Addressing the challenge of extended-spectrum beta-lactamases.
During the last decade, community-acquired extended-spectrum beta-lactamase (ESBL)-producing bacteria, and in particular Escherichia coli producing ESBLs of the CTX-M-type, have spread worldwide. These organisms are most often isolated from the urinary tract, but have also been isolated from bacteria in the blood. Cephalosporin- and fluoroquinolone-containing treatments are the two most common risk factors identified in patients with ESBL producers. In addition, associated resistance to other classes of antimicrobial agents are often observed in CTX-M producers, limiting the availability of therapeutic options. Carbapenems should be considered as the drug of choice for treating serious systemic infections caused by ESBL-producing bacteria, but preventing the spread of and appropriately managing these infections remains difficult.
Zahar
Jean-Ralph
JR
Université René Descartes, Hygiène Hospitalière, Centre d'Infectiologie Necker-Pasteur, CHU Necker Enfants-Malades, Paris, France.
Lortholary
Olivier
O
Martin
Claude
C
Potel
Gilles
G
Plesiat
Patrick
P
Nordmann
Patrice
P
D000900:Anti-Bacterial Agents / Q000494:pharmacology; D015780:Carbapenems / Q000494:pharmacology / Q000627:therapeutic use; D002511:Cephalosporins / Q000494:pharmacology / Q000627:therapeutic use; D017714:Community-Acquired Infections / Q000453:epidemiology / Q000382:microbiology; D024901:Drug Resistance, Multiple, Bacterial; D004926:Escherichia coli / Q000302:isolation & purification; D004927:Escherichia coli Infections / Q000382:microbiology; D024841:Fluoroquinolones / Q000494:pharmacology / Q000627:therapeutic use; D006801:Humans; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D016896:Treatment Outcome; D014552:Urinary Tract Infections / Q000453:epidemiology / Q000382:microbiology; D018440:beta-Lactam Resistance; D001618:beta-Lactamases / Q000145:classification / Q000235:genetics / Q000378:metabolism; D047090:beta-Lactams / Q000494:pharmacology*
D000900:Anti-Bacterial Agents; D015780:Carbapenems; D002511:Cephalosporins; D024841:Fluoroquinolones; D047090:beta-Lactams; D001618:beta-Lactamases