title: Characterization of ESBL disseminating plasmids.
abstract: Bacteria producing extended-spectrum β-lactamases (ESBLs) constitute a globally increasing problem that contributes to treatment complications and elevated death rates. The extremely successful dissemination by ESBL-producing Enterobacteriaceae during the latest decades is a result of the combination of mobilization, evolution and horizontal spread of β-lactamase genes on plasmids. In parallel, spread of these plasmids to particularly well-adapted bacterial clones (outbreak clones) has expanded. In this review we describe ESBL-producing bacteria and the genetic mechanisms for dissemination of ESBL resistance. We describe available methodology for studying plasmids and the importance of including plasmids in epidemiological typing as natural parts of the organisms. Plasmids play a fundamental role in how resistance arises and disseminates.
authors.affiliation: a From the Department of Laboratory Medicine (LABMED), Division of Clinical Microbiology , Karolinska University Hospital , Stockholm , Sweden.
authors.forename: Alma
authors.initials: A
authors.lastname: Brolund
authors.affiliation: b Department of Medical Biochemistry and Microbiology , Uppsala University , Uppsala , Sweden.
authors.forename: Linus
authors.initials: L
authors.lastname: Sandegren
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology; D003227:Conjugation, Genetic; D004755:Enterobacteriaceae / Q000187:drug effects / Q000201:enzymology* / Q000235:genetics*; D004756:Enterobacteriaceae Infections / Q000453:epidemiology / Q000382:microbiology*; D022761:Gene Transfer, Horizontal; D008826:Microbial Sensitivity Tests; D017720:Molecular Epidemiology; D010957:Plasmids; D018440:beta-Lactam Resistance / Q000235:genetics*; D001618:beta-Lactamases / Q000096:biosynthesis / Q000235:genetics*; D047090:beta-Lactams / Q000494:pharmacology
chemical_list: D000900:Anti-Bacterial Agents; D047090:beta-Lactams; D001618:beta-Lactamases
keywords: Enterobacteriaceae; epidemiological typing; extended-spectrum β-lactamase; plasmid typing; resistance