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- Title
CTX-M: changing the face of ESBLs in Europe.
- Authors
David M. Livermore; Rafael Canton; Marek Gniadkowski; Patrice Nordmann; Gian Maria Rossolini; Guillaume Arlet; Juan Ayala; Teresa M. Coque; Izabela Kern-Zdanowicz; Francesco Luzzaro; Laurent Poirel; Neil Woodford
- Abstract
Since around 2000—earlier in Poland and Spain and later in France and the UK—dramatic shifts have occurred in the prevalence and types of extended-spectrum β-lactamases (ESBLs) in Europe. Before this watershed, most producers were nosocomial isolates, often <it>Klebsiella</it> spp. or <it>Enterobacter</it> spp. from specialist care units, and had mutant TEM or SHV ESBLs. Subsequently, CTX-M ESBLs have become dominant, with much greater penetration into <it>Escherichia coli</it>, and with many infections in ‘complicated community’ patients, usually with underlying disease, recent antibiotic usage, or healthcare contact. The degree of clonality among producers varies with the country, as does the enzyme type produced, with group 9 (CTX-M-9 and -14) enzymes dominant in Spain and group 1 enzymes (particularly CTX-M-3 and -15) dominant elsewhere. Irrespective of the particular enzyme, most producers are multiresistant. These changing patterns present major therapeutic and infection control challenges, with the public health intervention points unclear.
- Subjects
ENZYMES; CATALYSTS; ESCHERICHIA; PROTEINS
- Publication
Journal of Antimicrobial Chemotherapy (JAC), 2007, Vol 59, Issue 2, p165
- ISSN
0305-7453
- Publication type
Article