[Interpretive reading of the antibiogram of enterobacteria].
Many of the resistance mechanisms of enterobacteria to antimicrobial agents are well understood; nevertheless several aspects remain unsolved, particularly with regard to prediction of clinical response. The resistance pattern observed in the antibiogram of a specific organism should be the sum of the natural resistance pattern, characteristic of the species, plus the acquired resistance. In enterobacteria the principal mechanism of resistance to beta lactams and aminoglycosides is enzyme production, Each enzyme recognizes one or more specific beta lactam or aminoglycoside, as a substrate. This translates as a specific resistance phenotype that allows one to infer the enzyme(s) implicated. Enzyme resistance is not, however, the only mechanism of resistance to these agents; often the pattern observed is multifactorial. Resistance to quinolones is due to point and sequence mutations which may be selected by initially active fluoroquinolones and cause a stepwise increase of resistance.
Navarro Risueño
Ferran
F
Servicio de Microbiología, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Spain. fnavarror@hsp.santpau.es
Miró Cardona
Elisenda
E
Mirelis Otero
Beatriz
B
D000123:Acetyltransferases / Q000037:antagonists & inhibitors / Q000145:classification / Q000235:genetics / Q000502:physiology; D000900:Anti-Bacterial Agents / Q000145:classification / Q000378:metabolism / Q000494:pharmacology*; D001426:Bacterial Proteins / Q000037:antagonists & inhibitors / Q000145:classification / Q000235:genetics / Q000502:physiology*; D002876:Chromosomes, Bacterial / Q000235:genetics; D027081:DNA Gyrase / Q000235:genetics; D026942:DNA Topoisomerases / Q000235:genetics; D024901:Drug Resistance, Multiple, Bacterial / Q000235:genetics; D004755:Enterobacteriaceae / Q000187:drug effects* / Q000201:enzymology / Q000235:genetics; D004791:Enzyme Inhibitors / Q000494:pharmacology; D015964:Gene Expression Regulation, Bacterial; D019868:Kanamycin Kinase / Q000037:antagonists & inhibitors / Q000145:classification / Q000235:genetics / Q000502:physiology; D008826:Microbial Sensitivity Tests; D010641:Phenotype; D011815:R Factors; D013379:Substrate Specificity; D065093:beta-Lactamase Inhibitors; D001618:beta-Lactamases / Q000145:classification / Q000235:genetics / Q000502:physiology
D000900:Anti-Bacterial Agents; D001426:Bacterial Proteins; D004791:Enzyme Inhibitors; D065093:beta-Lactamase Inhibitors; D000123:Acetyltransferases; C019681:aminoglycoside acetyltransferase; D019868:Kanamycin Kinase; D001618:beta-Lactamases; D026942:DNA Topoisomerases; D027081:DNA Gyrase