New β-Lactams: New Problems for the Internist
Authors: Christine C. Sanders
Journal: Annals of Internal Medicine (1991)

Editorials15 October 1991New β-Lactams: New Problems for the InternistChristine C. Sanders, PhDChristine C. Sanders, PhDAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-115-8-650 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptUntil the 1980s, infections caused by species of Enterobacter were relatively uncommon. According to the most recent National Nosocomial Infections Surveillance System data (1), however, Enterobacter has replaced Klebsiella pneumoniae as the third leading cause of gram-negative nosocomial infections behind Escherichia coli and Pseudomonas aeruginosa. In fact, it is the third leading cause of all nosocomial pneumonias. The increased prevalence of Enterobacter has paralleled the introduction and increased use of the expanded-spectrum cephalosporins, both in therapy and in prevention of infections in hospitalized patients.The association between use of newer cephalosporins and infections caused byEnterobacterspp. is made clear...References1. SchabergCulverGaynes DDR. Major trends in the microbial etiology of nosocomial infection. Am J Med. 1991 (Suppl) [In press]. MedlineGoogle Scholar2. ChowFineShlaesQuinnHooperJohnson JMDJDM. Enterobacter bacteremia: clinical features and emergence of antibiotic resistance during therapy. Ann Intern Med. 1991;115:585-90. LinkGoogle Scholar3. SandersSanders WC. Inducible β-lactamases: clinical and epidemiologic implications for use of newer cephalosporins. Rev Infect Dis. 1988;10:830-8. CrossrefMedlineGoogle Scholar4. Sanders C. Chromosomal cephalosporinases responsible for multiple resistance to newer beta-lactam antibiotics. Annu Rev Microbiol. 1987;41:573-93. 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Outbreak of ceftazidime resistance caused by extended-spectrum β-lactamases at a Massachusetts chronic-care facility. Antimicrob Agents Chemother. 1990;34:2193-9. CrossrefMedlineGoogle Scholar11. QuinnMiyashiroSahmFlammBush JDDRK. Novel plasmidmediated β-lactamase (TEM-1O) conferring selective resistance to ceftazidime and aztreonam in clinical isolates of Klebsiella pneumoniae. Antimicrob Agents Chemother 1989;33:1451-6. CrossrefMedlineGoogle Scholar12. ThomsonSandersWashington KCJ. High-level resistance to cefotaxime and ceftazidime in Klebsiella pneumoniae isolates from Cleveland, Ohio. Antimicrob Agents Chemother. 1991;35:1001-3. CrossrefMedlineGoogle Scholar13. SandersIaconisBodeySamonis CJGG. Resistance to ticarcillin-potassium clavulanate among clinical isolates of the family Enterobacteriaceae: role of PSE-1 β-lactamase and high levels of TEM-1 and SHV-1 and problems with false susceptibility in disk diffusion tests. Antimicrob Agents Chemother. 1988;32:1365-9. 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Author, Article, and Disclosure InformationAffiliations: Creighton University School of Medicine Omaha, NE 68178 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByIs double coverage of gram-negative organisms necessary?Acute Myelogenous Leukemia and Febrile NeutropeniaMedical ManagementUse of Several Inducer and Substrate Antibiotic Combinations in a Disk Approximation Assay Format To Screen for AmpC Induction in Patient Isolates of Pseudomonas aeruginosa , Enterobacter spp., Citrobacter spp., and Serratia sppDie perioperative Antibiotikaprophylaxe in der UrologieEpidemiology of infectious complications in cancer patientsThe clinical implications of ß-lactamasesInterrepeat Fingerprinting of Third-Generation Cephalosporin-Resistant Enterobacter cloacae Isolated during an Outbreak in a Neonatal Intensive Care UnitPrinciples of Antibiotic TherapyPrevalence of ciprofloxacin resistance in multiresistant gram-negative intensive care unit isolatesPROBLEMS WITH DETECTION OF β-LACTAM RESISTANCE AMONG NONFASTIDIOUS GRAM-NEGATIVE BACILLIIn vitro activity and beta-lactamase stability of FK-037, a parenteral cephalosporinAntimicrobial Prophylaxis in Surgery: Mechanisms, Misconceptions, and MischiefAntimicrobial Prophylaxis in Surgery: Mechanisms, Misconceptions, and MischiefHospital epidemiology: Evaluating the microbiologic ecology and antimicrobial susceptibilities within the hospital: A streamlined approachPharmacodynamics of once-daily amikacin in various combinations with cefepime, aztreonam, and ceftazidime against Pseudomonas aeruginosa in an in vitro infection modelThe Crisis in Antibiotic ResistanceAntibiotic-resistant Enterobacter and the Newer CephalosporinsEllen J. Mangione, MD, MPH, John M. Douglas, MDAntibiotic ResistanceResistance of Pseudomonas aeruginosa to ImipenemResistance of Pseudomonas aeruginosa to Imipenem 15 October 1991Volume 115, Issue 8Page: 650-651KeywordsEnterobacterEnterobacter infectionsEscherichia coliKlebsiella pneumoniaeMicrobiologyNosocomial infectionsPneumoniaPseudomonas aeruginosa Issue Published: 15 October 1991 PDF DownloadLoading ...