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Journal of Clinical Microbiology, February 2000, p. 677-681, Vol. 38, No. 2
Department of Microbiology, Toho University
School of Medicine, Ota-ku, Tokyo, Japan
Received 22 March 1999/Returned for modification 1 June
1999/Accepted 29 October 1999
During in vitro susceptibility testing of clinical isolates of
Proteus vulgaris, we noted that the MICs of several
expanded-spectrum cephems were much higher in the broth microdilution
method than in the agar dilution method (termed the MIC gap
phenomenon). Here we investigated the mechanism of the MIC gap
phenomenon. Cephems with the MIC gap phenomenon were of the oximino
type, such as cefotaxime, cefteram, and cefpodoxime, which serve as
good substrates for inducible class A
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Copyright © 2000, American Society for Microbiology. All rights reserved.
Problems Related to Determination of MICs of
Oximino-Type Expanded-Spectrum Cephems for Proteus
vulgaris
-lactamase (CumA) enzymes
produced by P. vulgaris; this finding suggests a
relationship between the MIC gap phenomenon and CumA. Since
peptidoglycan recycling shares a system common to that inducing CumA,
we analyzed the mechanism of the MIC gap phenomenon using P. vulgaris B317 and isogenic mutants with mutations in the
peptidoglycan recycling and
-lactamase induction systems. The MIC
gap phenomenon was observed in the parent strain B317 but not in B317G
(cumG-defective mutant; defective peptidoglycan recycling)
and B317R (cumR-defective mutant; defective CumA
transcriptional regulator). No
-lactamase activity was detected in
B317G and B317R.
-Lactamase activity and the MIC gap phenomenon were
restored in B317G/pMD301 (strain transcomplemented by a cloned cumG gene) and B317R/pMD501 (strain transcomplemented by a
cloned cumR gene). MICs determined by the agar dilution
method increased when lower agar concentrations were used. Our results
indicated that the mechanism of the MIC gap phenomenon is related to
peptidoglycan recycling and CumA induction systems. However, it remains
unclear how
-lactamase induction of P. vulgaris is
suppressed on agar plates.
*
Corresponding author. Mailing address: Department of
Microbiology, Toho University School of Medicine, 5-21-16, Omori-nishi, Ota-ku, Tokyo, Japan 143-8540. Phone: 81-3-3762-4151. Fax:
81-3-5493-5415. E-mail: akira{at}med.toho-u.ac.jp.
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