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Extended-spectrum beta-lactamase-producing organisms
M E Falagas1, D E Karageorgopoulos
1Alfa Institute of Biomedical Sciences, 9 Neapoleos Street, 151 23 Marousi, Athens, Greece. m.falagas@aibs.gr
The Journal of Hospital Infection
|July 15, 2009
Summary
Extended-spectrum beta-lactamases (ESBLs) are increasingly prevalent, especially CTX-M enzymes in E. coli. Treatment options for ESBL infections are limited, with carbapenems being the preferred choice.
Area of Science:
- Microbiology
- Infectious Diseases
- Antimicrobial Resistance
Background:
- Extended-spectrum beta-lactamases (ESBLs) are enzymes conferring resistance to cephalosporins.
- CTX-M enzymes are emerging as the dominant ESBL type, particularly in community-acquired infections.
- ESBL-producing Enterobacteriaceae are a growing concern in both community and hospital settings.
Purpose of the Study:
- To review the epidemiology and clinical significance of ESBL-producing Enterobacteriaceae.
- To discuss the challenges in treating infections caused by these resistant organisms.
- To evaluate current and potential therapeutic options for ESBL-associated infections.
Main Methods:
- Literature review of studies on ESBL epidemiology, clinical syndromes, and treatment.
- Analysis of trends in ESBL prevalence and types.
- Evaluation of antimicrobial susceptibility data and clinical outcomes.
Main Results:
- CTX-M enzymes are replacing older ESBL types, predominantly in Escherichia coli causing urinary tract infections.
- Nosocomial infections caused by ESBL-producing Klebsiella pneumoniae are increasing globally.
- Treatment of ESBL infections is challenging due to co-resistance to multiple antibiotic classes.
Conclusions:
- Effective infection control measures, including hygiene and antibiotic stewardship, are crucial.
- Carbapenems are the recommended treatment for serious ESBL-associated infections.
- Further research into alternative agents like tigecycline, polymyxins, and fosfomycin is warranted.
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