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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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