Burnham Institute
Member
http://www.thelancet.com/journals/laninf/article/PIIS1473309908700410/abstract
The Lancet Infectious Diseases 2008; 8:159-166
DOI:10.1016/S1473-3099(08)70041-0
Review
Extended-spectrum β-lactamase-producing Enterobacteriaceae: an emerging public-health concern
Dr Johann DD Pitout MD email address a b Corresponding Author Information and Kevin B Laupland MD b c d
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.
The Lancet Infectious Diseases 2008; 8:159-166
DOI:10.1016/S1473-3099(08)70041-0
Review
Extended-spectrum β-lactamase-producing Enterobacteriaceae: an emerging public-health concern
Dr Johann DD Pitout MD email address a b Corresponding Author Information and Kevin B Laupland MD b c d
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.