CTX-M: changing the face of ESBLs in the UK

Livermore, D. M. ORCID: https://orcid.org/0000-0002-9856-3703 and Hawkey, P. M. (2005) CTX-M: changing the face of ESBLs in the UK. Journal of Antimicrobial Chemotherapy, 56 (3). pp. 451-454. ISSN 0305-7453

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Abstract

The UK has experienced a sudden rise in extended-spectrum ß-lactamase (ESBL) rates, largely due to the appearance and spread of Escherichia coli producing CTX-M-15 type ß-lactamase. The British Society for Antimicrobial Chemotherapy organized two update meetings during 2004 to report and discuss the recognition, clinical diagnosis, treatment and control of bacteria producing these ß-lactamases. This paper reports the data and reviews made by contributors to the conferences. The historical distribution and emergence of ESBLs was reviewed along with the emergence of plasmid-mediated CTX-M ESBLs following their mobilization from the chromosome of Kluyvera spp. The first significant outbreak of CTX-M producers in the UK occurred in 2001 and involved Klebsiella pneumoniae with CTX-M-26 at one site, but by 2003, cloned and diverse E. coli with CTX-M-15 were widespread, with Shropshire one of the most affected regions. The specific experience in Shropshire was reported on and a comprehensive review made of the level of awareness of the need for ESBL detection in laboratories in England and Wales, together with a description of the variety of methods that may be applied, with recommendations for optimal methodology. The increased mortality associated with inappropriate treatment of infections caused by ESBL-producing strains was highlighted, together with discussion on potential control of cross-infection. The meeting concluded that the CTX-M genes have now become widespread in not only E. coli but other Enterobacteriaceae in the UK and this will represent a substantial threat to both the treatment of infections caused by these bacteria in the community and within hospitals.

Item Type:	Article
Faculty \ School:	Faculty of Medicine and Health Sciences > Norwich Medical School
Depositing User:	Rhiannon Harvey
Date Deposited:	11 Jul 2011 11:30
Last Modified:	16 Feb 2023 16:30
URI:	https://ueaeprints.uea.ac.uk/id/eprint/33496
DOI:	10.1093/jac/dki239

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