Extended-Spectrum β-Lactamases: a Clinical Update
Tóm tắt
Extended-spectrum β-lactamases (ESBLs) are a rapidly evolving group of β-lactamases which share the ability to hydrolyze third-generation cephalosporins and aztreonam yet are inhibited by clavulanic acid. Typically, they derive from genes for TEM-1, TEM-2, or SHV-1 by mutations that alter the amino acid configuration around the active site of these β-lactamases. This extends the spectrum of β-lactam antibiotics susceptible to hydrolysis by these enzymes. An increasing number of ESBLs not of TEM or SHV lineage have recently been described. The presence of ESBLs carries tremendous clinical significance. The ESBLs are frequently plasmid encoded. Plasmids responsible for ESBL production frequently carry genes encoding resistance to other drug classes (for example, aminoglycosides). Therefore, antibiotic options in the treatment of ESBL-producing organisms are extremely limited. Carbapenems are the treatment of choice for serious infections due to ESBL-producing organisms, yet carbapenem-resistant isolates have recently been reported. ESBL-producing organisms may appear susceptible to some extended-spectrum cephalosporins. However, treatment with such antibiotics has been associated with high failure rates. There is substantial debate as to the optimal method to prevent this occurrence. It has been proposed that cephalosporin breakpoints for the
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Akindele, J. A., and I. O. Rotilu. 1997. Outbreak of neonatal Klebsiella septicaemia: a review of antimicrobial sensitivities. Afr. J. Med. Med. Sci.26:51-53.
Manual of clinical microbiology 1999
Archambaud, M., E. Labau, D. Clave, and C. Suc. 1989. Bactericidal effect of cefotaxime-sulbactam and imipenem combined with gentamicin and/or ciprofloxacin against CTX-1 producing Klebsiella pneumoniae. Pathol. Biol. (Paris)37:534-539.
Ben Redjeb, S., G. Fournier, C. Mabilat, A. Ben Hassen, and A. Philippon. 1990. Two novel transferable extended-spectrum beta-lactamases from Klebsiella pneumoniae in Tunisia. FEMS Microbiol. Lett.55:33-38.
Borer, A., J. Gilad, G. Menashe, N. Peled, K. Riesenberg, and F. Schlaeffer. 2002. Extended-spectrum beta-lactamase-producing Enterobacteriaceae strains in community-acquired bacteremia in southern Israel. Med. Sci. Monit.8:CR44-47.
Centers for Disease Control. 2000. Laboratory capacity to detect antimicrobial resistance, 1998. Morb. Mortal. Wkly. Rep.48:1167-1171.
Chanawong, A., F. H. M'Zali, J. Heritage, A. Lulitanond, and P. M. Hawkey. 2000. Characterisation of extended-spectrum beta-lactamases of the SHV family using a combination of PCR-single strand conformational polymorphism (PCR-SSCP) and PCR-restriction fragment length polymorphism (PCR-RFLP). FEMS Microbiol. Lett.184:85-89.
Cheng, Y., Y. Li, and M. Chen. 1994. A plasmid-mediated SHV type extended-spectrum beta-lactamase in Beijing isolate of Enterobacter gergoviae. Wei Sheng Wu Xue Bao34:106-112.
De Champs, C., D. Rouby, D. Guelon, J. Sirot, D. Sirot, D. Beytout, and J. M. Gourgand. 1991. A case-control study of an outbreak of infections caused by Klebsiella pneumoniae strains producing CTX-1 (TEM-3) beta-lactamase. J. Hosp. Infect.18:5-13.
Didier, M. E., and D. G. Maki. 1997. Epidemiology of infection caused by multiresistant ESBL-producing Klebsiella (abstract). Infect. Control Hosp. Epidemiol.18:35.
Green, M., and K. Barbadora. 1998. Recovery of ceftazidime-resistant Klebsiella pneumoniae from pediatric liver and intestinal transplant recipients. Pediatr. Transplant.2:224-230.
Huang, Z. M., P. H. Mao, Y. Chen, L. Wu, and J. Wu. 2004. Study on the molecular epidemiology of SHV type beta-lactamase-encoding genes of multiple-drug-resistant Acinetobacter baumannii. Zhonghua Liu Xing Bing Xue Za Zhi.25:425-427.
Jean, S. S., L. J. Teng, P. R. Hsueh, S. W. Ho, and K. T. Luh. 2002. Antimicrobial susceptibilities among clinical isolates of extended-spectrum cephalosporin-resistant Gram-negative bacteria in a Taiwanese University Hospital. J. Antimicrob. Chemother.49:69-76.
Karim, A., L. Poirel, S. Nagarajan, and P. Nordmann. 2001. Plasmid-mediated extended-spectrum beta-lactamase (CTX-M-3 like) from India and gene association with insertion sequence ISEcp1. FEMS Microbiol. Lett.201:237-241.
Legakis, N. J., L. S. Tzouvelekis, G. Hatzoudis, E. Tzelepi, A. Gourkou, T. L. Pitt, and A. C. Vatopoulos. 1995. Klebsiella pneumoniae infections in Greek hospitals. Dissemination of plasmids encoding an SHV-5 type beta-lactamase. J. Hosp. Infect.31:177-187.
Marty, L., and V. Jarlier. 1998. Surveillance of multiresistant bacteria: justification, role of the laboratory, indicators, and recent French data. Pathol. Biol. (Paris)46:217-226.
