Β-lactam resistance: Difference between revisions

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Β-lactam resistance
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== Mechanisms ==
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==Mechanisms==
   
* ß-lactamase production: enzymatic breakdown of beta lactam antibiotic
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*ß-lactamase production: enzymatic breakdown of beta lactam antibiotic
* Penicillin binding protein mutations (e.g. MRSA)
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*Penicillin binding protein mutations (e.g. MRSA)
* Efflux pump mutations
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*Efflux pump mutations
* Porin channel mutations that reduce antibiotic influx
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*Porin channel mutations that reduce antibiotic influx
   
== Ambler Classification of ß-lactamases ==
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== β-lactamases ==
   
 
===Ambler Classification of ß-lactamases===
* Based on amino acid sequences rather than function
 
* Classes A, C, and D are serine ß-lactamases
 
* Class A: original active-site serine ß-lactamases
 
* Class B: original metallo-ß-lactamases
 
* Class C: AmpC ß-lactamases
 
* Class D: OXA ß-lactamases
 
   
 
*Based on amino acid sequences rather than function
== Specific ß-lactamases ==
 
 
*Classes A, C, and D are serine ß-lactamases
=== NDM-1 ===
 
 
*'''Class A:''' original active-site serine ß-lactamases
* Broad-spectrum metallo-beta-lactamase and carbapenemase
 
 
*'''Class B:''' original metallo-ß-lactamases
* Can be treated empirically with [[ceftazidime-avibactam]] and [[aztreonam]] +/- [[colistin]]
 
 
*'''Class C:''' AmpC ß-lactamases
 
*'''Class D:''' OXA ß-lactamases
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  +
===Specific ß-lactamases===
 
====NDM-1====
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*Broad-spectrum metallo-beta-lactamase and carbapenemase
 
*Can be treated empirically with [[ceftazidime-avibactam]] and [[aztreonam]] +/- [[colistin]]
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  +
== Efflux Pumps ==
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  +
* Major cause of resistance in [[Pseudomonas aeruginosa]] and similar species
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* e.g. MexAB-OprM, which confers broad antimicrobial resistance including cephalosporins and some carbapanems
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== Porin Loss ==
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* Most common cause of carbapenem resistance in [[Pseudomonas aeruginosa]]
   
 
[[Category:Antibiotics]]
 
[[Category:Antibiotics]]

Revision as of 08:13, 2 August 2020

Mechanisms

  • ß-lactamase production: enzymatic breakdown of beta lactam antibiotic
  • Penicillin binding protein mutations (e.g. MRSA)
  • Efflux pump mutations
  • Porin channel mutations that reduce antibiotic influx

β-lactamases

Ambler Classification of ß-lactamases

  • Based on amino acid sequences rather than function
  • Classes A, C, and D are serine ß-lactamases
  • Class A: original active-site serine ß-lactamases
  • Class B: original metallo-ß-lactamases
  • Class C: AmpC ß-lactamases
  • Class D: OXA ß-lactamases

Specific ß-lactamases

NDM-1

Efflux Pumps

  • Major cause of resistance in Pseudomonas aeruginosa and similar species
  • e.g. MexAB-OprM, which confers broad antimicrobial resistance including cephalosporins and some carbapanems

Porin Loss