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Antimicrobial Agents and Chemotherapy, July 1999, p. 1669-1673, Vol. 43, No. 7
Department of Microbiology,
Received 9 September 1998/Returned for modification 19 January
1999/Accepted 30 April 1999
Two clinical isolates of extended-spectrum
0066-4804/99/$04.00+0
Copyright © 1999, American Society for Microbiology. All rights reserved.
Roles of
-Lactamases and Porins in Activities of
Carbapenems and Cephalosporins against Klebsiella
pneumoniae
-lactamase (ESBL)-producing Klebsiella
pneumoniae were noted to be less susceptible than expected to
imipenem. Both were missing outer membrane proteins that serve as
channels for antibiotic entry. The role of
-lactamase in
resistance was investigated by eliminating the original ESBL and
introducing plasmids encoding various ESBLs and AmpC
-lactamase types, by studying the effect of an increased
inoculum, and by evaluating interactions with
-lactamase
inhibitors. The contribution of porin deficiency was investigated by
restoring a functional ompK36 gene on a plasmid. Plasmids
encoding AmpC-type
-lactamases provided resistance to
imipenem (up to 64 µg/ml) and meropenem (up to 16 µg/ml) in strains
deficient in porins. Carbapenem resistance showed little inoculum
effect, was not affected by clavulanate but was blocked by BRL 42715, and was diminished if OmpK36 porin was restored. Plasmids encoding TEM-
and SHV-type ESBLs conferred resistance to cefepime and cefpirome, as
well as to earlier oxyimino-
-lactams. This resistance was magnified
with an increased inoculum, was blocked by clavulanate, and was also
lowered by OmpK36 porin restoration. In addition, SHV-2
-lactamase had a small effect on carbapenem resistance
(imipenem MIC, 4 µg/ml, increasing to 16 µg/ml with a higher
inoculum) when porins were absent. In K. pneumoniae porin loss can thus augment resistance provided either by TEM- or SHV-type ESBLs or by plasmid-mediated AmpC enzymes to include the latest oxyimino-
-lactams and carbapenems.
*
Corresponding author. Mailing address: Department of
Microbiology, School of Medicine, University of Seville, Apdo. 914, 41080 Seville, Spain. Phone: 34-95-4557448. Fax: 34-95-4377413. E-mail: lmartin{at}cica.es.
Antimicrobial Agents and Chemotherapy, July 1999, p. 1669-1673, Vol. 43, No. 7
0066-4804/99/$04.00+0
Copyright © 1999, American Society for Microbiology. All rights reserved.
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