DOI: 10.1128/CMR.18.4.657-686.2005
Article Figures & Data
Figures
- FIG. 1.
Explosion of knowledge on extended-spectrum β-lactamases.
Tables
- TABLE 1.
Infection control interventions appropriate to controlling spread of ESBL-producing organisms within a hospital
Identify patients infected with ESBL-producing organisms by use of appropriate detection methods in the clinical microbiology laboratory Identify colonized patients by use of rectal swabs plated onto selective media Perform molecular epidemiologic analysis of strains from infected or colonized patients (for example, by use of pulsed-field gel electrophoresis) Institute contact isolation precautions, particularly if clonal spread is demonstrated Institute controls on antibiotic use, particularly if numerous strain types are demonstrated - TABLE 2.
Comparison of national MIC breakpoints for Enterobacteriaceae
Country MIC breakpointa (μg/ml) Cefotaxime Ceftazidime S (≤) R (≥) S (≤) R (≥) United States of America (CLSI) 8 64 8 32 United Kingdom 1 2 2 4 France 4 32 4 32 The Netherlands 4 16 4 16 Germany 2 8 4 32 Spain 1 8 1 8 Norway 2 16 2 16 Sweden 4 32 4 16 ↵a S, susceptible; R, resistant.
- TABLE 3.
Recommended treatment for infections with ESBL-producing organisms
Infection type Therapy of choice Second-line therapy Urinary tract infection Quinolonea Amoxicillin/clavualante Bacteremia Carbapenem Quinolonea Hospital-acquired pneumonia Carbapenem Quinolonea Intra-abdominal infection Carbapenem Quinolonea (plus metronidazole) Meningitis Meropenem Intrathecal polymyxin B ↵a If the organism is quinolone susceptible.
- Top
- Article
- SUMMARY
- INTRODUCTION
- DEFINITION OF EXTENDED-SPECTRUM β-LACTAMASES
- DIVERSITY OF ESBL TYPES
- EPIDEMIOLOGY OF ESBL-PRODUCING ORGANISMS
- INFECTION CONTROL IMPLICATIONS OF ESBL-PRODUCING ORGANISMS
- DETECTION OF ESBLs IN THE CLINICAL MICROBIOLOGY LABORATORY
- TREATMENT AND OUTCOME OF INFECTIONS WITH ESBL-PRODUCING ORGANISMS
- CONCLUSIONS
- ACKNOWLEDGMENTS
- REFERENCES
- Figures & Data
- Info & Metrics