Multiresistant Enterobacteriaceae: new threat of an old problem

Author: Pitout, Johann DD

Source: Expert Review of Anti-Infective Therapy, Volume 6, Number 5, October 2008 , pp. 657-669(13)

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Abstract:

The Enterobacteriaceae are among the most important causes of serious nosocomial and community-onset bacterial infections in humans, and resistance to antimicrobial agents in these species has become an increasingly relevant problem for healthcare providers. β-lactam and fluoroquinolone antibiotics are important drug classes used to treat infections caused by Enterobacteriaceae. Emerging resistance mechanisms against these agents have recently been described in Enterobacteriaceae and include the production of newer β-lactamases and plasmid-mediated quinolone resistance. The newer β-lactamases consist of the following: plasmid-mediated AmpC β-lactamases (e.g., ephamycin [CMY], CMY types), extended-spectrum β-lactamases (e.g., cefotaxime [CTX], CTX-M first isolated at Munich) and carbapenem-hydrolyzing enzymes (e.g., Klebsiella pneumoniae carbapenemase [KPC], KPC types and the metallo-β-lactamases). Recent developments in the epidemiology, clinical relevance and laboratory detection of infections caused by multiresistant Enterobacteriaceae with these new types of resistance mechanisms will be addressed in this review.

Keywords: carbapenem-hydrolyzing enzyme; extended-spectrum β-lactamase; multiresistant Enterobacteriaceae; newer β-lactamase; plasmid-mediated Amp C β-lactamase; plasmid-mediated quinolone resistance

Document Type: Research article

DOI: http://dx.doi.org/10.1586/14787210.6.5.657

Affiliations: 1: Departments of Pathology and Laboratory Medicine, Microbiology and Infectious Diseases, University of Calgary, Division of Microbiology, Calgary Laboratory Services, #9, 3535 Research Road NW, Calgary, Alberta, T2L 2K8, Canada., Email: johann.pit

Publication date: 2008-10-01

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Expert Review of Anti-infective Therapy provides expert reviews on therapeutics and diagnostics in the treatment of infectious disease. Coverage includes antibiotics, drug resistance, drug therapy, infectious disease medicine, antibacterial, antimicrobial, antifungal and antiviral approaches, and diagnostic tests.
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Multiresistant Enterobacteriaceae: new threat of an old problem

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