[Broad-spectrum beta-lactamases in Gram-negative bacteria].
BACKGROUND
beta-lactams are our most valuable and frequently used antibiotics. Resistance towards them, in both Gram-positive and Gram-negative bacteria, challenges their antimicrobial effect. beta-lactamases are the most important resistance mechanism against beta-lactams in Gram-negative bacteria.


METHODS
This review is based on literature retrieved through a non-systematic search of Pubmed (with the terms "ESBL", "AmpC", and "carbapenemases"), as well as the authors' own research experience.


CONCLUSIONS
We now observe a global dissemination of particularly broad spectrum beta-lactamases; extended-spectrum beta-lactamases (ESBLs), plasmid-mediated AmpC, and carbapenemases. These beta-lactamases are hosted by multidrug-resistant clones of Enterobacteriaceae, Pseudomonas aeruginosa with few, if any, therapeutic alternatives. We have observed that this pandemic has reached Norway with an increase in ESBL-producing Escherichia coli in particular, but also pan-resistant carbapenemase-producing K. pneumoniae, P. aeruginosa OG A. baumannii during the last years. The latter ones have been associated with import after hospitalization abroad, but this situation may change due to the epidemic potential of these resistant clones. Rapid diagnostic service and targeted infection control measures are important to prevent them from spreading.
Sundsfjord
Arnfinn
A
Avdeling for mikrobiologi og virologi Institutt for medisinsk biologi Det medisinske fakultet Universitetet i Tromsø 9037 Tromsø. arnfinn.sundsfjord@fagmed.uit.no
Simonsen
Gunnar Skov
GS
Haldorsen
Bjørg
B
Lundblad
Eirik Wasmuth
EW
Samuelsen
Orjan
O
D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001426:Bacterial Proteins / Q000096:biosynthesis / Q000378:metabolism; D015780:Carbapenems / Q000627:therapeutic use; D002511:Cephalosporins / Q000627:therapeutic use; D024901:Drug Resistance, Multiple, Bacterial; D006090:Gram-Negative Bacteria / Q000201:enzymology*; D016905:Gram-Negative Bacterial Infections / Q000188:drug therapy*; D006801:Humans; D008826:Microbial Sensitivity Tests; D008997:Monobactams / Q000627:therapeutic use; D010406:Penicillins / Q000627:therapeutic use; D010957:Plasmids; D018440:beta-Lactam Resistance / Q000187:drug effects; D001618:beta-Lactamases / Q000096:biosynthesis / Q000378:metabolism*; D047090:beta-Lactams / Q000627:therapeutic use*
D000900:Anti-Bacterial Agents; D001426:Bacterial Proteins; D015780:Carbapenems; D002511:Cephalosporins; D008997:Monobactams; D010406:Penicillins; D047090:beta-Lactams; C048795:AmpC beta-lactamases; D001618:beta-Lactamases