[Extended spectrum beta-lactamases]

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The Use of a β-lactamase-based Conductimetric Biosensor Assay to Detect Biomolecular Interactions
08:06

The Use of a β-lactamase-based Conductimetric Biosensor Assay to Detect Biomolecular Interactions

Published on: February 1, 2018

A Philippon1, G Arlet, P Lagrange

  • 1Hôpital Saint-Louis, service de bactériologie-virologie hygiène, Paris.

La Revue Du Praticien
|November 15, 1993
PubMed

Insights

Extended-spectrum beta-lactamases (ESBL) cause resistance to third-generation cephalosporins (C3G) in enterobacteria like K. pneumoniae. Early detection and selective decontamination are key to managing these hospital-acquired infections.

Area of Science:

  • Microbiology
  • Infectious Diseases
  • Antimicrobial Resistance

Context:

  • Over 30 extended-spectrum beta-lactamases (ESBL) have emerged since 1983, conferring resistance to third-generation cephalosporins (C3G).
  • Enterobacteria, particularly Klebsiella pneumoniae, are primary producers of ESBLs, often exhibiting susceptibility to oxyimino-beta-lactams.
  • These resistant strains are frequently isolated from intensive care unit (ICU) patients, leading to hospital-wide spread and outbreaks.

Purpose:

  • To highlight the emergence and spread of ESBL-producing enterobacteria.
  • To emphasize the utility of a double-disk test for detecting these nosocomial isolates.
  • To discuss the implications of antibiotic use on ESBL selection and potential control strategies.

Summary:

  • Extended-spectrum beta-lactamases (ESBL) confer resistance to C3G antibiotics in enterobacteria, notably Klebsiella pneumoniae.
  • A double-disk test aids in identifying ESBL-producing nosocomial isolates from clinical samples (urine, blood, wound, sputum).
  • Plasmid-encoded ESBL resistance spreads among enterobacteria, often alongside other antibiotic resistance markers, and may be driven by the use of newer antibiotics.

Impact:

  • Effective detection methods like the double-disk test are crucial for managing hospital-acquired infections caused by ESBL producers.
  • Understanding the plasmid-mediated spread of resistance informs infection control strategies.
  • While resistance is a concern, treatments with cefamycins, carbapenems, and beta-lactam inhibitors remain viable options.
  • Digestive selective decontamination shows promise in controlling ESBL outbreaks.

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