ESBL, AmpC and carbapenemases: emergence, dissemination and diagnostics of beta-lactamase-producing Gram-negative pathogens

作者：Pfeifer Yvonne^*

来源：Journal of Laboratory Medicine, 2010, 34(4): 205-215.

DOI：10.1515/JLM.2010.042

• antimicrobial resistance
• bacterial typing
• carbapenemase
• Enterobacteriaceae
• extended-spectrum beta-lactamase (ESBL)
• molecular epidemiology

The increasing number of beta-lactam resistant Gram-negative pathogens is mainly due to production of beta-lactamases. Bacteria adapt to newly developed beta-lactams by modification of these enzymes or acquisition of new beta-lactamases. At present, a large number of different beta-lactamases is known exhibiting a diverse spectrum efficacy. Several enzymes are able to hydrolyse modern beta-lactams such as carbapenems. Localisation of beta-lactamase genes within various mobile genetic elements enables the transfer of resistance within one species or between different Gram-negative species. This results in emergence of multidrug-resistant pathogens whose spectrum of resistance dramatically limits the therapeutic options. Within the scope of the German ARS study (Antibiotic Resistance Surveillance), the Robert Koch Institute Wernigerode investigates beta-lactamase production in cephalosporin- and carbapenem-resistant Enterobacteriaceae and Nonfermenters using molecular methods. The aim of this study is the analysis of prevalence and dissemination of relevant beta-lactamases as well as identification and surveillance of new beta-lactamases or multidrug-resistant nosocomial pathogens.

• 出版日期2010-7