High-level carbapenem-resistant (CpmR) mutants, with MICs for imipenem and carbapenem of greater than 128 micrograms/ml, were selected in vitro from four carbapenem-susceptible (CpmS) clinical isolates of Bacteroides fragilis. The CpmS strains produced very low levels of beta-lactamase activity, which was increased approx. 50- to 100-fold in the CpmR mutants. Isoelectric focussing and enzyme kinetic analysis (Km and Vrel) of the 'carbapenemases' from the CpmR mutants and similarly resistant clinical isolates suggested a close relatedness of the enzymes. A probe covering most of the cfiA gene encoding such an enzyme (Thompson, J.S. and Malamy, M.H. (1990) J. Bacteriol. 172, 2584-2593) hybridized with DNA from the CpmR mutants, their CpmS parental strains as well as clinical CpmR isolates, but not from randomly chosen carbapenem-susceptible strains. The possibility is considered that mutations leading to expression of the silent carbapenemase gene, and thereby to clinically relevant carbapenem resistance, may also occur in the clinical setting.

译文

:从四个脆弱类拟杆菌细菌临床分离株中筛选出高抗碳青霉烯(CpmR)突变体,亚胺培南和碳青霉烯的MIC均大于128微克/毫升。 CpmS菌株产生非常低水平的β-内酰胺酶活性,其活性大约增加。 CpmR突变体的50到100倍。等电点聚焦和酶动力学分析(Km和Vrel)来自CpmR突变体和具有类似抗药性的临床分离株的“卡宾碳烯”,表明这些酶具有密切的相关性。一种探针,覆盖了大多数编码这种酶的cfiA基因(Thompson,JS和Malamy,MH(1990)J. Bacteriol。172,2584-2593),与来自CpmR突变体,其CpmS亲本菌株以及临床CpmR的DNA杂交分离株,但不是随机选择的碳青霉烯敏感株。据认为,在临床环境中也可能发生导致沉默碳青霉烯酶基因表达并由此引起临床相关的碳青霉烯耐药性的突变。

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