antibiotics mediated by target alterations. Science 264: Bradford, P. A Extended-spectrum -lactamases in the 21st century: characterization, epidemiology, and detection of this important resistance threat. Clin Microbiol Rev 14: , table of contents. Bush, K., G. A. Jacoby, and A. A. Medeiros A functional classification scheme for -lactamases and its correlation with molecular structure. Antimicrob Agents Chemother 39: Frere, J. M lactamases and bacterial resistance to antibiotics. Mol Microbiol 16: Knox, J. R Extended-spectrum and inhibitor-resistant TEM-type -lactamases: mutations, specificity, and three-dimensional structure. Antimicrob Agents Chemother 39: Matagne, A., A. Dubus, M. Galleni, and J. M. Frere The -lactamase cycle: a tale of selective pressure and bacterial ingenuity. Nat Prod Rep 16: Matagne, A., J. Lamotte-Brasseur, and J. M. Frere Catalytic properties of class A -lactamases: efficiency and diversity. Biochem J 330 (Pt 2) : Nordmann, P., and L. Poirel Emerging carbapenemases in Gram-negative aerobes. Clin Microbiol Infect 8: Walsh, T. R., M. A. Toleman, L. Poirel, and P. Nordmann Metallo--lactamases: the quiet before the storm? Clin Microbiol Rev 18: Bonten, M. J., R. Willems, and R. A. Weinstein Vancomycin-resistant enterococci: why are they here, and where do they come from? Lancet Infect Dis 1: Menichetti, F Current and emerging serious Grampositive infections. Clin Microbiol Infect 11 Suppl 3: Patel, R Clinical impact of vancomycin-resistant enterococci. J Antimicrob Chemother 51 Suppl 3: iii Coffey, T. J., C. G. Dowson, M. Daniels, and B. G. Spratt Genetics and molecular biology of b-lactam-resist- Alba, J., C. Bauvois, Y. Ishii, M. Galleni, K. Masuda, M. Ishiguro, M. Ito, J. M. Frere, and K. Yamaguchi A detailed kinetic study of Mox-1, a plasmid-encoded class C -lactamase. FEMS Microbiol Lett 225: Alba, J., Y. Ishii, M. Galleni, J. M. Frere, M. Ito, and K. Yamaguchi Cefcapene inactivates chromosomeencoded class C -lactamases. J Infect Chemother 8: Ibuka, A., A. Taguchi, M. Ishiguro, S. Fushinobu, Y. Ishii, S. Kamitori, K. Okuyama, K. Yamaguchi, M. Konno, and H. Matsuzawa Crystal structure of the E166A mutant of extended-spectrum -lactamase Toho-1 at 1.8 A resolution. J Mol Biol 285: Ibuka, A. S., Y. Ishii, M. Galleni, M. Ishiguro, K. Yamaguchi, J. M. Frere, H. Matsuzawa, and H. Sakai Crystal structure of extended-spectrum -lactamase Toho-1: insights into the molecular mechanism for catalytic reaction and substrate specificity expansion. Biochemistry 42: Ishii, Y., S. Kimura, J. Alba, K. Shiroto, M. Otsuka, N. Hashizume, K. Tamura, and K. Yamaguchi Extended-spectrum -lactamase-producing Shiga toxin gene (Stx1)-positive Escherichia coli O26: H11: a new concern. J Clin Microbiol 43: Ishii, Y., A. Ohno, H. Taguchi, S. Imajo, M. Ishiguro, and H. Matsuzawa Cloning and sequence of the gene encoding a cefotaxime-hydrolyzing class A -lactamase isolated from Escherichia coli. Antimicrob Agents Chemother 39: Kimura, S., J. Alba, K. Shiroto, R. Sano, Y. Niki, S. Maesaki, K. Akizawa, M. Kaku, Y. Watanuki, Y. Ishii, and K. Yamaguchi Clonal diversity of metallo-lactamase-possessing Pseudomonas aeruginosa in geographically diverse regions of Japan. J Clin Microbiol 43: Kimura, S., M. Ishiguro, Y. Ishii, J. Alba, and K. Yamaguchi Role of a mutation at position 167 of CTX-M-19 in ceftazidime hydrolysis. Antimicrob Agents Chemother 48: Kojima, A., Y. Ishii, K. Ishihara, H. Esaki, T. Asai, C. Oda, Y. Tamura, T. Takahashi, and K. Yamaguchi Extended-Spectrum--Lactamase-Producing Escherichia coli Strains Isolated from Farm Animals from 1999 to

8 2002: Report from the Japanese Veterinary Antimicrobial Resistance Monitoring Program. Antimicrob Agents Chemother 49: Ma, L., J. Alba, F. Y. Chang, M. Ishiguro, K. Yamaguchi, L. K. Siu, and Y. Ishii Novel SHV-derived extendedspectrum b-lactamase, SHV-57, that confers resistance to ceftazidime but not cefazolin. Antimicrob Agents Chemother 49: Ma, L., Y. Ishii, F. Y. Chang, K. Yamaguchi, M. Ho, and L. K. Siu CTX-M-14, a plasmid-mediated CTX-M type extended-spectrum -lactamase isolated from Escherichia coli. Antimicrob Agents Chemother 46: Ma, L., Y. Ishii, M. Ishiguro, H. Matsuzawa, and K. Yamaguchi Cloning and sequencing of the gene encoding Toho-2, a class A -lactamase preferentially inhibited by tazobactam. Antimicrob Agents Chemother 42: Ma, L., H. Matsuo, Y. Ishii, and K. Yamaguchi Characterization of cefotaxime-resistant Escherichia coli isolates from a nosocomial outbreak at three geriatric hospitals. J Infect Chemother 8: Mercuri, P. S., Y. Ishii, L. Ma, G. M. Rossolini, F. Luzzaro, G. Amicosante, N. Franceschini, J. M. Frere, and M. Galleni Clonal diversity and metallo--lactamase production in clinical isolates of Stenotrophomonas maltophilia. Microb Drug Resist 8: Shimamura, T., A. Ibuka, S. Fushinobu, T. Wakagi, M. Ishiguro, Y. Ishii, and H. Matsuzawa Acyl-intermediate structures of the extended-spectrum class A lactamase, Toho-1, in complex with cefotaxime, cephalothin, and benzylpenicillin. J Biol Chem 277: Takenouchi, T., Y. Ishii, and K. Yamaguchi Properties of extended-spectrum -lactamases constructed by site-directed mutagenesis. J Infect Chemother 8: American Society for Microbiology Infection Control Doctor 37 UCLA Pardridge Journal of Nuclear Medicine ,700 BBB Pardridge BBB BBB

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