Decré D, Arlet G, Danglot C, Lucet J C, Fournier G, Bergogne-Bérézin E, Philippon A
Hôpital Bichat-Cl.-Bernard, Service de Microbiologie, Paris, France.
J Antimicrob Chemother. 1992 Dec;30(6):769-79. doi: 10.1093/jac/30.6.769.
A resistant (R) clinical isolate of Alcaligenes denitrificans subsp. xylosoxydans was recovered from CSF during treatment including piperacillin. This variant selected in vivo, and a second variant obtained in vitro from the initially susceptible (S) strain, both exhibited resistance to penicillins (ticarcillin, piperacillin) and cephalosporins, but remained susceptible to latamoxef and imipenem. Clavulanate (2 mg/L) restored the susceptibility of the two R-variants to penicillins. A beta-lactamase of pI 9.5 was detected in both S and R strains, but overproduction was observed only in the in-vivo and in-vitro R-variants. This inducible beta-lactamase hydrolysed benzylpenicillin, cephalothin and cephaloridine efficiently, but amoxycillin, ticarcillin and cefoperazone were only moderate substrates. The enzyme was inhibited by clavulanate, cloxacillin and imipenem (IC50 between 3 and 9 mM), but not by aztreonam and chloride ions (1 mM). Resistance to beta-lactams was not transferable by conjugation to Escherichia coli or Pseudomonas aeruginosa, and DNA agarose gel electrophoresis indicated that no plasmid was present in the isolates. Restriction patterns of chromosomal DNA isolated from the S and R isolates were similar after digestion by NotI and HindIII.
在包括哌拉西林的治疗过程中,从脑脊液中分离出一株反硝化产碱杆菌木糖氧化亚种的耐药(R)临床分离株。这种变体是在体内筛选出来的,从最初敏感(S)菌株体外获得的第二种变体,两者均对青霉素(替卡西林、哌拉西林)和头孢菌素耐药,但对拉氧头孢和亚胺培南仍敏感。克拉维酸(2mg/L)恢复了这两种R变体对青霉素的敏感性。在S和R菌株中均检测到一种pI为9.5的β-内酰胺酶,但仅在体内和体外R变体中观察到过量产生。这种诱导型β-内酰胺酶能有效水解苄青霉素、头孢噻吩和头孢利定,但阿莫西林、替卡西林和头孢哌酮只是中度底物。该酶被克拉维酸、氯唑西林和亚胺培南抑制(IC50在3至9mM之间),但不被氨曲南和氯离子(1mM)抑制。对β-内酰胺类药物的耐药性不能通过接合转移到大肠杆菌或铜绿假单胞菌,DNA琼脂糖凝胶电泳表明分离株中不存在质粒。用NotI和HindIII消化后,从S和R分离株中分离的染色体DNA的限制性图谱相似。