Beta-lactamase production in members of the family Enterobacteriaceae and resistance to beta-lactam-enzyme inhibitor combinations

Antimicrob Agents Chemother. 1990 Apr;34(4):622-7. doi: 10.1128/AAC.34.4.622.

Abstract

Recent reports that members of the family Enterobacteriaceae that produce high levels of certain beta-lactamases are often resistant to ticarcillin-clavulanate prompted this study to assess the relationship between type and amount of enzyme produced and susceptibility to ticarcillin-clavulanate, piperacillin-tazobactam, and cefoperazone-sulbactam. Agar dilution MICs were determined by using 73 strains of Enterobacteriaceae that produced a single beta-lactamase that had been characterized and quantified and a beta-lactamase-negative control strain of Escherichia coli. For E. coli and Klebsiella pneumoniae, MICs of each combination increased as levels of TEM, SHV-1, or class IV enzymes increased. However, the percentage of strains that were resistant was highest for ticarcillin-clavulanate (32%), with only 18 and 6% resistant to piperacillin-tazobactam and cefoperazone-sulbactam, respectively. Strains producing PSE-1, regardless of level, were resistant or moderately susceptible to ticarcillin-clavulanate but were susceptible to piperacillin-tazobactam and cefoperazone-sulbactam. HMS-1 and OHIO-1 beta-lactamases were associated with resistance to ticarcillin-clavulanate and piperacillin-tazobactam, respectively. High levels of class IV enzymes in Klebsiella oxytoca were associated with resistance to all three combinations. These results indicate that the level and type of beta-lactamase produced by members of the family Enterobacteriaceae are important determinants of susceptibility to beta-lactam-inhibitor combinations, especially ticarcillin-clavulanate.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anti-Bacterial Agents / pharmacology*
  • Cefoperazone / pharmacology*
  • Clavulanic Acid
  • Clavulanic Acids / pharmacology*
  • Drug Combinations
  • Enterobacteriaceae / drug effects*
  • Enterobacteriaceae / enzymology
  • Microbial Sensitivity Tests
  • Penicillins / pharmacology*
  • Piperacillin / pharmacology*
  • Sulbactam / pharmacology*
  • Ticarcillin / pharmacology*
  • beta-Lactamase Inhibitors*
  • beta-Lactamases / biosynthesis

Substances

  • Anti-Bacterial Agents
  • Clavulanic Acids
  • Drug Combinations
  • Penicillins
  • beta-Lactamase Inhibitors
  • Clavulanic Acid
  • Cefoperazone
  • beta-Lactamases
  • Ticarcillin
  • Sulbactam
  • Piperacillin