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Extended-spectrum beta-lactamases.

Philip J Turner¹

¹AstraZeneca Pharmaceuticals, Macclesfield, United Kingdom. philip.turner@astrazeneca.com

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America

|July 21, 2005

Summary

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Beta-lactamase enzymes, including expanded-spectrum beta-lactamases (ESBLs), are increasingly common in bacteria like Escherichia coli. ESBLs confer resistance to many antibiotics, making carbapenems the recommended treatment for infections caused by these resistant strains.

Area of Science:

Microbiology
Antimicrobial Resistance

Background:

Beta-lactamase enzymes, first identified in 1940, are prevalent in Enterobacteriaceae and other bacteria.
Over 130 TEM-type and 50 SHV-type beta-lactamases are known, primarily in Escherichia coli, Klebsiella pneumoniae, and Proteus mirabilis.

Purpose of the Study:

To highlight the growing prevalence and impact of beta-lactamase-producing organisms.
To inform clinical microbiology practices regarding the detection and treatment of infections caused by these resistant strains.

Main Methods:

Review of existing data on beta-lactamase types and prevalence.
Analysis of antibiotic resistance patterns associated with beta-lactamase production.

Main Results:

Expanded-spectrum beta-lactamases (ESBLs) inactivate oxyimino-cephalosporins and are often co-associated with resistance to aminoglycosides, fluoroquinolones, piperacillin-tazobactam, and cefepime.

Related Experiment Videos

The incidence of ESBLs varies geographically.

ESBL-producing organisms are found in various Enterobacteriaceae and some nonenteric bacteria, like Acinetobacter species.

Conclusions:

Microbiology laboratories should routinely screen for ESBL-producing strains.
Carbapenems are the recommended antibiotics for treating infections caused by ESBL-producing organisms.