Journal of Antimicrobial Chemotherapy (2001) 47, 247-250
© 2001 The British Society for Antimicrobial Chemotherapy
Leading article |
Of Pseudomonas, porins, pumps and carbapenems
Antibiotic Resistance Monitoring and Reference Laboratory, Central Public Health Laboratory, 61 Colindale Avenue, London NW9 5HT, UK
The carbapenems, imipenem and meropenem, are anomalous ß-lactams in their antipseudomonal behaviour, as well as in their ß-lactamase stability. In the case of imipenem, MICs for Pseudomonas aeruginosa isolates are unrelated to those of other ß-lactams, whereas a strong relationship exists between the MICs of different penicillins and cephalosporins for most Pseudomonas isolates.1–4 This observation is partly because imipenem MICs are independent of derepression of the chromosomal AmpC ß-lactamase, whereas this factor strongly co-determines the MICs of penicillins and cephalosporins.5 More critically, the MICs of imipenem are unaffected by the broad-spectrum intrinsic resistance expressed by many P. aeruginosa isolates, whereas this mechanism strongly co-determines the MICs of penicillins, cephalosporins
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