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Extended-Spectrum β-Lactamases (ESBLs): Characterization, Epidemiology and Detection 

Authors: A. A. Shah a;  F. Hasan a;  S. Ahmed a; A. Hameed a
Affiliation:   a Microbiology Research Laboratory, Department of Biological Sciences, Quaid-i-Azam University, Islamabad, Pakistan
DOI: 10.1080/10408410490266429
Publication Frequency: 4 issues per year
Published in: journal Critical Reviews in Microbiology, Volume 30, Issue 1 January 2004 , pages 25 - 32
Subject: Microbiology;
Number of References: 45
Formats available: HTML (English) : PDF (English)
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Abstract

β-lactamases of Enterobacteriaceae are the most important mechanism of resistance against β-lactam drugs. Two types of β-lactamases can confer resistance against 3rd generation cephalosporins. Chromosomally mediated β-lactamases are inducible and are not inhibited by clavulanic acid. Resistance due to these enzymes is non-transferable. The 2nd type of enzyme is plasmid-mediated β-lactamases, which are inhibited by clavulanic acid. These enzymes are more important clinically as these can be transferred between various species of Enterobacteria ceae. These enzymes are called extended-spectrum β-lactamases (ESBLs). ESBL-producing Enterobacteriaceae have been responsible for numerous outbreaks of infection throughout the world and pose challenging infection control issues. Antibacterial choice is often complicated by multi-resistance. ESBLs can confer resistance against all β-lactam drugs except carbapenems and cephamycins. Nursing home patients may be an important reservoir of ESBL-containing multiple antibiotic-resistant organisms. Use of broad-spectrum oral antibiotics and probably poor infection control practices may facilitate spread of this plasmid-mediated resistance. In addition to known populations at risk, ambulatory patients with chronic conditions represent another patient population that may harbor ESBL-producing organisms. Various methods can be used for detection of ESBLs in the laboratory. These tests include double disc diffusion test, Vitek ESBL test, E Tests, MIC Determination, genetic method, and isoelectric focusing (IEF).
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