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Extended-spectrum β-lactamase-producing Enterobacteriaceae: an emerging public-health concern

Authors
Journal
The Lancet Infectious Diseases
1473-3099
Publisher
Elsevier
Publication Date
Volume
8
Issue
3
Identifiers
DOI: 10.1016/s1473-3099(08)70041-0
Keywords
  • Review And Opinion
  • Review
Disciplines
  • Biology
  • Medicine

Abstract

Summary The medical community relies on clinical expertise and published guidelines to assist physicians with choices in empirical therapy for system-based infectious syndromes, such as community-acquired pneumonia and urinary-tract infections (UTIs). From the late 1990s, multidrug-resistant Enterobacteriaceae (mostly Escherichia coli) that produce extended-spectrum β lactamases (ESBLs), such as the CTX-M enzymes, have emerged within the community setting as an important cause of UTIs. Recent reports have also described ESBL-producing E coli as a cause of bloodstream infections associated with these community-onset UTIs. The carbapenems are widely regarded as the drugs of choice for the treatment of severe infections caused by ESBL-producing Enterobacteriaceae, although comparative clinical trials are scarce. Thus, more rapid diagnostic testing of ESBL-producing bacteria and the possible modification of guidelines for community-onset bacteraemia associated with UTIs are required.

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