Update 1991 pp 387-395 | Cite as

Mechanisms of Resistance to β-Lactam Antibiotics

  • J. P. Quinn
Conference paper
Part of the Update in Intensive Care and Emergency Medicine book series (UICM, volume 14)


β-Lactam antibiotics are the most widely used class of antibacterial agents worldwide. One of the major problems affecting the use of these drugs is the widespread prevalence and increasing incidence of bacterial resistance, particularly among nosocomial pathogens. The purpose of this chapter is to provide a brief overview of the major mechanisms responsible for this resistance. An understanding of these mechanisms may prove useful in evaluating and utilizing these drugs optimally.


Antimicrob Agent Enterobacter Cloaca Lactam Antibiotic Viridans Streptococcus Lactamase Inhibitor 
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  1. 1.
    Nikaido H (1985) Role of permeability barriers in resistance to β-lactam antibiotics. Pharmacol Ther 27:197–231PubMedCrossRefGoogle Scholar
  2. 2.
    Bush K, Tanaka SK, Bonner DP, Sykes RB (1985) Resistance caused by decreased penetration of β-lactam antibiotics into Enterobacter cloacae. Antimicrob Agents Chemother 27:555–560PubMedGoogle Scholar
  3. 3.
    Woodruff WA, Parr TR Jr, Hancock REW, Hanne LF, Nicas TI, Iglewski BH (1986) Ex-pression in Escherichia coli and function of Pseudomonas aeruginosa outer membrane porin protein F. J Bacteriol 167:473–479PubMedGoogle Scholar
  4. 4.
    Quinn JP, Dudek EJ, DiVincenzo CA, Lucks DA, Lerner SA (1986) Emergence of resistance to imipenem during therapy for Pseudomonas aeruginosa infections. J Infect Dis 154:289–294PubMedCrossRefGoogle Scholar
  5. 5.
    Quinn JP, Studemeister AE, DiVincenzo CA, Lerner SA (1988) Resistance to imipenem in Pseudomonas aeruginosa:clinical experience and biochemical mechanism. Rev Infect Dis 10:892–898PubMedCrossRefGoogle Scholar
  6. 6.
    Korfman G, Wiedemann B (1988) Genetic control of β-lactamase production in Enterobacter cloacae. Rev Infect Dis 10:793–799CrossRefGoogle Scholar
  7. 7.
    Quinn JP, DiVincenzo CA, Foster J (1987) Emergence of resistance to ceftazidime during therapy lor Enterobacter cloacae infections. J Infect Dis 155:942–947PubMedCrossRefGoogle Scholar
  8. 8.
    Vu H, Nikaido H (1985) Role of β-lactam hydrolysis in the mechanism of resistance of a β-lactamase constitutive Enterobacter cloacae strain to expanded spectrum β-lactams. Antimicrob Agents Chemother 27:393–398PubMedGoogle Scholar
  9. 9.
    Aronoff S, Schlaes D(1987) Factors influencing evolution of β-lactam resistance in inducible strains of Enterobacter cloacae and Pseudomonas aeruginosa. J Infect Dis 155:936–941PubMedCrossRefGoogle Scholar
  10. 10.
    Bauernfiend A (1986) Classification of β-lactamases. Rev Infect Dis 8 (Suppl 5) 5470–5481Google Scholar
  11. 11.
    Sougakoff W, Goussard S, Gerbaud G, Courvalin P (1988) Plasmid-mediated resistance to third-generation cephalosporins caused by point mutations in TEM-type penicillinase genes. Rev Infect Dis 10:879–884PubMedCrossRefGoogle Scholar
  12. 12.
    Kitzis MD, Billot-Klein D, Goldstein FW, Williamson R, Tran Van Nhieu G, Carlet J, et al. (1988) Dissemination of the novel-plasmid mediated β-lactamase CTX-1 which confers resistance to broad-spectrum cephalosporins and its inhibition by β-lactamase inhibitors. Antimicrob Agents Chemother 32:9–14PubMedGoogle Scholar
  13. 13.
    Quinn JP, Miyashiro D, Sahm D, Flamm R, Bush K (1989) Novel plasmid-mediated β-lactamase (TEM 10) hydrolyzing ceftazidime and aztreonam in clinical isolates of Klebsiella pneumoniae. Antimicrob Agents Chemother 33:1451–1456PubMedGoogle Scholar
  14. 14.
    Retsema JA, English AR, Girard A, et al. (1986) Sulbactam/ampicillin: in vitro spectrum, potency and activity in models of acute infection. Rev Infect Dis (suppl 5):S528–534CrossRefGoogle Scholar
  15. 15.
    Malouin F, Bryan LE (1986) Modification of penicillin-binding proteins as mechanisms of β-lactam resistance. Antimicrob Agents Chemother 30:1–5PubMedGoogle Scholar
  16. 16.
    Quinn JP, DiVincenzo CA, Lucks DA, Luskin RL, Shatzer KL, Lerner SA (1988) Serious infections due to penicillin-resistant strains of viridans streptococci with altered penicillin-binding proteins. J Infect Dis 764–769Google Scholar
  17. 17.
    Chow J, Shlaes D, Quinn J, et al. (1990) Mechanisms of resistance emerging during antibiotic therapy for Enterobacter infections. 30th ICAAC, Atlanta, GAGoogle Scholar
  18. 18.
    Wachsmuth K (1986) Molecular epidemiology of bacterial infections: examples of methodology and of investigations of outbreaks. Rev Infect Dis 8:682–692PubMedCrossRefGoogle Scholar
  19. 19.
    Olson B, Weinstein R, Nathan C, Chamberlin W, Kabins S (1985) Occult aminoglycoside resistance in P. aeruginosa. J Infect Dis 152:769–774PubMedCrossRefGoogle Scholar
  20. 20.
    Flynn D, Weinstein R, Nathan C, Easton M, Kabins S (1987) Patients’ endogenous flora as the source of “nosocomial” Enterobacter in cardiac surgery. J Infect Dis 156:363–368PubMedCrossRefGoogle Scholar
  21. 21.
    Fung-Tomc J, Huczko E, Pearce M, Kessler RE (1988) Frequency of in vitro resistance of Pseudomonas aeruginosa to cefepime, ceftazidime and cefotaxime. Antimicrob Agents Chemother 32:1443–1445PubMedGoogle Scholar

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© Springer-Verlag Berlin, Heidelberg 1991

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  • J. P. Quinn

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