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PubMed2004

[Mechanisms of resistance in Enterobacteriaceae towards beta-lactamase antibiotics].

Except for Salmonella spp., all Enterobacteriaceae produce intrinsic chromosomal encoded beta-lactamases which, beside their physiologic role in cell-wall synthesis and natural beta-lactam protection, are responsible for intrinsic resistance of individual species among Enterobacteriaceae. E. coli and Shigella spp. produce a small amount of AmpC beta-lactamases and are susceptible to ampicillin and other beta-lactam antibiotic agents. Enterobacter spp, C. freundii, Serratia spp., M. morganii, P. stuarti and P. rettgeri produce small amounts of inducible AmpC beta-lactamases which are not inhibited by beta-lactamases inhibitor, causing intrinsic resistance to ampicillin, co-amoxiclav and first-generation cephalosporins. K. pneumoniae produces small amounts of SHV-1 beta-lactamases, and K. oxytoca chromosomal K1 beta-lactamase, causing resistance to ampicillin, carbencillin, ticarcillin and attenuated zone of inhibition to piperacillin, compared to piperacillin with tazobactam. They are susceptible to beta-lactamase inhibitors. Whereas P. mirabilis shows a minor chromosomal expression of beta-lactamases, P. vulgaris produces chromosomal beta-lactamases of class A (cefuroximases), causing resistance to ampicillin, ticarcillin, and first- and second-generation cephalosporins. Antibiotics have caused the appearance of acquired or secondary beta-lactamases, with the sole function of protecting bacteria from antibiotics. The production of broad-spectrum beta-lactamases (TEM-1, TEM-2, SHV-1, OXA-1) results in resistance to ampicillin, ticarcillin, first-generation cephalosporins and piperacillin. A high level of beta-lactamases leads to resistance to their inhibitors. The plasmid-mediated extended-spectrum beta-lactamases (ESBLs) are of increasing concern. Most are mutants of classic TEM- and SHV-beta-lactamases types. Unlike these parent enzymes, ESBLs hydrolyze oxymino-cephalosporins such as cefuroxime, cefotaxime, ceftriaxone, ceftizoxime, ceftazidime, cefpirome and cefepime, aztreonam, as well as penicillins and other cephalosporins, except for cephamycin (cefoxitin and cefotetan). They are inhibited by beta-lactamase inhibitors. AmpC beta-lactamases are chromosomal and inducible in most Enterobacter spp., C. freundii, Serratia spp., M. morganii and Providentia spp. They are resistant to almost all penicillins and cephalosporins, to beta-lactamase inhibitors and aztreonam, and are susceptible to cefepime and carbapenems as well. Plasmid-mediated AmpC beta-lactamases have arisen through the transfer of chromosomal genes for the inducible AmpC beta-lactamase onto plasmids. All plasmid-mediated AmpC beta-lactamases have similar substrate profiles to the parental enzymes from which they appear to be derived. With one exception, plasmid-mediated AmpCs differ from chromosomal AmpCs in being uninducible. The National Committee for Clinical Laboratory Standards (NCCLS) has issued recommendations for ESBL screening and confirmation for isolates of E. coli, K. pneumoniae and K. oxytoca. No NCCLS recommendations exist for ESBLs detection and reporting for other organisms or for detecting plasmid-mediated AmpC beta-lactamases. High-level expression of AmpC may prevent recognition of an ESBL in species that produce a chromosomally encoded inducible AmpC beta-lactamase. AmpC-inducible species (e. g. Enterobacter spp. and C. freundii) can be recognized by cefoxitin/cefotaxime disk antagonism tests. Since clinical laboratories are first to encounter bacteria with new forms of antibiotic resistance, they need appropriate tools to recognize these bacteria, including trained staff with sufficient time and equipment to follow up important observations. Because bacterial pathogenes are constantly changing, training must be an ongoing process.

Enterobacteriaceae↗
PubMed2005

Phenotypic characteristics of clinical isolates of Klebsiella pneumoniae & evaluation of available phenotypic techniques for detection of extended spectrum beta-lactamases.

