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Enterobacteriaceae.

Miles Denton1

  • 1Department of Microbiology, Leeds General Infirmary, Leeds LS1 3EX, UK. miles.denton@leedsth.nhs.uk

International Journal of Antimicrobial Agents
|August 3, 2007
PubMed
Summary
This summary is machine-generated.

Rising resistance to cephalosporins and fluoroquinolones in Enterobacteriaceae, especially E. coli, is limiting treatment options. This trend necessitates careful antibiotic prescribing to prevent further resistance development.

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Area of Science:

  • Microbiology
  • Infectious Diseases
  • Pharmacology

Background:

  • Enterobacteriaceae resistance to key antibiotics has evolved significantly since the 1980s.
  • Multidrug-resistant Enterobacteriaceae are a growing concern, particularly in hospital settings.
  • Emergence of resistance in community settings poses new challenges.

Purpose of the Study:

  • To review the changing epidemiology of cephalosporin and fluoroquinolone resistance in Enterobacteriaceae.
  • To assess the impact of this resistance on current and future prescribing practices.
  • To highlight the potential for increased carbapenem use and subsequent resistance.

Main Methods:

  • Literature review of studies published since the 1980s.
  • Analysis of resistance trends in Enterobacteriaceae, focusing on cephalosporins and fluoroquinolones.

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  • Examination of the co-expression of resistance mechanisms, such as extended-spectrum beta-lactamases (ESBLs) and fluoroquinolone resistance.

    • Main Results:

    • Escherichia coli co-expressing CTX-M type ESBLs and fluoroquinolone resistance are increasingly prevalent in the community.
    • This resistance impacts previously reliable first-line treatments like cephalosporins and ciprofloxacin.
    • Effective treatment options for urinary tract infections and bacteremia are diminishing.

    Conclusions:

    • Reduced effective antibiotic options will likely lead to increased carbapenem prescribing.
    • Increased carbapenem use will exert further selective pressure for carbapenemases and other carbapenem resistance mechanisms.
    • Urgent strategies are needed to mitigate the spread of resistance and preserve antibiotic efficacy.