Medeiros, A. A. 1997. Evolution and dissemination of beta-lactamases accelerated by generations of beta-lactam antibiotics. Clin. Infect. Dis. 24 Suppl. 1:S19-45.
Mendes, C., A. Hsiung, C. Kiffer, C. Oplustil, S. Sinto, I. Mimica, and C. Zoccoli. 2000. Evaluation of the in vitro activity of 9 antimicrobials against bacterial strains isolated from patients in intensive care units in Brazil: MYSTIC Antimicrobial Surveillance Program. Braz. J. Infect. Dis.4:236-244.
Midolo, P. D., D. Matthews, C. D. Fernandez, and T. G. Kerr. 2002. Detection of extended spectrum beta-lactamases in the routine clinical microbiology laboratory. Pathology34:362-364.
Muder, R. R., C. Brennen, S. D. Drenning, J. E. Stout, and M. M. Wagener. 1997. Multiply antibiotic-resistant gram-negative bacilli in a long-term-care facility: a case-control study of patient risk factors and prior antibiotic use. Infect. Control Hosp. Epidemiol.18:809-813.
Mulgrave, L. 1990. Extended broad-spectrum beta-lactamases in Australia. Med. J. Aust.152:444-445.
Mulgrave, L., and P. V. Attwood. 1993. Characterization of an SHV-5 related extended broad-spectrum beta-lactamase in Enterobacteriaceae from Western Australia. Pathology25:71-75.
National Committee for Clinical Laboratory Standards. 2005. Performance standards for antimicrobial susceptibility testing; 15th informational supplement (M100-S15). National Committee for Clinical Laboratory Standards Wayne Pa.
Petit, A., H. Ben Yaghlane-Bouslama, L. Sofer, and R. Labia. 1992. Does high level production of SHV-type penicillinase confer resistance to ceftazidime in Enterobacteriaceae? FEMS Microbiol. Lett.71:89-94.
Rogues, A. M., G. Boulard, A. Allery, C. Arpin, C. Quesnel, C. Quentin, C. Bebear, J. C. Labadie, and J. P. Gachie. 2000. Thermometers as a vehicle for transmission of extended-spectrum-beta-lactamase producing Klebisiella pneumoniae. J. Hosp. Infect.45:76-77.
Sader, H. S., A. C. Gales, T. D. Granacher, M. A. Pfaller, and R. N. Jones. 2000. Prevalence of antimicrobial resistance among respiratory tract isolates in Latin America: results from SENTRY antimicrobial surveillance program (1997-98). Braz. J. Infect. Dis.4:245-254.
Sanders, C. C. 1996. In vitro activity of fourth generation cephalosporins against enterobacteriaceae producing extended-spectrum beta-lactamases. J. Chemother.8(Suppl. 2):57-62.
Schooneveldt, J. M., G. R. Nimmo, and P. Giffard. 1998. Detection and characterisation of extended spectrum beta-lactamases in Klebsiella pneumoniae causing nosocomial infection. Pathology30:164-168.
Sekowska, A., G. Janicka, C. Klyszejko, M. Wojda, M. Wroblewski, and M. Szymankiewicz. 2002. Resistance of Klebsiella pneumoniae strains producing and not producing ESBL (extended-spectrum beta-lactamase) type enzymes to selected non-beta-lactam antibiotics. Med. Sci. Monit.8:BR100-104.
Shipton, S. E., M. F. Cotton, G. Wessels, and E. Wasserman. 2001. Nosocomial endocarditis due to extended-spectrum beta-lactamase-producing Klebsiella pneumoniae in a child. S. Afr. Med. J.91:321-322.
Soulier, A., F. Barbut, J. M. Ollivier, J. C. Petit, and A. Lienhart. 1995. Decreased transmission of Enterobacteriaceae with extended-spectrum beta-lactamases in an intensive care unit by nursing reorganization. J. Hosp. Infect.31:89-97.
Sykes, R. B., and K. Bush. 1982. Physiology, biochemistry and inactivation of beta-lactamases, p. 155-207. In R. B. Morin and M. Gorman (ed.), The chemistry and biology of beta-lactam antibiotics, vol. 3. Academic Press, London, England.
Szabo, D., I. Barcs, and F. Rozgonyi. 1997. Extended-spectrum beta-lactamases: an actual problem of hospital microbiology (review). Acta Microbiol. Immunol. Hung.44:309-325.
Vahaboglu, H., S. Saribas, H. Akbal, R. Ozturk, and A. Yucel. 1998. Activities of cefepime and five other antibiotics against nosocomial PER-1-type and/or OXA-10-type beta-lactamase-producing Pseudomonas aeruginosa and Acinetobacter spp. J. Antimicrob. Chemother.42:269-270.
Weldhagen, G. F., and A. Prinsloo. 2004. Molecular detection of GES-2 extended spectrum beta-lactamase producing Pseudomonas aeruginosa in Pretoria, South Africa. Int. J. Antimicrob. Agents24:35-38.
Yu, Y., W. Zhou, Y. Chen, Y. Ding, and Y. Ma. 2002. Epidemiological and antibiotic resistant study on extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella pneumoniae in Zhejiang Province. Chin Med. J. (Engl.)115:1479-1482.