Extended‐Spectrum β‐Lactamases: Epidemiology, Detection, and Treatment

  title={Extended‐Spectrum $\beta$‐Lactamases: Epidemiology, Detection, and Treatment},
  author={Surakit Nathisuwan and David S. Burgess and James S. Lewis},
  journal={Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy},
Extended‐spectrum β‐lactamases (ESBLs) are extremely broad spectrum β‐lactamase enzymes found in a variety of Enterobacteriaceae. Most strains producing these β‐lactamases are Klebsiella pneumoniae, other Klebsiella species (i.e., K. oxytoca), and Escherichia coli. When producing these enzymes, organisms become highly effective at inactivating various β‐lactam antibiotics. In addition, ESBL‐producing bacteria are frequently resistant to many classes of antibiotics, resulting in difficult‐to… 
Frequency determination of blaTEM & blaSHV in the Extended-Spectrum Beta-Lactamase producing Escherichia coli isolates from Karaj
This study aimed to determine the frequency of blaTEM and blaSHV genes in the extended-spectrum βlactamases, producing E. coli strains from urinary tract infections in Karaj city.
Current Perspectives on Extended-Spectrum Beta-Lactamase–Producing Gram-Negative Bacilli
There are now over 200 recognized ESBLs in a variety of gram-negative bacilli conferring resistance to penicillins, cephalosporins, a monobactam, and even carbapenems.
Detection of Extended Spectrum β-lactamase Production Among Uropathogens
Constant revision of antibiotic policies with infection control interventions is suggested for the control of initial outbreak of ESBL producing organisms in a hospital or specialized unit of hospital.
Isolation of Extended Spectrum Β-Lactamases in Urine Samples
This study reveals the prevalence of ESBL producing organisms is a significant uropathogen in the authors' area and Constant revision of antibiotic policies with infection control interventions is suggested.
A Study on Extended Spectrum Β -Lactamases in Coliforms
Imipenem appears to be the drug of choice for serious infections confirmed to be caused by ESBLs.
Extended Spectrum β Lactamase-producing Klebsiella pneumoniae Infections: a Review of the Literature
The epidemiology of ESBL-producing K. pneumoniae, the mechanisms of resistance, and treatment strategies for infections caused by these organisms are reviewed.
SHV β-lactamases : DNA diagnostics and evolution
It was found that multiple β-lactamase families within single isolates complicate the process of detecting the resistance status of isolate using non-quantitative DNA diagnostic methods, and the presence of the IS26 insertion upstream of blaSHV is positively correlated with resistance levels.
Extended-spectrum β-lactamase/AmpC-producing uropathogenic Escherichia coli from HIV patients: do they have a low virulence score?
It is concluded that antibiotic-resistant phylogroup D isolates with limited virulence are competent enough to establish infections in HIV patients, while among non-HIV patients, an array of virulence factors is essential for E. coli to overcome host defences irrespective of antibiotic resistance.
Detection of extended spectrum β-lactamase in Pseudomonas spp. isolated from two tertiary care hospitals in Bangladesh
BackgroundExtended spectrum ß-lactamases (ESBLs) represent a major group of lactamases responsible for resistance, mostly produced by gram-negative bacteria, to newer generations of ß-lactam drugs
Global dissemination of β2-lactamases mediating resistance to cephalosporins and carbapenems
  • T. Gootz
  • Biology
    Expert review of anti-infective therapy
  • 2004
While the main era of β-lactam discovery programs is over, these agents continue to be the most widely prescribed antimicrobials in both community and hospital settings, resulting in a literal explosion of new β- lactamase variants of existing enzyme classes.


More extended-spectrum beta-lactamases.
Extended-spectrum,-lactamases were first recognized in Europe, have become increasingly prevalent there, and are being reported around the world, including many sites in the United States.
Extended-spectrum beta-lactamases.
It came as an unwelcome surprise when Klebsiella isolates with plasmid-mediated resistance to broad-spectrum cephalosporins were found in the Federal isolates, and the genesis of these plasmids-determined extended-Spectrum 1-lactamases and the contribution that they have made to the understanding of 1- lactamase structure-activity relationships are the subjects of this review.
Efficacy of Different β-Lactams against an Extended-Spectrum β-Lactamase-Producing Klebsiella pneumoniae Strain in the Rat Intra-Abdominal Abscess Model
Although standard-inoculum MICs were within the susceptible range for all compounds, cefoperazone, cefotaxime, and cefpirome were significantly less effective than imipenem or the combination of
Detection and Reporting of Organisms Producing Extended-Spectrum β-Lactamases: Survey of Laboratories in Connecticut
It is suggested that many laboratories have difficulty detecting resistance in ESBL and AmpC-producing organisms and may be unaware of the NCCLS guidelines on modifying susceptibility testing reports for ESBL-producing strains.
Evolution and dissemination of β-lactamases accelerated by generations of β-lactam antibiotics
The structure and evolution of beta-lactamases are reviewed in an attempt to understand the pressures that have contributed to their emergence.
Extended-spectrum plasmid-mediated β-lactamases
Cephamycins should be used with caution to treat infections caused by ESBL-producing K. pneumoniae because of the relative ease with which clinical strains decrease the expression of outer membrane proteins, and the combination of a third-generation cephalosporin and a beta-lactamase inhibitor such as sulbactam could be of interest against some strains producing certain ESBLs.
Extended-spectrum -lactamases
Resistance to broad-spectrum cephalosporins among Klebsiella pneumoniae has increased significantly, particularly in the intensive care unit setting, in the past decade. The problem has been noted
Can Results Obtained with Commercially Available MicroScan Microdilution Panels Serve as an Indicator of β-Lactamase Production among Escherichia coli andKlebsiella Isolates with Hidden Resistance to ExpandedSpectrum Cephalosporins and Aztreonam?
Results suggest that microdilution panels can be used by clinical laboratories as an indicator of certain β-lactamases that may produce hidden but clinically significant resistance among isolates of E. coli, K. pneumoniae, and Klebsiella oxytoca.
Detection of extended-spectrum beta-lactamase (ESBL)-producing strains by the Etest ESBL screen
The Etest ESBL screen test with the ceftazidime substrate appears to be a useful method for detecting or validating the presence of enteric bacilli potentially producing this type of beta-lactamase.