Journal Article

Emergence of Enterobacteriaceae producing extended-spectrum β-lactamases (ESBLs) in the community

Johann D. D. Pitout, Patrice Nordmann, Kevin B. Laupland and Laurent Poirel

in Journal of Antimicrobial Chemotherapy

Published on behalf of British Society for Antimicrobial Chemotherapy

Volume 56, issue 1, pages 52-59
Published in print July 2005 | ISSN: 0305-7453
Published online May 2005 | e-ISSN: 1460-2091 | DOI:
Emergence of Enterobacteriaceae producing extended-spectrum β-lactamases (ESBLs) in the community

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Enterobacteriaceae, especially Klebsiella spp. producing extended-spectrum β-lactamases (ESBLs) such as SHV and TEM types, have been established since the 1980s as a major cause of hospital-acquired infections. Appropriate infection control practices have largely prevented the dissemination of these bacteria within many hospitals, although outbreaks have been reported. However, during the late 1990s and 2000s, Enterobacteriaceae (mostly Escherichia coli) producing novel ESBLs, the CTX-M enzymes, have been identified predominantly from the community as a cause of urinary tract infections. Resistance to other classes of antibiotics, especially the fluoroquinolones, is often associated with ESBL-producing organisms. Many clinical laboratories are still not aware of the importance of screening for ESBL-producing Enterobacteriaceae originating from the community. A heightened awareness of these organisms by clinicians and enhanced testing by laboratories, including molecular surveillance studies, is required to reduce treatment failures, to limit their introduction into hospitals and to prevent the spread of these emerging pathogens within the community.

Keywords: antibiotic-resistant organisms; ESBL-producing Enterobacteriaceae; community-onset infection

Journal Article.  5828 words.  Illustrated.

Subjects: Medical Oncology ; Critical Care

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