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154 Chapter 8 Figure 5. Boxplots of number of acquired resistance encoding genes other than CMY-2 for CMY-2-producing E. coli isolates with an MIC (minimal inhibitory concentration) for cefotaxime, ceftazidime and piperacillin/tazobactam. Box plot explanation: bottom of the box, lower quartile; top of the box, upper quartile; line in the middle, median; end of the whiskers, lowest data point still within 1.5 times the interquartile range (IQR) below lower quartile and highest data point still within 1.5 times the IQR above upper quartile; ○ symbol outside the whiskers: outliers with isolate number. Mutations in the promoter/attenuator region of the chromosomal ampC gene related to hyperproduction of blaAmpC, as described by Tracz et al., were not detected (Tracz et al. 2007). Table 1 shows the MLST-typing results, including six isolates with MLST sequence type (ST) 131. The wgMLST analysis revealed that two ST131 isolates (16 and 17), obtained from the same patient, were genetically closely related. Because of their differences in susceptibility and ePCN, both isolates were included in further analysis. The other isolates were obtained from separate patients and were genetically distinct based on wgMLST analysis.

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