BACKGROUND & OBJECTIVES: Identifying organisms that harbour extended spectrum beta lactamases (ESBLs) is a major challenge for a diagnostic clinical microbiology laboratory. Wide variety of ESBLs produced and lack of a sensitive phenotypic method for their detection make the detection of ESBLs difficult and is responsible for under-recognition. The present study was undertaken to evaluate phenotypic characteristics, initial screening tests and established confirmatory phenotypic methods for detection of ESBLs Klebsiella pneumoniae isolates prevalent in a hospital in north India. METHODS: One hundred, non-repeat clinical isolates of K. pneumoniae collected over a period of six months were included in the study. Susceptibilities of the isolates to 20 different antimicrobial agents were determined. Agar dilution and broth dilution methods were used to determine minimum inhibitory concentrations (MICs) of ceftazidime (CAZ) and cefotaxime (CTX). CAZ and CTX were used with and without clavulanic acid to detect ESBL harbouring isolates. Using agar dilution and broth dilution, MIC reduction of two and three doubling dilutions were evaluated as a criterion for ESBL harbouring isolates. Standard double disk synergy test (DDST) with disks placed at 30 mm and modified DDST with disks placed at 16 mm center-to-center distance, using at least two different third generation cephalosporins and combined disk method were also performed to detect ESBL harbouring isolates. RESULTS: Multi-drug resistance (resistance to three or more antimicrobials of different classes) was found among 94 per cent of the isolates. Pooling the results of all the three confirmatory techniques MIC reduction of >3 doubling dilutions using broth dilution method (using CTX and CAZ), combined disk method [(using CTX, ceftriaxone [(CRO), CAZ and aztreonam)] and standard DDST (using CTX, CRO, CAZ and aztreonam), revealed as many as 87 per cent of the isolates as ESBL producers. CTX had greater sensitivity in identifying isolates that harboured ESBLs. Modified DDST using CTX was as sensitive method as broth dilution method and combined disk method in detecting ESBL harbouring isolates. MIC reduction technique using agar dilution method and standard DDST had lowest overall sensitivity in detecting ESBLs. INTERPRETATION & CONCLUSION: Modified DDST using at least two different third generation cephalosporins was considered to be the best technique for detection of ESBL producing K. pneumoniae at our hospital. MIC reduction test with >2 doubling dilution reduction in MICs was found to be a better criterion than the presently recommended >3 doubling dilution reduction. For screening of potential ESBL producers, MIC determination using agar dilution was as good as that using broth dilution method. However, while performing MIC reduction test agar dilution method was found highly unreliable for detection of ESBL harbouring isolates.

Humans↗
PubMed2006

[Emergence of AmpC enzyme and antibiotics resistance in gram-negative bacilli].

OBJECTIVE: To investigate the relationship between emergence of AmpC enzyme and drug resistance in the gram-negative bacilli in Xiangya Hospital and to provide information for the treatment of antibiotics. METHODS: The bacteria were identified; the susceptibility was determined by Microscan microbiological identification system; and the AmpC enzyme was detected by disc diffusion method. RESULTS: Of the 204 gram-negative strains, the positive rate of AmpC enzyme was 19.61%; AmpC-positive strains resisted to ceftriaxone, piperacillin, ceftazidime, cefotaxime, cefoperazone, aztreonam, piperacillin/tazobactam, cefuroxime, ceftazidime/clavulanic, and cefotaxime/clavulanic. But AmpC-negative strains were susceptible to those antibiotics. There were significant differences, between the two groups (All P < 0.05). Both groups were susceptible to cefepime, imipenem, meropenem, cefoperazone/sulbactam, levofloxacin, and amikacin. CONCLUSION: The detection of AmpC enzyme is helpful to the screen of drug resistant strains. Most bacilli with AmpC enzyme show the resistance to third-generation cephosporins, aztreonam, and the beta-lactamase inhibitors, but susceptible to imipenem, cefepime, meropenem, cefoperazone/sulbactam, levofloxacin, and amikacin, which provides the information for the antibiotic therapy.

Adolescent↗
PubMed2006

[Epidemiologic surveillance of multi-drug resistant Pseudomonas aeruginosa in Mantova Hospital (Italy)].

For the period 2002-2005 we verified and compared the data of the prevalence and resistance of Pseudomonas aeruginosa (PA) isolated in Mantova Hospital (Italy) with the data from the international database. From the first six-month period of 2004 a significant increase was found (9% vs 28.8%) in the prevalence of multi-drug resistant PA (MDR-PA). The principal wards involved were the Intensive Care Unit and the Department of Respiratory Diseases. A significant increase in resistance rates was observed for all antimicrobials tested, in particular for aztreonam, ceftazidime, ciprofloxacin, gentamycin and imipenem. The lowest dual resistance rates were observed between amikacina with piperacillin/tazobactam, while the highest were for those that included ciprofloxacin and beta-lactams (aztreonam, cefepime). In this study we confirm the importance of continuous surveillance of laboratory data and tightening local control measures for nosocomial infections in order to prevent the spread and selection of MDR-PA.

