Abstract
During the last decade, community-acquired extended-spectrum beta-lactamase (ESBL)-producing bacteria, and in particular Escherichia coli producing ESBLs of the CTX-M-type, have spread worldwide. These organisms are most often isolated from the urinary tract, but have also been isolated from bacteria in the blood. Cephalosporin- and fluoroquinolone-containing treatments are the two most common risk factors identified in patients with ESBL producers. In addition, associated resistance to other classes of antimicrobial agents are often observed in CTX-M producers, limiting the availability of therapeutic options. Carbapenems should be considered as the drug of choice for treating serious systemic infections caused by ESBL-producing bacteria, but preventing the spread of and appropriately managing these infections remains difficult.
MeSH terms
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Anti-Bacterial Agents / pharmacology
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Carbapenems / pharmacology
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Carbapenems / therapeutic use
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Cephalosporins / pharmacology
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Cephalosporins / therapeutic use
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Community-Acquired Infections / epidemiology
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Community-Acquired Infections / microbiology
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Drug Resistance, Multiple, Bacterial
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Escherichia coli / isolation & purification
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Escherichia coli Infections / microbiology
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Fluoroquinolones / pharmacology
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Fluoroquinolones / therapeutic use
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Humans
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Randomized Controlled Trials as Topic
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Risk Factors
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Treatment Outcome
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Urinary Tract Infections / epidemiology
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Urinary Tract Infections / microbiology
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beta-Lactam Resistance
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beta-Lactamases* / classification
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beta-Lactamases* / genetics
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beta-Lactamases* / metabolism
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beta-Lactams / pharmacology*
Substances
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Anti-Bacterial Agents
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Carbapenems
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Cephalosporins
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Fluoroquinolones
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beta-Lactams
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beta-Lactamases