TY - JOUR
T1 - Amp C β-lactamase-producing Escherichia coli in neonatal meningitis
T2 - Diagnostic and therapeutic challenge
AU - Fakioglu, E.
AU - Queenan, A. M.
AU - Bush, K.
AU - Jenkins, S. G.
AU - Herold, B. C.
PY - 2006/8
Y1 - 2006/8
N2 - Antibiotic resistance is a global health priority. Major defenses for Gram-negative bacteria are β-lactamase enzymes, which have co-evolved with the development and increasing utilization of new antibiotics. Bacteria harboring the plasmid-mediated AmpC enzymes are increasingly prevalent among adult patients, but have not previously been reported in neonates. Early-onset neonatal meningitis caused by an AmpC β-lactamase-producing Escherichia coli is described for the first time; the plasmid was identified as a transferable CMY-2 family β-lactamase. Limited experience with newer antibiotics and pharmacokinetics in neonates presents a therapeutic challenge. Currently, there are no Clinical Laboratory Standards Institute (CLSI) recommendations for detecting AmpC nor is the optimal treatment for AmpC-producing organisms known. Thus, it is imperative that clinicians have a high index of suspicion when antimicrobial susceptibility patterns are inconsistent. Development of better microbiology screening tests to rapidly detect resistance is essential. Additionally, pharmacokinetic studies with newer antibiotics in neonates are warranted.
AB - Antibiotic resistance is a global health priority. Major defenses for Gram-negative bacteria are β-lactamase enzymes, which have co-evolved with the development and increasing utilization of new antibiotics. Bacteria harboring the plasmid-mediated AmpC enzymes are increasingly prevalent among adult patients, but have not previously been reported in neonates. Early-onset neonatal meningitis caused by an AmpC β-lactamase-producing Escherichia coli is described for the first time; the plasmid was identified as a transferable CMY-2 family β-lactamase. Limited experience with newer antibiotics and pharmacokinetics in neonates presents a therapeutic challenge. Currently, there are no Clinical Laboratory Standards Institute (CLSI) recommendations for detecting AmpC nor is the optimal treatment for AmpC-producing organisms known. Thus, it is imperative that clinicians have a high index of suspicion when antimicrobial susceptibility patterns are inconsistent. Development of better microbiology screening tests to rapidly detect resistance is essential. Additionally, pharmacokinetic studies with newer antibiotics in neonates are warranted.
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U2 - 10.1038/sj.jp.7211550
DO - 10.1038/sj.jp.7211550
M3 - Article
C2 - 16871223
AN - SCOPUS:33746526033
SN - 0743-8346
VL - 26
SP - 515
EP - 517
JO - Journal of Perinatology
JF - Journal of Perinatology
IS - 8
ER -