title: Prevalence and spread of extended-spectrum beta-lactamase-producing Enterobacteriaceae in Europe.
abstract: Extended-spectrum beta-lactamases (ESBLs) represent a major threat among resistant bacterial isolates. The first types described were derivatives of the TEM-1, TEM-2 and SHV-1 enzymes during the 1980s in Europe, mainly in Klebsiella pneumoniae associated with nosocomial outbreaks. Nowadays, they are mostly found among Escherichia coli isolates in community-acquired infections, with an increasing occurrence of CTX-M enzymes. The prevalence of ESBLs in Europe is higher than in the USA but lower than in Asia and South America. However, important differences among European countries have been observed. Spread of mobile genetic elements, mainly epidemic plasmids, and the dispersion of specific clones have been responsible for the increase in ESBL-producing isolates, such as those with TEM-4, TEM-24, TEM-52, SHV-12, CTX-M-9, CTX-M-14, CTX-M-3, CTX-M-15 and CTX-M-32 enzymes.
authors.affiliation: Servicio de Microbiología, Hospital Universitario Ramón y Cajal, Madrid, Spain. rcanton.hrc@salud.madrid.org
authors.forename: R
authors.initials: R
authors.lastname: Cantón
authors.forename: A
authors.initials: A
authors.lastname: Novais
authors.forename: A
authors.initials: A
authors.lastname: Valverde
authors.forename: E
authors.initials: E
authors.lastname: Machado
authors.forename: L
authors.initials: L
authors.lastname: Peixe
authors.forename: F
authors.initials: F
authors.lastname: Baquero
authors.forename: T M
authors.initials: TM
authors.lastname: Coque
mesh_terms: D002353:Carrier State / Q000453:epidemiology / Q000382:microbiology / Q000635:transmission; D017714:Community-Acquired Infections / Q000453:epidemiology / Q000382:microbiology / Q000635:transmission; D003428:Cross Infection / Q000453:epidemiology / Q000382:microbiology / Q000635:transmission; D004251:DNA Transposable Elements / Q000235:genetics; D024901:Drug Resistance, Multiple, Bacterial; D004755:Enterobacteriaceae / Q000145:classification / Q000187:drug effects* / Q000201:enzymology* / Q000235:genetics; D004756:Enterobacteriaceae Infections / Q000453:epidemiology* / Q000382:microbiology / Q000635:transmission*; D005060:Europe / Q000453:epidemiology; D006801:Humans; D010957:Plasmids / Q000235:genetics; D015995:Prevalence; D001618:beta-Lactamases / Q000096:biosynthesis / Q000145:classification* / Q000235:genetics*
chemical_list: D004251:DNA Transposable Elements; D001618:beta-Lactamases