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My early research centred on ?-lactamases, and I showed how an apparently weak activity could protect a bacterium if the enzyme had high affinity and the ?-lactam permeated only slowly. This led to showing that models describing the interplay of ?-lactamase and permeability were adequate for Escherichia coli but not Pseudomonas aeruginosa, and I contributed to work revealing that this inadequacy was because P. aeruginosa also effluxes ?-lactams. Other early work explored the induction of AmpC ?-lactamases and the selection of AmpC-derepressed mutants from AmpC-inducible populations of Enterobacter and P. aeruginosa, showing selection to be the more important factor. I have been responsible for describing and investigating the properties of many new ?-lactamases, including those conferring resistance to carbapenems – the last reserve ?-lactams against many otherwise multiresistant bacteria.
My work increasingly spread from the mechanisms of resistance to its epidemiology. At the UK Health Protection Agency (Public Health England) I led groups that demonstrated the dramatic rises in MRSA in the late 1990s, ciprofloxacin-resistant gonococci around 2002-3, carbapenemase-resistant Acinetobacter spp. and cephalosporin-resistant E. coli from around 2003 and the recent rise in carbapenemases, partly linked to the repeated import of strains with NDM-1 enzyme via patients previously hospitalised in the Indian subcontinent.
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JOURNAL OF ANTIMICROBIAL CHEMOTHERAPYno. 1 (2024): 123-127
INTERNATIONAL JOURNAL OF ANTIMICROBIAL AGENTSno. 3 (2024): 107081-107081
PAOLO BENEDETTI, MANUELA PEGORARO, ELENA NOVELLO, CHIARA ROMUALDI,VINICIO MANFRIN,DAVID MARTIN LIVERMORE
Research Square (Research Square) (2022)
Open Forum Infectious Diseasesno. Supplement_2 (2022)
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