Body Fluids↗
PubMed2007

Prevalence of extended-spectrum beta-lactamases-producing isolates over a 1-year period at a University Hospital in Oman.

OBJECTIVE: To evaluate the prevalence of extended-spectrum beta-lactamases isolates over one year period at Sultan Qaboos University Hospital. METHODS: We identified the ESBL isolates during a 12-month period from July 2004 to June 2005, using a commercial system, and confirmed the result using the National Committee for Clinical Laboratory Standards-approved double-disk diffusion method. RESULTS: Sensitivity was recorded for a wide range of antibiotics, aminoglycosides, carbapenem, cephalosporins, quinolones, aztreonam, ampicillin, amoxicillin/clavulanate, ampicillin/sulbactam, piperacillin-tazobactam, trimethoprim/ sulfamethoxazole and nitrofurantoin. Of the total ESBL isolated, 29.6% were from medical ward, followed by outpatients clinic, 24.3%. Urine was the main source of ESBLs 70.4%, followed by 16.5% from blood. We observed a 100% sensitivity to carbapenems, whereas 93.9% of the isolates were susceptible to amikacin. Cephalosporins were 100% resistant, except for cefoxitin, which demonstrated sensitivity of 77.4%. Aztreonam, ampicillin, co-amoxyclav and ampicillin/sulbactam were 100% resistant. Of the isolates, 57.4% were sensitive to nitrofurantoin, whereas Tazocin showed 49.6% sensitivity and co-trimoxazole 13.9%. To quinolones, 74.8% of the isolates were resistant. CONCLUSION: Excess use of third generation cephalosporins led to increase rate of ESBLs, which are difficult to treat. Carbapenem are most reliable for treatment of infections caused by ESBL isolates. However, overuse of carbapenem may lead to resistance of other gram-negative organisms. Therefore, justifiable use of third-generation cephalosporins, will be an effective means of controlling and decreasing the spread of ESBL isolates.

Escherichia coli↗
PubMed1996

Prevalence of antibiotic resistance among Egyptian Salmonella typhi strains.

This report describes the resistance of 537 Salmonella typhi isolates identified in Egypt between 1990-1994. Results indicated a high isolation rate for multiple resistant S. typhi (> 71% of isolates collected in 1992-93), particularly to the three standard drug regimens of the clinically relevant antibiotics; ampicillin, chloramphenicol and trimethoprim-sulfamethoxazole. This adds to the complexity and difficulty of treating infections caused by these organisms. Resistance of S. typhi was associated with a transferable 120 MD plasmid. The organism was sensitive to amikacin, aztreonam, cephalothin, ceftriaxone, gentamicin and nalidixic acid, suggesting the use of aztreonam and ceftriaxone as alternative therapeutic drugs for the treatment of multidrug-resistant S. typhi. These results may provide a clinically useful evaluation of the spread and acquisition of resistance among S. typhi strains in Egypt.

Anti-Bacterial Agents↗
PubMed1991

[Nontraditional beta-lactam antibiotics].

In recent years several beta-lactam derivatives have been obtained, which differ markedly from the traditional penicillins and cephalosporins, some of which have been introduced in the clinic. Clavulanic acid has an oxygen atom instead of sulfur but differs also markedly on C2 and C6. This inhibitor of penicillinase is used in association with amoxicillin and ticarcillin. Sulbactam and tazobactam are other beta-lactamase inhibitors, which are also used in association with penicillins. In the carbapenems sulfur is replaced by a carbon atom and a double bond is also present. Thienamycin, which is rather labile, has been transformed into a more stable product, imipenem, which is used in the treatment of infections with gram-positive and -negative bacteria. Other carbapenems are being studied. Several synthetic penems also present an interesting activity and may be used in medicine. Monobactams are monocyclic beta-lactams isolated from bacteria. By modification of the natural products aztreonam was obtained, a substance which is used in the treatment of infections with gram-negative bacteria. Other monobactams, prepared by total synthesis like aztreonam, are being studied.

Anti-Bacterial Agents↗
PubMed1989

[In vitro activity of 16 antimicrobial agents against Helicobacter (Campylobacter) pylori].

