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  Česky / Czech version Epidemiol. Mikrobiol. Imunol., 50, 2001, No. 3, p. 121-130
 
Occurrence and Mechanisms of Resistance to beta-Lactam Antibiotics in Clinically Important Species of the Genus Enterobacter  
Michálková-Papajová D., Bujdáková H., Klimáčková J., Moravčíková M., Kettner M. 

Katedra mikrobiológie a virológie, Prírodovedecká fakulta Univerzity Komenského, Bratislava
 


Summary:

       Extended-spectrum beta-lactam antibiotics have found great medical importance, but their wide use in clinical practice leads to increasing resistance to them. The more frequent occurrence of infections caused by Bush group 1 beta-lactamase producing organisms, including Species of the genus Enterobacter, is a serious problem in this field. Resistance to beta-lactams in this important nosocomial pathogens can be due to 1) reduction in outer membrane permeability to antibiotics caused by alterations in outer membrane lipopolysacharides or proteins (porins); 2) production of beta-lactamases, which inactivate beta-lactams and can also lead to resistance by non-hydrolytic mechanistu called trapping. Production of plasmid-mediated extended-spectrum beta-lactamases, but especially chromosomally-mediated inducible cephalosporinase AmpC, which can be synthesized constitutively in large amounts as consequence of spontaneous chromosomal mutations, are of great clinical importance. Fourth-generation cephalosporins and carbapenems are the most effective in the treatment of infections caused by Species belonging to the genus Enterobacter, but combination of high level beta-lactamase production and decreased outer membrane permeability, which is not rare in Enterobacter spp., leads to resistance even to these drugs.

        Key words: Enterobacter - beta-lactams - resistance.
       

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