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Related Experiment Videos

Resistance in gram-negative bacteria: enterobacteriaceae.

David L Paterson1

  • 1Antibiotic Management Program, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA. patersond@dom.pitt.edu

The American Journal of Medicine
|June 1, 2006
PubMed
Summary

Antimicrobial resistance in Enterobacteriaceae, including extended-spectrum beta-lactamases (ESBLs), complicates infections. Carbapenems remain key, but rising resistance necessitates improved antibiotic stewardship and infection control.

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Area of Science:

  • Microbiology
  • Infectious Diseases
  • Antimicrobial Resistance

Background:

  • Enterobacteriaceae infections are increasingly difficult to treat due to rising resistance.
  • Significant proportions of Klebsiella pneumoniae and Enterobacter spp. infections in US ICUs are resistant to third-generation cephalosporins.
  • Resistance mechanisms include extended-spectrum beta-lactamases (ESBLs) and AmpC beta-lactamases, often plasmid-mediated and co-occurring with multidrug resistance.

Purpose of the Study:

  • To review the current landscape of resistance in Enterobacteriaceae.
  • To highlight the clinical implications of ESBL and other resistance mechanisms.
  • To emphasize the importance of carbapenems and the threat of emerging carbapenem resistance.

Main Methods:

  • Literature review of antimicrobial resistance trends in Enterobacteriaceae.

Related Experiment Videos

  • Analysis of resistance mechanisms, including ESBLs, AmpC beta-lactamases, and quinolone resistance.
  • Discussion of treatment implications and emerging resistance patterns.

    • Main Results:

    • Third-generation cephalosporin resistance is common in K. pneumoniae and Enterobacter spp. due to ESBLs and AmpC overproduction.
    • ESBL-producing Enterobacteriaceae, including Salmonella, are increasingly prevalent in healthcare and community settings.
    • Carbapenems are generally effective, but carbapenem resistance, notably KPC-type carbapenemases, is a growing concern.

    Conclusions:

    • The spread of resistance in Enterobacteriaceae poses a significant threat to public health.
    • Effective treatment relies on carbapenems, but their utility is challenged by emerging resistance.
    • Enhanced antibiotic stewardship and infection control measures are critical to curb the global spread of resistance.