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Resistance characteristics of blood culture isolates of Enterobacter cloacae with special reference to beta‐lactamases and relation to preceding antimicrobial therapy
Author(s) -
Weischer MERETE,
Schumacher HELGA,
Kolmos HANS JØRN
Publication year - 1994
Publication title -
apmis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.909
H-Index - 88
eISSN - 1600-0463
pISSN - 0903-4641
DOI - 10.1111/j.1699-0463.1994.tb04884.x
Subject(s) - cefoxitin , enterobacter cloacae , cephalosporin , cefotaxime , microbiology and biotechnology , ampicillin , enterobacter , antimicrobial , antibiotics , antibiotic resistance , beta lactamase , biology , population , amp resistance , drug resistance , enterobacteriaceae , medicine , bacteria , escherichia coli , staphylococcus aureus , gene , genetics , environmental health
Resistance characteristics of 53 blood culture isolates of E. cloacae were examined and correlated with antimicrobial treatment preceding bacteraemia. Resistance patterns of 22 antimicrobial agents, presence of resistant mutants, and inducibility of beta‐lactamase were investigated; furthermore, population analysis and investigation of beta‐lactamase production of selected isolates were performed. Thirty‐two isolates (60%) were resistant to cephalothin and/or cefoxitin and/or ampicillin, and 14 isolates (26%) had further resistance characteristics, 7 of the 14 being resistant to non‐beta‐lactam antibiotics. All ampicillin‐susceptible and 76% of cefotaxime‐susceptible isolates had resistant mutants in the zone of inhibition when high inoculum was used. All isolates investigated had inducible chromosomal beta‐lactamases, and, in addition, two isolates had an enzyme corresponding with TEM‐1. Correlation of resistance patterns and antimicrobial treatment preceding bacteraemia showed that treatment with a third‐generation cephalosporin was associated with beta‐lactam multiresistance. In conclusion, susceptibility testing of beta‐lactam antibiotics of Enterobacter must be interpreted with caution and monotherapy with an extended‐spectrum cephalosporin should be avoided unless presence of resistant mutants and inducibility of beta‐lactamase can be excluded.