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. 2012:2012:625170.
doi: 10.1155/2012/625170. Epub 2011 Jun 6.

ESBLs: A Clear and Present Danger?

Rishi H-P Dhillon  1 , John Clark
Affiliations

ESBLs: A Clear and Present Danger?

Rishi H-P Dhillon et al. Crit Care Res Pract. 2012.

Abstract

Extended spectrum β-lactamases (ESBLs) are enzymes produced by a variety of Gram negative bacteria which confer an increased resistance to commonly used antibiotics. They are a worrying global public health issue as infections caused by such enzyme-producing organisms are associated with a higher morbidity and mortality and greater fiscal burden. Coupled with increasing prevalence rates worldwide and an ever diminishing supply in the antibiotic armamentarium, these enzymes represent a clear and present danger to public health. This article aims to give an overview of the current situation regarding ESBLs, with a focus on the epidemiology and management of such infections.

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Figures

Figure 1
Figure 1
Figure 2
Figure 2
Synergy is seen as an expansion of the cephalosporin zone adjacent to the clavulanate containing disc CAZ—good substrate for TEM and SHV's, CTX—Good for CTX-M ESBLs. The organism may appear resistant to 3rd-generation cephs, but susceptibility is restored by the presence of clavulanate.
Figure 3
Figure 3
MICs that are >8 fold lower with clavulanate (left) or the presence of keyhole zones (right) imply ESBL production.
See this image and copyright information in PMC

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