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Title:           Single point mutations in global regulatory genes restore cephalosporin resistance in a low-MIC Enterococcus faecium natural isolate
Subject:         Antimicrob Agents Chemother 2026.70:e01948-25
Keywords:        ampicillin-susceptible Enterococcus faecium, cephalosporin intrinsic resistance, CroS, NusG, RpoB, PBP5
Author:          Miquel Sánchez-Osuna, Paula Bierge, Inmaculada Gómez-Sánchez, Judith Guitart-Matas, Víctor Monsálvez, Patricia Rabanal, Ana P. Pereira, Ana R. Freitas, Luisa Peixe, Mateu Espasa, Oriol Gasch, Carla Novais, Oscar Q. Pich
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     Item: 
      Title: Single point mutations in global regulatory genes restore cephalosporin resistance in a low-MIC Enterococcus faecium natural isolate
      Children: 
       Item: 
        Title: MATERIALS AND METHODS
        Children: 
         Item: 
          Title: Isolation and clinical context of the E. faecium Efm5 strain
         Item: 
          Title: Antibiotic susceptibility testing
         Item: 
          Title: Recovery of CPH high-MIC isolates
         Item: 
          Title: Whole-genome sequencing
         Item: 
          Title: Comparative genomics
         Item: 
          Title: Growth curves
         Item: 
          Title: In vitro time kill curves
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          Title: Immunoblotting
         Item: 
          Title: Transcriptional and transcriptomic analysis
         Item: 
          Title: Electron microscopy
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        Title: RESULTS
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         Item: 
          Title: Low cephalosporin MICs observed in Enterococcus faecium Efm5 isolate
         Item: 
          Title: Single-point mutations drive cephalosporin high-MIC variants of Enterococcus faecium Efm5
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          Title: Differential growth of Enterococcus faecium Efm5 and high-MIC variants
         Item: 
          Title: Increased PBP5 expression in CPH high-MIC variants
         Item: 
          Title: Global functional and metabolic reprogramming in CPH high-MIC variants
         Item: 
          Title: Distinct ultrastructural features in E. faecium Efm5 and cephalosporin high-MIC variants
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        Title: DISCUSSION
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