Journal Article

Trends in β-Lactam Resistance Among Enterobacteriaceae

Patrice Nordmann

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 27, issue Supplement_1, pages S100-S106
Published in print August 1998 | ISSN: 1058-4838
Published online August 1998 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/514905
Trends in β-Lactam Resistance Among Enterobacteriaceae

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β-Lactam resistance among Enterobacteriaceae is related primarily to the emergence of novel blactamases. The class A extended-spectrum β-lactamases hydrolyze extended-spectrum β-lactams and are inhibited by clavulanic acid. These β-lactamases are divided in two groups: TEM and SHV derivatives and non-TEM and non-SHV extended-spectrum β-lactamases (CTX-M1, CTXM2, MEN-1, PER-1, PER-2, TOHO-1, and VEB-1). The plasmid-mediated cephalosporinases (MIR- 1, FOX-1, MOX-1, BIL-1, CMY-1, CMY-2, and LAT-1) hydrolyze extended-spectrum cephalosporins and cephamycins and are not inhibited by clavulanic acid. They have been reported in Europe and in the United States. The 15 inhibitor-resistant penicillinases are TEM derivatives (except for SHV- 10) and plasmid mediated, and they are mainly from Escherichia coli isolates. The carbapenemases noted among Enterobacteriaceae are either the chromosomally located penicillinases (Sme-1, NmcA, IMI-1) found in rare Enterobacter cloacae or Serratia marcescens isolates or the plasmid-mediated metalloenzyme IMP-1 that is widespread in Japan. The incidence of resistance among Enterobacteriaceae related to the other more common β-lactam-resistance mechanisms has continued to rise worldwide.

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Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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