PMID: 9635237Jun 23, 1998Paper

Important and emerging beta-lactamase-mediated resistances in hospital-based pathogens: the Amp C enzymes

Diagnostic Microbiology and Infectious Disease
R N Jones

Abstract

Resistance to third-generation cephalosporins mediated by beta-lactamases is an increasing problem for clinical therapeutics. A wide range of Enterobacteriaceae produce these AmpC enzymes (Bush-Jacoby-Medeiros group 1), including Enterobacter spp., Citrobacter freundii, Morganella morganii, Providencia spp., and Serratia marcescens. Resistance via this mechanism has been shown to be statistically correlated with the use of some third-generation cephalosporins, and the infections caused by these stably derepressed enzyme-producing species seem to occur most frequently in the seriously ill. More recently the genes encoding this enzyme have been documented on plasmids capable of transfer into other species such as Klebsiella pneumoniae. Fourth-generation cephalosporins, with stability and low affinity for the Amp C beta-lactamases and the ability to penetrate rapidly into the periplasmic space of Gram-negative organisms, offer a viable alternative in the treatment of these infections or as empiric regimens. Furthermore, these compounds (example: cefpirome) possess greater potency against the frequently occurring Gram-positive cocci such as oxacillin-susceptible staphylococci and the streptococci (including some penicillin-resistan...Continue Reading

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Citations

Dec 21, 2002·Diagnostic Microbiology and Infectious Disease·Helio S SaderUNKNOWN SENTRY Participants Group (Latin America)
May 6, 2003·Diagnostic Microbiology and Infectious Disease·Wen-Liang YuRonald N Jones
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