[Emergence of plasmid mediated AmpC β-lactamasas: Origin, importance, detection and therapeutical options].
AmpC β-lactamases can hydrolyze penicillins, oxyimino-, 7-α-methoxycephalosporins and monobactams. Susceptibility to cefepime or cefpirome is little affected and is unchanged for carbapenems. Originally such genes are thought to have been mobilized to mobile genetic elements from the chromosomal ampC genes from members of Enterobacteriaceae facilitating their spread and now they can appear in bacterial lacking or poorly expressing a chromosomal ampC gene. The prevalence of infection by plasmid mediated AmpC (pAmpC) varies depending on the type of enzyme and geographical location and blaCMY-2 is the most frequently detected worldwide. Typically, pAmpC producing isolates are associated with resistance to multiple antibiotics making the selection of an effective antibiotic difficult. Phenotypic and molecular methods to detect pAmpC are described and the role of different antibiotics in the treatment of these infections is examined. Surveillance studies about the evolution of this emerging resistant mechanism are important in clinical isolates. Evaluate the in vitro susceptibility of these isolates and the clinical efficacy of other therapeutic options is required.
Servicio de Microbiología, Hospital Clínico Universitario Lozano Blesa, Avda San Juan Bosco 15, 50009 Zaragoza, Spain.
Cristina
C
Seral
María José
MJ
Gude
F Javier
FJ
Castillo
D000900:Anti-Bacterial Agents / Q000494:pharmacology* / Q000627:therapeutic use*; D001419:Bacteria / Q000187:drug effects* / Q000201:enzymology; D001424:Bacterial Infections / Q000453:epidemiology / Q000382:microbiology; D001426:Bacterial Proteins / Q000235:genetics*; D024881:Drug Resistance, Bacterial / Q000235:genetics*; D010957:Plasmids / Q000235:genetics*; D001618:beta-Lactamases / Q000235:genetics*
D000900:Anti-Bacterial Agents; D001426:Bacterial Proteins; C048795:AmpC beta-lactamases; D001618:beta-Lactamases