Clinical management of infections caused by enterobacteriaceae that express extended-spectrum β-Lactamase and AmpC enzymes

Harris, Patrick N. A. (2015) Clinical management of infections caused by enterobacteriaceae that express extended-spectrum β-Lactamase and AmpC enzymes. Seminars in Respiratory and Critical Care Medicine, 36 1: 56-73. doi:10.1055/s-0034-1398387


Author Harris, Patrick N. A.
Title Clinical management of infections caused by enterobacteriaceae that express extended-spectrum β-Lactamase and AmpC enzymes
Journal name Seminars in Respiratory and Critical Care Medicine   Check publisher's open access policy
ISSN 1098-9048
1069-3424
Publication date 2015
Sub-type Article (original research)
DOI 10.1055/s-0034-1398387
Open Access Status Not yet assessed
Volume 36
Issue 1
Start page 56
End page 73
Total pages 18
Place of publication New York, NY United States
Publisher Thieme Medical Publishers, Inc.
Language eng
Formatted abstract
The production of β-lactamase is the principal mechanism by which gram-negative bacteria resist the action of β-lactam antibiotics. In recent decades, there has been an alarming explosion in the diversity, global dissemination, host range, and spectrum of activity of β-lactamases. This has been most clearly reflected by the marked increase in infections caused by bacteria that express extended-spectrum β-lactamases (ESBLs). Some bacterial species possess chromosomally encoded broad-spectrum cephalosporinases (AmpC) that may be expressed at high level by mutational loss of regulatory genes and are intrinsic in some common Enterobacteriaceae, such as Enterobacter spp. Recently, high-level AmpC production has also been seen in new species such as Escherichia coli via plasmid acquisition. ESBL and AmpC producers present challenges to susceptibility testing and the selection of appropriate antimicrobial therapy. This review describes the current global epidemiology of ESBL producers, examines reported risk factors for infections caused by gram-negative bacteria that express ESBL or AmpC enzymes, and discusses the options for antimicrobial therapy, including “re-discovered” older antibiotics and novel agents in development.
Keyword Enterobacteriaceae
Extended-spectrum β-lactamase
AmpC
Therapy
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: UQ Centre for Clinical Research Publications
 
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