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In the first step conversion of carnitine to -butyrobetaine occurs in gut bacteria containing the CaiTABCDE gene cluster such as Escherichia coli , Enterobacter cloacae , Klebsiella pneumoniae , and Salmonella enterica

Clayton AH, et al

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References: UK Statutory Instrument 2004/1031 (as amended) Medicines for Human Use (Clinical Trials) Regulations