Extended-spectrum beta-lactamases

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Extended-spectrum beta-lactamases, most commonly found in Klebsiella pneumoniae and Escherichia coli, have increased markedly in the past decade, particularly in the intensive care unit setting. The problem has been significant in the United States but is even more prevalent in parts of Latin America and Asia. These plasmid-mediated beta-lactamases confer resistance to broad-spectrum beta-lactam antibiotics, including third- and fourth-generation cephalosporins, aztreonam, and extended-spectrum penicillins. Other resistances, such as aminoglycoside resistance and trimethoprim/sulfamethoxazole resistance, are often cotransferred on the same plasmid. Fluoroquinolone resistance is often associated, resulting in an organism that is resistant to most of the usual antimicrobial options. Although carbapenems are currently considered the drugs of choice for these pathogens, widespread use of these agents may lead to other resistance problems. Due to limited therapeutic options, prevention and control measures are important. Traditional infection control measures, such as contact precautions, are recommended to prevent spread in intensive care units. In addition, because this type of antimicrobial resistance appears to be particularly influenced by antibiotic utilization, antibiotic control measures may also be a very important intervention in limiting the spread of extended-spectrum beta-lactamases.

Original languageEnglish (US)
Pages (from-to)79-87
Number of pages9
JournalSeminars in Respiratory and Critical Care Medicine
Volume24
Issue number1
StatePublished - Feb 2003

Fingerprint

beta-Lactamases
Anti-Bacterial Agents
Intensive Care Units
Plasmids
Trimethoprim Resistance
Aztreonam
Carbapenems
Latin America
Fluoroquinolones
Sulfamethoxazole Drug Combination Trimethoprim
Klebsiella pneumoniae
beta-Lactams
Aminoglycosides
Cephalosporins
Infection Control
Penicillins
Escherichia coli
Pharmaceutical Preparations
Therapeutics

Keywords

  • Extended-spectrum beta-lactamases
  • Gram-negative resistance
  • Klebsiella pneumoniae

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine
  • Critical Care

Cite this

Extended-spectrum beta-lactamases. / Patterson, Jan E.

In: Seminars in Respiratory and Critical Care Medicine, Vol. 24, No. 1, 02.2003, p. 79-87.

Research output: Contribution to journalArticle

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