The Role of Beta-Lactamase-Producing-Bacteria in Mixed Infections I Children

Abstract

Beta-lactamase-producing bacteria (BLPB) can play an important role in polymicrobial infections. They can have a direct pathogenic impact in causing the infection as well as an indirect effect through their ability to produce the enzyme beta-lactamase. BLPB may not only survive penicillin therapy but can also, as was demonstrated in in vitro and in vivo studies, protect other penicillin-susceptible bacteria from penicillin by releasing the free enzyme into their environment. This phenomenon occurs in upper respiratory tract, skin, soft tissue, surgical and other infections. The clinical, in vitro, and in vivo evidence supporting the role of these organisms in the increased failure rate of penicillin in eradication of these infections and the implication of that increased rate on the management of infections is discussed. Penicillins have been the drugs of choice for the treatment of a variety of bacterial infections in children. However, within the past six decades, an increased resistance to these agents has been observed. In addition to organism long known to resistant beta-lactamases, such as Staphylococcus aureus and Enterobacteriaceae, other previously susceptible bacteria became increasingly resistant to these agents due to several mechanisms including the production of the enzyme beta-lactamase (BL). These organisms include aerobic and facultative bacteria such as Haemophilus influenzae, Moraxella catarrhalis, as well as anaerobic Gram-negative bacilli (AGNB, i.e. Bacteroidesfragilis group, pigmented Prevotella and Porphyromonas, Prevotellabivia, and Prevotella disiens) and Fusobacterium spp.) [1-3]. Beta-lactamase-producing bacteria (BLPB) can have an important clinical role in clinical infections. These bacteria can be pathogenic in their own merit as well as have an indirect effect through their ability to produce the enzyme BL into their surroundings. BLPB may not only survive penicillin therapy but also may shield other beta-lactamesusceptible bacteria from these agents by releasing the enzyme into their surroundings ( Figure 1) [4]. *Corresponding author: Itzhak Brook, Department of Pediatrics, Georgetown University School of Medicine, MD, MSc, 4431 Albemarle St. NW, Washington DC 20016, USA, Tel : 202 363 4253; E-mail: ib6@georgetown.edu Received August 08, 2011; Accepted January 05, 2012; Published January 09, 2012 Citation: Brook I (2012) The Role of Beta-Lactamase-Producing-Bacteria in Mixed Infections I Children. Pediatr Therapeut 2:e105. doi:10.4172/2161-0665.1000e105 Copyright: © 2012 Brook I. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.