Cefoxitin Resistance to Beta-Lactamase: a Major Factor for Susceptibility of Bacteroides fragilis to the Antibiotic

Toluene-treated cell suspensions of Bacteroides fragilis were used to screen clinical isolates for the production of β-lactamase. Approximately one-third of the isolates possessed considerable cephalosporinase activity. A significant correlation was found between β-lactamase production and resistance to cephalosporin antibiotics. Several isolates were resistant to cefuroxime and cefamandole and produced enzymes capable of hydrolyzing these antibiotics. However, none of the 79 strains tested could hydrolyze the cephamycin derivative, cefoxitin. A large percentage (>90%) of the strains were susceptible to cefoxitin. Therefore, resistance to lactamase hydrolysis is a major factor for the effectiveness of cefoxitin against B. fragilis. Detailed studies of four isolates suggest that two different enzymes may be produced. Both are cephalosporinases but differ with regard to cellular distribution and substrate specificity. Cefoxitin is not a substrate for either enzyme, but it is an excellent competitive inhibitor (K_i ≈ 0.1 μM).