Extended-spectrum beta-lactamases: implications for the clinical microbiology laboratory, therapy, and infection control.
Extended-spectrum beta-lactamase (ESBL) producing gram-negative bacilli are a growing concern in human medicine today. When producing these enzymes, organisms (mostly K. pneumoniae and E. coli) become highly efficient at inactivating the newer third-generation cephaloporins (such as cefotaxime, ceftazidime, and ceftriaxone). In addition, ESBL-producing bacteria are frequently resistant to many classes of non-beta-lactam antibiotics, resulting in difficult-to-treat infections. This review gives an introduction into the topic and is focused on various aspects of ESBLs; it covers the current epidemiology, the problems of ESBL detection and the clinical relevance of infections caused by ESBL-producing organisms. Therapeutic options and potential strategies for dealing with this growing problem are also discussed in this article.
Stürenburg
Enno
E
Institut für Infektionsmedizin, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany. e.stuerenburg@uke.uni-hamburg.de
Mack
Dietrich
D
D006090:Gram-Negative Bacteria / Q000187:drug effects* / Q000201:enzymology*; D016905:Gram-Negative Bacterial Infections / Q000188:drug therapy*; D006801:Humans; D017053:Infection Control; D008826:Microbial Sensitivity Tests; D012307:Risk Factors; D018440:beta-Lactam Resistance / Q000502:physiology; D001618:beta-Lactamases / Q000502:physiology*; D047090:beta-Lactams / Q000494:pharmacology*
D047090:beta-Lactams; D001618:beta-Lactamases