[Characteristics and clinical value of extended-spectrum beta-lactamases].
The literature data and the findings of the authors' studies on the role of extended-spectrum bata-lactamases (ESBL) in providing the clinical effect in the treatment of infections due to ESBL-producing organisms were analyzed. The analysis allowed to consider the NCCLS recommendations not sufficiently valid. According to these recommendations the ESBL-producing organisms (among E. coli and Klebsiella spp.) should be regarded as resistant to penicillins, cephalosporins and aztreonam. Susceptibility of 62 Enterobacteriaceae strains that were isolated in 4 therapeutic centres of Tomsk, Nazran and Moscow and proved to be ESBL-producing organisms was tested and it was shown that the 3rd and 4th generation cephalosporins could not be referred to a homogenous group. The same was confirmed by the prospective and retrospective investigations of a multiprofile hospital on the clinical and bacteriological efficacies of the 3rd generation cephalosporins and cefepime in the treatment of hospital-acquired infections due to Enterobacteriaceae strains producing ESBL.
Berezin
A G
AG
National Research Centre of Antibiotics, Municipal Clinical Hospital No. 7, Moscow.
Romashov
O M
OM
Iakovlev
S V
SV
Sidorenko
S V
SV
D000293:Adolescent; D000328:Adult; D000368:Aged; D000818:Animals; D000900:Anti-Bacterial Agents / Q000378:metabolism / Q000627:therapeutic use*; D001398:Aztreonam / Q000378:metabolism / Q000627:therapeutic use; D002511:Cephalosporins / Q000378:metabolism / Q000627:therapeutic use; D003151:Community Health Centers; D004755:Enterobacteriaceae / Q000187:drug effects / Q000201:enzymology* / Q000472:pathogenicity; D004756:Enterobacteriaceae Infections / Q000188:drug therapy*; D004926:Escherichia coli / Q000187:drug effects / Q000201:enzymology; D006801:Humans; D007709:Klebsiella / Q000187:drug effects / Q000201:enzymology; D008875:Middle Aged; D010406:Penicillins / Q000378:metabolism / Q000627:therapeutic use; D012426:Russia; D018440:beta-Lactam Resistance; D001618:beta-Lactamases / Q000378:metabolism*
D000900:Anti-Bacterial Agents; D002511:Cephalosporins; D010406:Penicillins; D001618:beta-Lactamases; D001398:Aztreonam