case_images: PMC9464452_01
case_images: Clinical course of the patient. (A) PCT in the peripheral blood. (B)  CRP in the peripheral blood. (C) White blood cell (WBC) count in the peripheral blood. (D) Neutrophil percentage (NEUT%) in the peripheral blood.
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case_images: PMC9464452_01_IDR-15-5309-g0001.jpg
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case_images: Overall, inflammatory markers (PCT, CRP, WBC count and neutrophilic granulocyte percentage (NEUT%) in his peripheral blood) also peaked during this time (Figure 1).
case_images: Mechanisms of resistance. (A) Genomic map of K. pneumoniae 20JS63 harbored antibiotic resistance genes including kpc-2, CTX-M-65, SHV-11, TEM-1B, rmtB, qnrS1, tetA, and dfrA14. (B) Position of mutation in pmrB gene conferring colistin resistance. (C) Interatomic interaction between residue at the 157 (red mark) position and neighbor residue of both wild- and mutant-type PmrB protein.
case_images: IDR-15-5309-g0002.jpg
case_images: PMC9464452_01_IDR-15-5309-g0002.jpg
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case_images: CTX-M-65, SHV-11, TEM-1B, rmtB, qnrS1, tetA, and dfrA14. Circos (the version number: 0.69) was used to make a circular map of the bacterial genome so that the drug resistance genes can be visualized on the bacterial genome (Figure 2A). The mutant pmrB gene detected in this isolate differed from the wild type featured a single threonine to proline amino acid substitution at position 157 (Figure 2B). DynaMut web server (http://biosig.unimelb.edu.au/dynamut/) was used to analyze the effect of mutation on structure of mutated PmrB protein (Figure 2C).