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Emergence of resistance in gram-negative bacteria during therapy with expanded-spectrum cephalosporins

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  • Current Topic Inducible Beta-Lactamases: Enzymes of Increasing Clinical Importance
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Abstract

To assess the clinical importance of emergence of beta-lactam resistance caused by stable derepression of chromosomal beta-lactamases, sequential cultures from patients treated with expanded-spectrum cephalosporins were monitored for the persistence of bacteria possessing these enzymes. Antibiotic susceptibilities and beta-lactamase production before and after cefoxitin induction were determined in sequential isolates of individual bacterial strains. Of 49 strains isolated from 44 patients, 25 strains (51%) were eradicated by cephalosporin therapy, 17 strains (35%) persisted with unchanged susceptibility in sequential cultures, and 7 strains (14%) from 7 patients developed multiple beta-lactam resistance during cephalosporin therapy. In 6 of the 7 strains, resistance was associated with stable derepression of beta-lactamases. In the patient group whose strains developed resistance, subsequent use of non-beta-lactam antibiotics was more frequent and mortality was higher.

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Authors and Affiliations

  1. Department of Medical Microbiology, Creighton University School of Medicine, 2500 California St, 68178, Omaha, Nebraska, USA

    D. L. Dworzack, M. P. Pugsley, C. C. Sanders & E. A. Horowitz

Authors
  1. D. L. Dworzack
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  2. M. P. Pugsley
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  3. C. C. Sanders
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  4. E. A. Horowitz
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Dworzack, D.L., Pugsley, M.P., Sanders, C.C. et al. Emergence of resistance in gram-negative bacteria during therapy with expanded-spectrum cephalosporins. Eur. J, Clin. Microbiol. 6, 456–459 (1987). https://doi.org/10.1007/BF02013110

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  • DOI: https://doi.org/10.1007/BF02013110

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