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Related Experiment Videos

[Extended spectrum beta-lactamases]

A Philippon1, G Arlet, P Lagrange

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

La Revue Du Praticien
|November 15, 1993
PubMed
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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.

Related Experiment Videos

  • 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.