title: Role of a cefoxitin-inducible beta-lactamase in a case of breakthrough bacteremia.
abstract: Development of resistance during therapy with cefamandole contributes to treatment failure.  A simple cefoxitin disk test was recently described which detects a cefamandole-active inducible beta-lactamase not otherwise detectable with cefamandole as the inducer. A case of breakthrough Enterobacter bacteremia due to selection of a resistant subpopulation is reported in an immunocompromised patient. The use of this simple disk test in selected clinical cases is advocated.
mesh_terms: D000328:Adult; D001419:Bacteria / Q000187:drug effects*; D002435:Cefamandole / Q000494:pharmacology* / Q000627:therapeutic use; D002440:Cefoxitin; D002511:Cephalosporins / Q000494:pharmacology*; D004754:Enterobacter / Q000187:drug effects* / Q000201:enzymology; D004755:Enterobacteriaceae / Q000187:drug effects*; D004756:Enterobacteriaceae Infections / Q000188:drug therapy*; D004790:Enzyme Induction; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests / Q000379:methods; D001618:beta-Lactamases / Q000096:biosynthesis
chemical_list: D002511:Cephalosporins; D002435:Cefamandole; D002440:Cefoxitin; D001618:beta-Lactamases