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MECHANIZMY OPORNOŚCI HAEMOPHILUS INFLUENZAE
NA ANTYBIOTYKI b-LAKTAMOWE
Tomasz Wołkowicz1, Marcin Kadłubowski2*
Elżbieta Katarzyna Jagusztyn-Krynicka1, Waleria Hryniewicz2,3
1Zakład Genetyki Bakterii, Instytut Mikrobiologii, Wydział Biologii, Uniwersytet Warszawski ul. Miecznikowa 1, 02-096 Warszawa
2Zakład Epidemiologii i Mikrobiologii Klinicznej, Narodowy Instytut Leków ul. Chełmska 30/34, 00-725 Warszawa, tel. 0-22 851 46 70, 
3Centralny Ośrodek Badań Jakości w Diagnostyce Mikrobiologicznej, ul. Chełmska 30/34, 00-725 Warszawa
Wpłynęło w kwietniu 2008 r.
1. Charakterystyka Haemophilus influenzae. 2. Antybiotykoterapia zakażeń wywoływanych przez H. influenzae. 3. Mechanizmy warunkujące oporność na antybiotyki b-laktamowe. 3.1. Wytwarzanie b-laktamaz. 3.2. Zmiany w białkach PBP i fenotyp BLNAR. 3.3. Inne mechanizmy warunkujące oporność na antybiotyki b-laktamowe. 4. Wielolekooporność. 5. Podsumowanie
Mechanisms of resistance of Haemophilus influenzae to b-lactam antibiotics
Abstract: Haemophilus influenzae is an important respiratory tract pathogen, which can cause numerous invasive and non-invasive infections. The major group of chemotherapeutics used in the treatment of infections caused by this species are b-lactam antibiotics, especially aminopenicillins and cephalosporines. The most common mechanism of resistance to these agents is the production of b-lactamase - an enzyme, which inactivates these antibiotics. In clinical strains of H. influenzae, TEM and ROB b-lactamases have been identified. Other mechanisms of resistance to b-lactams are mutations in the ftsI gene, which encodes penicillin-binding proteins - PBP3A and PBP3B. These mutations cause alterations in PBP3A and PBP3B and decrease their affinity to b-lactam antibiotics. Strains showing resistance to b-lactams through this mechanism are called Beta-Lactamase Negative (or Non-producing), Ampicillin Resistant (BLNAR). This pheno-type is difficult to detect by standard microbiological methods. In Poland, the number of clinical respiratory H. influenzae isolates with BLNAR phenotype is rising. BLNAR phenotype can promote other mechanisms of antimicrobial resistance, such as efflux pumps or production of extended spectrum b-lactamases (ESBL), which do not play an important role, when existing in H. influenzae on their own.
1. Characteristics of Haemophilus influenzae. 2. Antibiotic therapy of infections caused by H. influenzae. 3. Mechanisms of resistance to b-lactam antibiotics. 3.1. b-lactamase production. 3.2. Alterations in PBP and BLNAR phenotype. 3.3. Other mechanisms of resistance to b-lactam antibiotics. 4. Multidrug resistance. 5. Summary
Słowa kluczowe: Antybiotyki, b-laktamy, BLNAR, Haemophilus influenzae, lekooporność
Key words: Antibiotics, b-lactams, BLNAR, Haemophilus influenzae, antimicrobial resistance
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