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Clinical Microbiology Reviews, Oct 1995, 557-584, Vol 8, No. 4
Copyright © 1995 by the American Society for Microbiology. All rights reserved.

beta-Lactamases in laboratory and clinical resistance

DM Livermore
Department of Medical Microbiology, London Hospital Medical College, United Kingdom.

beta-Lactamases are the commonest single cause of bacterial resistance to beta-lactam antibiotics. Numerous chromosomal and plasmid-mediated types are known and may be classified by their sequences or phenotypic properties. The ability of a beta-lactamase to cause resistance varies with its activity, quantity, and cellular location and, for gram- negative organisms, the permeability of the producer strain. beta- Lactamases sometimes cause obvious resistance to substrate drugs in routine tests; often, however, these enzymes reduce susceptibility without causing resistance at current, pharmacologically chosen breakpoints. This review considers the ability of the prevalent beta- lactamases to cause resistance to widely used beta-lactams, whether resistance is accurately reflected in routine tests, and the extent to which the antibiogram for an organism can be used to predict the type of beta-lactamase that it produces.


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