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Title: A Change in the Epidemiology of Infections Due to Extended-Spectrum b-Lactamase–Producing Organisms
Authors: Rodriguez-Baño, Jesus
Paterson, David L.
metadata.dc.contributor.authoraffiliation: [Rodriguez-Baño,J] Sección de Enfermedades Infecciosas, Hospital Universitario Virgen Macarena, Seville, Spain. [Paterson ,DL]Division of Infectious Diseases, University of Pittsburgh Medical
Keywords: epidemiology;beta-lactamase;epidemiologia;beta-lactamases
metadata.dc.subject.mesh: Medical Subject Headings::Diseases::Bacterial Infections and Mycoses::Bacterial Infections::Bacteremia
Medical Subject Headings::Diseases::Bacterial Infections and Mycoses::Infection::Cross Infection
Medical Subject Headings::Organisms::Bacteria::Gram-Negative Bacteria::Gram-Negative Facultatively Anaerobic Rods::Enterobacteriaceae
Medical Subject Headings::Diseases::Bacterial Infections and Mycoses::Bacterial Infections::Gram-Negative Bacterial Infections::Enterobacteriaceae Infections
Medical Subject Headings::Anatomy::Fluids and Secretions::Feces
Medical Subject Headings::Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans
Medical Subject Headings::Chemicals and Drugs::Enzymes and Coenzymes::Enzymes::Hydrolases::Amidohydrolases::beta-Lactamases
Issue Date: 1-Apr-2006
Publisher: University of Chicago Press
Citation: Rodriguez-Baño J, Paterson DL. A Change in the Epidemiology of Infections Due to Extended-Spectrum b-Lactamase–Producing Organisms. Clin Infect Dis. (2006) 42 (7): 935-937
Abstract: Extended-spectrum β-lactamases (ESBLs) form a heterogeneous group that share the property of hydrolytic activity against the oxyimino-β-lactams while remaining susceptible to inhibition by β-lactamase inhibitors, such as clavulanic acid. From a clinical point of view, they are important because they confer resistance to penicillins, aztreonam, and cephalosporins, and ESBL-producing organisms are typically also resistant to aminoglycosides, trimethoprim-sulfamethoxazole, and quinolones [1]. Until recently, the main problem posed by ESBLs was related to nosocomial outbreaks caused by ESBL-producing Klebsiella species. These outbreaks are usually clonal, the strains are mainly spread through cross-transmission, and the risk factors are similar to those found for other multidrug-resistant nosocomial pathogens [2]. In Europe and the United States, most ESBL-producing Klebsiella isolates harbored enzymes belonging to the TEM and SHV families [3]. Detection of colonized patients by performing surveillance cultures within affected units, isolation precautions for colonized patients, and restriction of oxyimino-β-lactam use are frequently useful for the control of these outbreaks [1]. There is no evidence that hospital-acquired ESBL-producing klebsiellae are decreasing in importance—in fact, data from the Centers for Disease Control and Prevention show that 20.6% of Klebsiella pneumoniae isolates from United States intensive care units in 2003 were probable producers of ESBL [4]. This represented a 47% increase, compared with the preceding 5 years. However, during the last few years, an impressive increase in the number of ESBL-producing Escherichia coli (and, less frequently, other Enterobacteriaceae) is being described in several parts of the world [5–8]. This emergent phenomenon shows some differences from the problem posed by Klebsiella species; many of these ESBL-producing E. coli are isolated …
metadata.dc.identifier.doi: 10.1086/500945
ISSN: 1058-4838
Appears in Collections:01- Artículos - Hospital Virgen Macarena

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