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Transferable resistance to cephalosporins, ureidopenicillins and trimethoprim
Abstract:
Transferable resistance to classical Cephalosporins emerged three years ago among Enterobacteriaceae simultaneously in several hospitals and was associated with resistance to other betalactam drugs, i.e. with a transmissible TEM-like betalactamase. A systematic survey of incidence of R plasmids in Proteus sp. lead, in two district PHLs, to demonstration of transferable Azlocillin resistance. This resistance was most frequently associated with that for Carbenicillin, but also strains susceptible to CAR but resistant to AZL have been isolated. Trimethoprim resistance was in this country first described by Schŏn, but, since then, it is now frequently found transferable in polyresistant strains from hospitals, resistant also to betalactam antibiotics, Gentamicin and other drugs.
Insights
Emerging transferable resistance to cephalosporins and other beta-lactam antibiotics in Enterobacteriaceae is a growing concern. This study highlights the spread of resistance genes, including those for azlocillin and trimethoprim, in hospital settings.
Area of Science:
- Microbiology
- Infectious Diseases
- Antimicrobial Resistance
Background:
- Transferable resistance to cephalosporins in Enterobacteriaceae has emerged recently in multiple hospitals.
- This resistance is linked to transmissible TEM-like beta-lactamases, conferring resistance to other beta-lactam drugs.
- Previous descriptions of trimethoprim resistance exist, but its increasing prevalence in polyresistant strains is noted.
Purpose of the Study:
- To investigate the incidence of R plasmids in Proteus sp.
- To identify and characterize transferable resistance to specific antibiotics like azlocillin.
- To understand the co-occurrence of antibiotic resistance patterns in hospital-acquired pathogens.
Main Methods:
- Systematic survey of R plasmid incidence in Proteus species.
- Isolation and characterization of resistant bacterial strains.
- Phenotypic testing for antibiotic susceptibility, including cephalosporins, azlocillin, carbenicillin, trimethoprim, and gentamicin.
Main Results:
- Transferable resistance to classical cephalosporins emerged in Enterobacteriaceae across several hospitals.
- A survey revealed transferable azlocillin resistance in Proteus sp., often associated with carbenicillin resistance.
- Strains resistant to azlocillin but susceptible to carbenicillin were also identified.
- Transferable trimethoprim resistance is frequently found in polyresistant hospital strains, co-resistant to beta-lactam antibiotics and gentamicin.
Conclusions:
- The emergence and spread of transferable resistance to cephalosporins and other beta-lactams pose a significant clinical challenge.
- Azlocillin resistance is transferable in Proteus species, with varying associations with carbenicillin resistance.
- The increasing prevalence of transferable trimethoprim resistance in multidrug-resistant hospital bacteria necessitates ongoing surveillance and control measures.