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Inducible beta-lactamases: clinical and epidemiologic implications for use of newer cephalosporins

W E Sanders1, C C Sanders

  • 1Departments of Medical Microbiology and Medicine, Creighton University School of Medicine, Omaha, Nebraska 68178-0213.

Reviews of Infectious Diseases
|July 1, 1988
PubMed

Insights

Antibiotic resistance to beta-lactam drugs is a growing concern in hospitals. This resistance, often missed by standard tests, leads to treatment failures in patients with specific bacterial infections.

Area of Science:

  • Microbiology
  • Infectious Diseases
  • Pharmacology

Background:

  • Beta-lactam antibiotics are crucial for treating bacterial infections.
  • Inducible beta-lactamases are enzymes produced by certain bacteria that confer resistance to beta-lactam antibiotics.
  • Emergence of multidrug resistance is a significant challenge in clinical settings.

Observation:

  • Resistance to newer cephalosporins has emerged in 14%-56% of patients infected with organisms producing inducible beta-lactamases.
  • This resistance is linked to clinical failure or relapse in 25%-75% of cases.
  • Widespread use of newer cephalosporins correlates with the spread of multidrug-resistant organisms in hospitals.

Findings:

  • Combination therapy shows limited impact on resistance rates or clinical outcomes.
  • Standard susceptibility testing may fail to detect inducible beta-lactamase-mediated resistance.
  • Calculation methods for resistance rates can underestimate the problem's true magnitude.

Implications:

  • Clinical management of infections caused by inducible beta-lactamase-producing organisms requires careful consideration of antibiotic resistance.
  • Improved diagnostic methods are needed to accurately detect resistance.
  • Strategies to curb the spread of multidrug-resistant bacteria are essential, especially in hospital environments.

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