title: Beta-lactamase expression and cross-resistance to beta-lactam antibiotics in a nosocomial population of Enterobacter.
abstract: This study sought to quantitatively describe the spectrum of constitutive and inducible beta-lactamase activity present in a tertiary care center's population of Enterobacter species. beta-Lactamase activity in the absence and presence of 2 recognized beta-lactamase-inducing antibiotics, cefoxitin and imipenem, was measured. The Enterobacter cloacae (n = 35) population was strikingly bimodal, expressing 'all-or-none' cross-resistance to beta-lactams (except imipenem) corresponding to the baseline level of beta-lactamase expression. E. aerogenes (n = 14) displayed a less dichotomous pattern of resistance, and MICs of beta-lactam antibiotics were less strongly related to the magnitude of enzyme activity. We conclude that our nosocomial population of E. cloacae, like strains rendered resistant to beta-lactams in vitro, is largely dependent upon beta-lactamase as a mechanism of this resistance. Furthermore, we document the presence of a large subpopulation of beta-lactam-susceptible isolates possessing inducible beta-lactamase and therefore subject to selection for enzyme derepression.
authors.affiliation: Department of Pathology, Bowman Gray School of Medicine of Wake Forest University, Winston-Salem, N.C. 27157-1072.
authors.forename: C H
authors.initials: CH
authors.lastname: Steffee
authors.forename: B L
authors.initials: BL
authors.lastname: Wasilauskas
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D003428:Cross Infection / Q000382:microbiology*; D004352:Drug Resistance, Microbial; D004754:Enterobacter / Q000187:drug effects / Q000201:enzymology*; D016972:Enterobacter cloacae / Q000187:drug effects / Q000201:enzymology; D004756:Enterobacteriaceae Infections / Q000382:microbiology*; D008826:Microbial Sensitivity Tests; D013045:Species Specificity; D001618:beta-Lactamases / Q000032:analysis*; D047090:beta-Lactams
chemical_list: D000900:Anti-Bacterial Agents; D047090:beta-Lactams; D001618:beta-Lactamases