Resistance to beta-lactam antibiotics in Bacteroides spp.
Bacteroides spp., particularly B. fragilis, are well-recognised bacterial pathogens. Production of the typical beta-lactamases of Bacteroides restricts the therapeutic use of beta-lactam agents mainly to the beta-lactamase inhibitor combinations and carbapenems. These compounds have the advantage of broad-spectrum activity and the ability to combat polymicrobial infections. Resistance of Bacteroides spp. to beta-lactam antibiotics appears to be increasing, largely because of an overall increase in beta-lactamase activity. There has been a rise in the prevalence of isolates showing high-level production of typical Bacteroides beta-lactamases and an increase in reports other potent beta-lactamase types. In the case of B. fragilis, metallo-enzymes are a particular threat to current therapeutic practice, as they are not inhibited by common beta-lactamase inhibitors and are able to hydrolyse carbapenems. The presence of permeability barriers may confer low-level beta-lactam resistance and supplement the effect of beta-lactamase activity. There are also sporadic reports of loss of beta-lactam activity because of reduced affinity of the penicillin-binding proteins.
Edwards
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Division of Microbiology and Infectious Diseases, University Hospital, Queen's Medical Centre, Nottingham.
D000900:Anti-Bacterial Agents / Q000378:metabolism / Q000494:pharmacology* / Q000627:therapeutic use; D001439:Bacteroides / Q000187:drug effects* / Q000201:enzymology / Q000378:metabolism; D001442:Bacteroides Infections / Q000188:drug therapy* / Q000382:microbiology; D002463:Cell Membrane Permeability; D004352:Drug Resistance, Microbial / Q000502:physiology; D006801:Humans; D001618:beta-Lactamases / Q000096:biosynthesis; D047090:beta-Lactams
D000900:Anti-Bacterial Agents; D047090:beta-Lactams; D001618:beta-Lactamases