Campylobacter pylori has been associated with the etiology of gastritis and duodenal ulcer. It has been shown that several drugs, among them a variety of antimicrobials, eliminate C. pylori from gastric mucosa at least for a time, resulting in an improvement of the patients' symptoms. The activity of 16 antimicrobials (ampicillin, cefazolin, cefuroxime, cefotaxime, imipenem, aztreonam, tigemonam, erythromycin, vancomycin, nalidixic acid, colistin , norfloxacin, ciprofloxacin, difloxacin, ofloxacin and perfloxacin) was tested against 30 clinical isolates of C. pylori. The antimicrobials showing the highest activity were ampicillin, imipenem and ciprofloxacin, followed by cefazolin, cefuroxime, cefotaxime, aztreonam, tigemonam, erythromycin and difloxacin. Nalidixic acid, colistin and vancomycin were virtually ineffective against C. pylori.

Anti-Bacterial Agents↗
PubMed1989

Investigation of the ability of newer beta-lactam antibiotics to select resistant mutants from Serratia marcescens after mutagenesis with nitrosoguanidine.

Resistant mutants could easily be selected from a nitrosoguanidine-treated culture of Serratia marcescens with piperacillin, cefotaxime, cefoxitin, cefotetan, latamoxef (moxalactam) and aztreonam. Imipenem on the other hand was significantly less effective in mutant selection. Resistant clones broadly fell into two distinct classes. Most mutants did not show increased beta-lactamase; their resistance seemed to be due to changed outer membrane proteins. Other mutants had strongly increased cephalosporinase activity, although the derepression was only partial. Piperacillin, cefotaxime and aztreonam preferentially selected the derepressed phenotype, whereas mutants selected with cefoxitin, cefotetan, moxalactam and imipenem were exclusively of the non-derepressed phenotype. There was a significant degree of cross-resistance between the beta-lactam antibiotics except imipenem which was only slightly less active against the membrane-altered mutants.

Anti-Bacterial Agents↗
PubMed1989

Antimicrobial agents in the management of urinary tract infection: an experimental evaluation.

Persistent and recurrent infections of the urinary tract are a formidable clinical problem, but several recently developed antibiotics have properties that suggest an increased ability to eradicate such infections. Three of the new-generation antibiotics were compared with established agents by using animal models of urinary tract infection. Of the antibiotics tested, gentamicin and ceftriaxone alone were capable of eradicating infection from acute and chronically infected kidney tissue. Chronic lower urinary tract infection was best managed by using norfloxacin or ceftriaxone. Gentamicin, aztreonam, cotrimoxazole and ampicillin were much less effective. In subacute pyelonephritis, gentamicin, aztreonam, norfloxacin and ceftriaxone successfully eliminated microorganisms from most of the infected kidneys, whereas ampicillin and cotrimoxazole had little effect on bacterial numbers. The data have provided an experimental basis for the selection of antibiotics in the management of persistent urinary tract infection.

Acute Disease↗
PubMed1989

[Resistance of enterobacteria and Pseudomonas to old and new antimicrobial agents].

Antibiotic sensitivity to eight common use antibiotics for 9,538 enterobacteria and Pseudomonas strains isolated from hospitalized children was studied using the serial dilution plate technique. Minimum inhibitory concentration to seven new antibiotics for 310 strains was also determined. Enterobacteria showed high resistance (50-80%) to ampicillin, carbenicillin, sulbenicillin, chloramphenicol and trimethoprim/sulfamethoxazole; resistance to piperacillin, gentamicin, tobramycin, and netilmicin was moderate (15-45%), and resistance to amikacin, cefotaxime, moxalactam and aztreonam was low (2-10%). Pseudomonas strains showed less than 20% resistance to carbenicillin, piperacillin, amikacin and aztreonam. Enterobacteria isolated from urine samples showed low resistance to nitrofurantoin and nalidixic acid (15%). Therapeutic recommendation for most frequent infections caused by these etiologic agents based on the resistance values found were elaborated.

Anti-Bacterial Agents↗
PubMed1986

[Failure of new beta-lactam antibiotics in the treatment of severe Enterobacter cloacae infections].

