OBJECTIVES: To investigate the molecular epidemiology of Enterobacteriaceae producing extended-spectrum beta-lactamases (ESBLs) in London and South-East England. METHODS: A prospective study involving 16 hospital microbiology laboratories in London and South-East England was undertaken over a 12 week period. Each laboratory submitted up to 100 consecutive cephalosporin-resistant Enterobacteriaceae isolates judged clinically significant by microbiology staff. Centralized testing was undertaken to confirm organism identification and cephalosporin resistance and to analyse resistance mechanisms. RESULTS: The predominant mechanism of cephalosporin resistance in isolates from both hospital and community settings was the production of CTX-M-type ESBLs, with CTX-M-producing Escherichia coli as the most numerous resistant organism overall. Other major mechanisms of cephalosporin resistance included production of non-CTX-M ESBLs and AmpC beta-lactamases. Most ESBL (both CTX-M and non-CTX-M) producers were multiply resistant to non-beta-lactam antibiotics, including trimethoprim, ciprofloxacin and gentamicin. CONCLUSIONS: CTX-M enzymes, which were unrecorded in the UK prior to 2000, have become the major mechanism of cephalosporin resistance in Enterobacteriaceae in South-East England. E. coli has overtaken Klebsiella and Enterobacter spp. to become the major host for ESBLs. Due to the multiple antibiotic resistance exhibited by many ESBL-producers, these changes have major implications for antimicrobial therapy.
OBJECTIVES: To investigate the molecular epidemiology of Enterobacteriaceae producing extended-spectrum beta-lactamases (ESBLs) in London and South-East England. METHODS: A prospective study involving 16 hospital microbiology laboratories in London and South-East England was undertaken over a 12 week period. Each laboratory submitted up to 100 consecutive cephalosporin-resistant Enterobacteriaceae isolates judged clinically significant by microbiology staff. Centralized testing was undertaken to confirm organism identification and cephalosporin resistance and to analyse resistance mechanisms. RESULTS: The predominant mechanism of cephalosporin resistance in isolates from both hospital and community settings was the production of CTX-M-type ESBLs, with CTX-M-producing Escherichia coli as the most numerous resistant organism overall. Other major mechanisms of cephalosporin resistance included production of non-CTX-M ESBLs and AmpC beta-lactamases. Most ESBL (both CTX-M and non-CTX-M) producers were multiply resistant to non-beta-lactam antibiotics, including trimethoprim, ciprofloxacin and gentamicin. CONCLUSIONS: CTX-M enzymes, which were unrecorded in the UK prior to 2000, have become the major mechanism of cephalosporin resistance in Enterobacteriaceae in South-East England. E. coli has overtaken Klebsiella and Enterobacter spp. to become the major host for ESBLs. Due to the multiple antibiotic resistance exhibited by many ESBL-producers, these changes have major implications for antimicrobial therapy.
Authors: Patricia J Baudry; Kim Nichol; Melanie DeCorby; Laura Mataseje; Michael R Mulvey; Daryl J Hoban; George G Zhanel Journal: Antimicrob Agents Chemother Date: 2008-02-25 Impact factor: 5.191
Authors: Xuan Qin; Danielle M Zerr; Scott J Weissman; Janet A Englund; Donna M Denno; Eileen J Klein; Phillip I Tarr; Justin Kwong; Jennifer R Stapp; Luis G Tulloch; Emmanouil Galanakis Journal: Antimicrob Agents Chemother Date: 2008-09-02 Impact factor: 5.191
Authors: Wil H F Goessens; Johan W Mouton; Marian T Ten Kate; Fritz Sörgel; Martina Kinzig; Irma A J M Bakker-Woudenberg Journal: Antimicrob Agents Chemother Date: 2012-11-05 Impact factor: 5.191
Authors: Chris M Pillar; Mohana K Torres; Nina P Brown; Dineshchandra Shah; Daniel F Sahm Journal: Antimicrob Agents Chemother Date: 2008-09-08 Impact factor: 5.191