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Direct and indirect pathogenicity of beta-lactamase-producing bacteria in mixed infections in children
1Department of Pediatrics, Uniformed Services, University of Health Sciences, Bethesda, Maryland.
Abstract:
The recent emergence of numerous aerobic and anaerobic beta-lactamase-producing bacterial strains has been associated with an increase in the failure rate of penicillins in the therapy of infection caused by these organisms. These include respiratory tract, skin of soft tissue, female genital tract, intra-abdominal, and other miscellaneous infections. The important aerobic beta-lactamase-producing bacteria (BLPB) include Staphylococcus aureus, Branhamella catarrhalis, Haemophilus sp., Neisseria gonorrhoeae, Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, and Legionella sp. The anaerobic BLPB are all Bacteroidiaceae and include Bacteroides fragilis group, B. melaninogenicus group, B. oralis, B. oris-buccae, and Fusobacterium sp. Laboratory, animal, and clinical studies that support the indirect pathogenicity of these organisms and the distribution of these BLPB in various infections are reviewed. BLPB may not only have a direct pathogenic role in causing the infection, but also an indirect pathogenic role. The indirect pathogenicity of these organisms is apparent through their ability not only to survive penicillin therapy, but also to protect penicillin-susceptible pathogens from that drug. These direct and indirect virulence characteristics of aerobic and anaerobic BLPB require the administration of appropriate antimicrobial therapy directed against all pathogens in mixed infections.
Insights
Beta-lactamase-producing bacteria (BLPB) are causing increased penicillin treatment failures in various infections. These bacteria can directly cause infections and indirectly protect other pathogens, necessitating targeted antimicrobial therapy.
Area of Science:
- Microbiology
- Infectious Diseases
- Pharmacology
Background:
- Rising prevalence of aerobic and anaerobic beta-lactamase-producing bacteria (BLPB).
- Increased failure rates of penicillin therapy for infections caused by BLPB.
- BLPB implicated in diverse infections including respiratory, skin, soft tissue, and intra-abdominal.
Purpose of the Study:
- To review laboratory, animal, and clinical studies on BLPB.
- To discuss the direct and indirect pathogenicity of BLPB.
- To highlight the need for appropriate antimicrobial strategies against BLPB.
Main Methods:
- Review of existing scientific literature.
- Analysis of studies on bacterial pathogenicity and drug resistance.
- Examination of BLPB distribution in various infection types.
Main Results:
- BLPB exhibit both direct and indirect pathogenic mechanisms.
- Indirect pathogenicity includes survival of penicillin therapy and protection of susceptible pathogens.
- Key aerobic BLPB include Staphylococcus aureus, Escherichia coli, and Pseudomonas aeruginosa.
- Key anaerobic BLPB include Bacteroides fragilis and Fusobacterium species.
Conclusions:
- BLPB pose a significant challenge to penicillin efficacy.
- Understanding direct and indirect virulence is crucial for treatment.
- Appropriate antimicrobial therapy is essential for mixed infections involving BLPB.