CTX-M:changing the face of ESBLs in Europe

Livermore, David M, Canton, Rafael, Gniadkowski, Marek, Nordmann, Patrice, Rossolini, Gian Maria, Arlet, Guillaume, Ayala, Juan, Coque, Teresa M, Kern-Zdanowicz, Izabela, Luzzaro, Francesco, Poirel, Laurent and Woodford, Neil (2007) CTX-M:changing the face of ESBLs in Europe. Journal of Antimicrobial Chemotherapy, 59 (2). pp. 165-174. ISSN 0305-7453

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Abstract

Since around 2000 - earlier in Poland and Spain and later in France and the UK - dramatic shifts have occurred in the prevalence and types of extended-spectrum beta-lactamases (ESBLs) in Europe. Before this watershed, most producers were nosocomial isolates, often Klebsiella spp. or Enterobacter spp. from specialist care units, and had mutant TEM or SHV ESBLs. Subsequently, CTX-M ESBLs have become dominant, with much greater penetration into Escherichia coli, and with many infections in 'complicated community' patients, usually with underlying disease, recent antibiotic usage, or healthcare contact. The degree of clonality among producers varies with the country, as does the enzyme type produced, with group 9 (CTX-M-9 and -14) enzymes dominant in Spain and group 1 enzymes (particularly CTX-M-3 and -15) dominant elsewhere. Irrespective of the particular enzyme, most producers are multiresistant. These changing patterns present major therapeutic and infection control challenges, with the public health intervention points unclear.

Item Type: Article
Uncontrolled Keywords: community-acquired infections,enterobacter,enterobacteriaceae infections,escherichia coli,escherichia coli infections,europe,humans,klebsiella,klebsiella infections,mutation,beta-lactamases
Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School
Related URLs:
Depositing User: Rhiannon Harvey
Date Deposited: 07 Jul 2011 11:30
Last Modified: 21 Apr 2020 19:37
URI: https://ueaeprints.uea.ac.uk/id/eprint/33454
DOI: 10.1093/jac/dkl483

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