In 12 patients infected with an Enterobacter cloacae (E. cl.) initially susceptible to the 3rd generation cephalosporins, we observed the emergence in vivo of variants resistant to most of the new beta-lactam antibiotics (carboxy-penicillins, ureido-penicillins, 3rd generation cephalosporins and aztreonam). These variants remained susceptible to mecillinam and imipenem. The variant emerged under treatment with cefotaxime in 3 cases, with moxalactam in 3 cases, with aztreonam, carbenicillin, and ticarcillin in 1 case each and without treatment in 1 case. An aminoglycoside was combined with the beta-lactam antibiotic in 6 cases. Therapeutic failure was attributed to emergence of the resistant variant in 6 out of 12 cases (with an aminoglycoside in 3 cases, with the beta-lactam antibiotic alone in 3 cases). These case reports underline the importance of bacteriological monitoring of patients infected with E. cl. treated with a beta-lactam antibiotic. The susceptibility to beta-lactam antibiotics of the E. cl. strains isolated during treatment should be systematically retested.

Adult↗
PubMed1988

[Plasmid resistance to 3d generation cephalosporins].

Beta-lactamases still play an important part in medical bacteriology, as shown by the emergence, since 1983, of plasmid-mediated beta-lactamases with an enlarged spectrum (SHV-2, CTX-1, etc.). Such enzymes are only produced by enterobacteria and, more specifically, by Klebsiella pneumoniae. This phenomenon, described in Europe and in Africa, is certainly more widespread than it would appear, as some strains are now known to be less sensitive to third generation cephalosporins (MIC 1 to 4 mg/l). Despite differences in behaviour (cefotaximase and ceftazidimase phenotypes), resistance to amino-, carboxy- and ureido-penicillins is associated with reduced sensitivity or resistance to oxyimino beta-lactams (cefotaxime, ceftriaxone, ceftazidime, aztreonam), but cefamycins and imipenem are untouched. Being sensitive to enzyme inhibitors (e.g. clavulanic acid), these beta-lactamases can easily be detected and some infections (notably urinary tract infections) can probably be treated using these inhibitors. These enzymes show modified kinetic constants (better affinity and quicker hydrolysis) against penicillins, third generation aminothiazolimino-cephalosporins and aztreonam. The producing strains are mutants, with aminoacid 1 to 2 substitutions, of those which produce the usual plasmid-borne and transposable beta-lactamases (TEM or SHV). Because these beta-lactamases are plasmid-mediated, enzyme production mechanisms are spreading among enterobacteria species in relation to other resistance markers (tobramycin, netilmicin, amikacin). Strains which produce these new enzymes are mainly isolated from patients treated in intensive care units.

Cell Membrane Permeability↗
PubMed1988

Synthesis and in vitro antibacterial activity of a new series of monobactam derivatives.

Using as a model monobactams with a substituted alpha-oxyimino moiety in the side chain (aztreonam), a series of 2-(2-aminothiazol-4-yl)-2-hydrazono-acetamido monobactam (II a, f) were prepared by condensation of the hydrazones (I a, e) (Z form) with tetrabutylammonium 3-amino-4-methyl-2-oxo-1-azetidin-sulphonate. Isomerization occurred during this synthesis and gave the E form of all compounds. Monobactams (II a, f) showed no significant in vitro antibacterial activity when compared with aztreonam and with some cephalosporins bearing the same E-hydrazono side chain.

Anti-Bacterial Agents↗
PubMed1986

Antimicrobial induced alterations of the human oropharyngeal and intestinal microflora.

Although the role of the normal oropharyngeal and intestinal microflora is not fully understood, there are evidences that alterations in the flora may have serious consequences. The most common and significant cause of disturbances in the normal microflora is the administration of antimicrobial agents. The microflora can be influenced by antimicrobial agents because of incomplete absorption of any orally administered antimicrobial agent, secretion of an antimicrobial agent by the salivary glands or in the bile, or secretion from the intestinal mucosa. In most cases the influence is not beneficial to the patient because suppression of the indigenous microorganisms often permits potential pathogens to overgrow and cause septic conditions, stomatitis, diarrhoea, or colitis. Antimicrobial agents that influence the normal microflora also promote the emergence of antimicrobial-resistant strains. During the recent years, the impact of different antimicrobial agents on the human microflora has been investigated by our research group. Thus the effects on the oropharyngeal and intestinal microflora by peroral administration of penicillin, bacampicillin, erythromycin, clindamycin, doxycycline, nitroimidazole, norfloxacin and ciprofloxacin have been studied. The impact on the microflora by parenteral administration of ampicillin + sulbactam, azlocillin, aztreonam, piperacillin, cefoperazone, cefoxitin, ceftriaxone, moxalactam, imipenem, nitroimidazole and clindamycin has also been investigated. Pronounced changes were observed in the microflora in patients receiving clindamycin, erythromycin, cefoperazone, ceftriaxone and moxalactam, whereas moderate changes were seen in those patients receiving doxycycline, cefoxitin, aztreonam, ampicillin + sulbactam, azlocillin and piperacillin. Penicillin, bacampicillin, imipenem, nitroimidazole, ciprofloxacin and norfloxacin produced only minor changes.(ABSTRACT TRUNCATED AT 250 WORDS)

