In Vivo Selection of a Cephamycin-Resistant, Porin-Deficient Mutant of Klebsiello pneumoniae Producing a TEM-3  -Lactamase

Pangon, B.; Bizet, Chantal; Bure, A; Pichon, François; Philippon, A.; Régnier, B.; Gutmann, Laurent

doi:10.1093/infdis/159.5.1005

Cited by 140 publications

(87 citation statements)

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“…The clinical details of 26 patients previously reported (2,4,8,15,17,18,19,21,22,23,28) are reported in Table 3. When the data for the 10 patients from the international K. pneumoniae bacteremia study were combined with those for the 26 previously reported patients, data for a total of 36 patients were available for analysis.…”

Section: Resultsmentioning

confidence: 99%

“…More than 90% of ESBL-producing organisms were "susceptible" to cephamycins (Table 1). However, there are only two reports in peer-reviewed literature of the use of cephamycins for the treatment of serious infections with ESBL-producing organisms (15,22). In one case, relapse of infection occurred with a cefoxitin-resistant strain (15).…”

Section: Discussionmentioning

confidence: 99%

“…However, there are only two reports in peer-reviewed literature of the use of cephamycins for the treatment of serious infections with ESBL-producing organisms (15,22). In one case, relapse of infection occurred with a cefoxitin-resistant strain (15). Of the five patients evaluated in this report who were treated with cefepime, four experienced clinical failure.…”

Section: Discussionmentioning

confidence: 99%

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Outcome of Cephalosporin Treatment for Serious Infections Due to Apparently Susceptible Organisms Producing Extended-Spectrum β-Lactamases: Implications for the Clinical Microbiology Laboratory

et al. 2001

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Although extended-spectrum beta-lactamases (ESBLs) hydrolyze cephalosporin antibiotics, some ESBLproducing organisms are not resistant to all cephalosporins when tested in vitro. Some authors have suggested that screening klebsiellae or Escherichia coli for ESBL production is not clinically necessary, and when most recently surveyed the majority of American clinical microbiology laboratories did not make efforts to detect ESBLs. We performed a prospective, multinational study of Klebsiella pneumoniae bacteremia and identified 10 patients who were treated for ESBL-producing K. pneumoniae bacteremia with cephalosporins and whose infecting organisms were not resistant in vitro to the utilized cephalosporin. In addition, we reviewed 26 similar cases of severe infections which had previously been reported. Of these 36 patients, 4 had to be excluded from analysis. Of the remaining 32 patients, 100% (4 of 4) patients experienced clinical failure when MICs of the cephalosporin used for treatment were in the intermediate range and 54% (15 of 28) experienced failure when MICs of the cephalosporin used for treatment were in the susceptible range. Thus, it is clinically important to detect ESBL production by klebsiellae or E. coli even when cephalosporin MICs are in the susceptible range (< 8 g/ml) and to report ESBL-producing organisms as resistant to aztreonam and all cephalosporins (with the exception of cephamycins).

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Outcome of Cephalosporin Treatment for Serious Infections Due to Apparently Susceptible Organisms Producing Extended-Spectrum β-Lactamases: Implications for the Clinical Microbiology Laboratory

et al. 2001

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“…Several studies reported the alteration of porin patterns in drug-resistant K. pneumoniae. Loss of porin accompanied by the production of ␤-lactamase produced cephamycin resistance in vivo in K. pneumoniae (480). This organism normally expresses OmpK35 (an OmpF homolog) and OmpK36 (an OmpC homolog).…”

Section: Porins and Antibiotic Resistancementioning

confidence: 99%

Molecular Basis of Bacterial Outer Membrane Permeability Revisited

Nikaido

2003

Microbiol Mol Biol Rev

3,839

3,800

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Gram-negative bacteria characteristically are surrounded by an additional membrane layer, the outer membrane. Although outer membrane components often play important roles in the interaction of symbiotic or pathogenic bacteria with their host organisms, the major role of this membrane must usually be to serve as a permeability barrier to prevent the entry of noxious compounds and at the same time to allow the influx of nutrient molecules. This review summarizes the development in the field since our previous review (H. Nikaido and M. Vaara, Microbiol. Rev. 49:1-32, 1985) was published. With the discovery of protein channels, structural knowledge enables us to understand in molecular detail how porins, specific channels, TonB-linked receptors, and other proteins function. We are now beginning to see how the export of large proteins occurs across the outer membrane. With our knowledge of the lipopolysaccharide-phospholipid asymmetric bilayer of the outer membrane, we are finally beginning to understand how this bilayer can retard the entry of lipophilic compounds, owing to our increasing knowledge about the chemistry of lipopolysaccharide from diverse organisms and the way in which lipopolysaccharide structure is modified by environmental conditions

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“…Concerns with administering cephamycins for the treatment of ESBL infections stem from reports demonstrating acquisition of OMP mutations and/or plasmids encoding AmpC cephalosporinases during exposure to these agents [11][12][13][14]. In at least 1 published case, a patient with a K. pneumoniae ESBL isolate became resistant to both flomoxef and carbapenem therapy, after exposure to flomoxef, due to an OMPk36 mutation, in combination with acquisition of the plasmid-mediated AmpC cephalosporinase gene bla DHA-1 [14].…”

Section: Cephamycinsmentioning

confidence: 99%

The Use of Noncarbapenem β-Lactams for the Treatment of Extended-Spectrum β-Lactamase Infections

Tamma¹,

Rodríguez‐Baño

2017

Clinical Infectious Diseases

154

117

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The continued rise in infections caused by extended-spectrum β-lactamase (ESBL)-producing pathogens is recognized globally as one of the most pressing concerns facing the healthcare community. Carbapenems are widely regarded as the antibiotics of choice for the treatment of ESBL-producing infections, even when in vitro activity to other β-lactams has been demonstrated. However, indiscriminant carbapenem use is not without consequence, and carbapenem overuse has contributed to the emergence of carbapenem-resistant Enterobacteriaceae. The use of non-carbapenem β-lactams for the treatment of ESBL infections has yielded conflicting results. In this review, we discuss the available data for the use of cephamycins, cefepime, piperacillin-tazobactam, ceftolozane-tazobactam, and ceftazidime-avibactam for the treatment of ESBL infections.

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In Vivo Selection of a Cephamycin-Resistant, Porin-Deficient Mutant of Klebsiello pneumoniae Producing a TEM-3 -Lactamase

Cited by 140 publications

References 0 publications

Outcome of Cephalosporin Treatment for Serious Infections Due to Apparently Susceptible Organisms Producing Extended-Spectrum β-Lactamases: Implications for the Clinical Microbiology Laboratory

Outcome of Cephalosporin Treatment for Serious Infections Due to Apparently Susceptible Organisms Producing Extended-Spectrum β-Lactamases: Implications for the Clinical Microbiology Laboratory

Molecular Basis of Bacterial Outer Membrane Permeability Revisited

The Use of Noncarbapenem β-Lactams for the Treatment of Extended-Spectrum β-Lactamase Infections

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