Extended-Spectrum {beta}-Lactamases in the 21st Century: Characterization, Epidemiology, and Detection of This Important Resistance Threat

doi:10.1128/CMR.14.4.933-951.2001

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Clinical Microbiology Reviews, October 2001, p. 933-951, Vol. 14, No. 4
0893-8512/01/$04.00+0 DOI: 10.1128/CMR.14.4.933-951.2001
Copyright © 2001, American Society for Microbiology. All rights reserved.

Extended-Spectrum $beta$ -Lactamases in the 21st Century: Characterization, Epidemiology, and Detection of This Important Resistance Threat

Patricia A. Bradford^*

Wyeth-Ayerst Research, Pearl River, New York

$beta$ -Lactamases continue to be the leading cause of resistance to $beta$ -lactam antibiotics among gram-negative bacteria. In recentyears there has been an increased incidence and prevalence ofextended-spectrum $beta$ -lactamases (ESBLs), enzymes that hydrolyzeand cause resistance to oxyimino-cephalosporins and aztreonam.The majority of ESBLs are derived from the widespread broad-spectrum $beta$ -lactamases TEM-1 and SHV-1. There are also new families of ESBLs,including the CTX-M and OXA-type enzymes as well as novel, unrelated $beta$ -lactamases. Several different methods for the detection of ESBLsin clinical isolates have been suggested. While each of the testshas merit, none of the tests is able to detect all of the ESBLsencountered. ESBLs have become widespread throughout the worldand are now found in a significant percentage of Escherichia coliand Klebsiella pneumoniae strains in certain countries. They havealso been found in other Enterobacteriaceae strains and Pseudomonasaeruginosa. Strains expressing these $beta$ -lactamases will presenta host of therapeutic challenges as we head into the 21stcentury.

^* Mailing address: Wyeth-Ayerst Research, 401 N. Middletown Rd., Pearl River, NY 10965. Phone: (845) 732-4386. Fax: (845) 732-5671.E-mail: bradfop{at}war.wyeth.com.

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Extended-Spectrum -Lactamases in the 21st Century: Characterization, Epidemiology, and Detection of This Important Resistance Threat

Extended-Spectrum $beta$ -Lactamases in the 21st Century: Characterization, Epidemiology, and Detection of This Important Resistance Threat