Anti-Bacterial Agents↗
PubMed1995

Effect of different regimens of gut decontamination on bacterial translocation and mortality in experimental acute pancreatitis.

OBJECTIVE: To assess the effect of four regimens of antibiotics (compared with a control regimen of distilled water) given orally on gut decontamination, bacterial translocation, and mortality in acute necrotising pancreatitis in mice. DESIGN: Randomised experimental study. SETTING: University hospitals, USA and Italy. MATERIALS: 150 young Swiss Webster mice. INTERVENTION: All mice were fed a diet deficient in choline and supplemented with ethionine. They were then randomised to be given by gavage (36 hours after starting the diet): distilled water (controls, group 1); aztreonam along (group 2); neomycin, erythromycin, metronidazole (group 3); polymyxin B and amikacin (group 4); polymyxin B, amikacin, amphotericin B (group 5). 20 Mice in each group were treated for 10 days, and the remaining 10 in each group were killed after 3 days. MAIN OUTCOME MEASURES: Survival, and qualitative and quantitative cultures of the liver, lungs, pancreas and caecum. RESULTS: The best survival rate during the first 7 days was in group 5, but by day 10 there was no difference among the groups. All the antibiotic regimens reduced the number of bacteria in the caecum and all but aztreonam alone (group 2) reduced the rate of translocation of both Gram negative and Gram positive bacteria to all organs studied. Translocation of yeast occurred in those animals in groups 2, 3, and 4 in which there was overgrowth of fungi in the caecum. CONCLUSION: Gram negative and Gram positive organisms and fungi may have an important role in infective morbidity and mortality in acute pancreatitis, and selective decontamination with polymyxin B, amikacin, amphotericin B reduced the incidence of translocation related infections and early mortality in mice with acute necrotising pancreatitis.

Acute Disease↗
PubMed1994

[Antibiotic prophylaxis and reconstructive operations in patients with burn sequelae].

The results of the clinicolaboratory investigation of the efficacy of antibiotic prophylaxis in 215 patients subjected to reconstructive operations for postburn scars are presented. The biological investigation of the postburn scars revealed the presence of microflora in about half of the patients. The microflora was mainly represented by Staphylococcus aureus and S. epidermidis. The level of the dissemination was not high. Ulcerated scars had higher levels of the bacterial contamination. The pharmacokinetic study of cefazolin, carbenicillin, aztreonam and gentamicin showed that the release of the first three drugs to the scar tissues was good. The clinical observations demonstrated that purulent inflammatory complications developed in patients with risk factors (ulceration of the scar, necrotic foci in the wound, involvement of the oral cavity and nasal passages to the operation), not treated with the antibiotics or treated with the drugs not inhibiting the microflora of the operation wounds (gentamicin, aztreonam). The results permitted to recommend the use of the antibiotic prophylaxis in reconstructive operations only in risk patients with burn consequences. With this purpose it is advisable to use antibiotics satisfactorily penetrating to the tissues of the postburn scars and active against the microflora vegetating in them (cefazolin and carbenicillin).

Anti-Bacterial Agents↗
PubMed1994

Interactions of ceftibuten with extended-spectrum beta-lactamases: a bacteriological and enzymatic analysis.

The authors analysed the antibacterial activity of ceftibuten, cefotaxime, ceftazidime and aztreonam against Klebsiella pneumoniae strains, including those which produced novel extended-spectrum beta-lactamases. These molecules were also tested for their susceptibility to cell-free extracts of the corresponding beta-lactamases. Both approaches showed that ceftibuten was not hydrolysed by the CTX-1/TEM-3, SHV-2 and SHV-3 beta-lactamases, while cefotaxime, ceftazidime and aztreonam were hydrolysed. Nevertheless all compounds were substrates for the SHV-4 and SHV-5 beta-lactamases, and the organisms which produced these beta-lactamases showed increased MICs.

Ceftibuten↗