The Clinical Outcome of Infections Due to Extended Spectrum β-Lactamase Producing (ESBL) Enterobacteriaceae

摘要

beta-lactamase production remains the most important mechanism of antibiotic resistance in Gram negative pathogens. This is exemplified by the extended-spectrum beta-lactamases (ESBLs), which have ability to hydrolyze most beta-lactams such as 3rd and 4th -generation cephalosporins, monobactams and more recently the carbapenems. Carbapenemases produced by enterobacteriaceae can be metallo-beta-lactamases, oxacillinases, or clavulanic-acid-inhibited β-lactamases-Ambler class A. Three major families of last group include the imipenem-hydrolyzing enzymes (IMI), Serratia marcescens enzymes (SME) and the most frequent K. pneumoniae carbapenemase (KPC) enzymes first identified in 1996 in North Carolina, USA (1). These enzymes are increasingly prevalent worldwide (2, 3) and, as a consequence, we decided to determine the extent of the problem locally and to correlate this with clinical outcome.