Antimicrobial Resistance in Extended-Spectrum β-Lactamase-Producing Bacteria
Summary
Extended‐spectrum β‐lactamase (ESBL)‐producing bacteria pose a mounting threat to global health by inactivating a broad range of β‐lactam antibiotics, including third‐generation cephalosporins and monobactams. These enzymes—most notably CTX‐M, TEM and SHV variants—are frequently encoded on conjugative plasmids and integrons, facilitating rapid horizontal transfer among Enterobacterales such as Escherichia coli and Klebsiella pneumoniae. The dissemination of ESBL genes has been driven by selective pressure from widespread antibiotic use in human medicine, agriculture and veterinary practice, leading to multidrug‐resistant (MDR) phenotypes that severely limit therapeutic options. Carbapenems have been the cornerstone of therapy for severe ESBL infections, yet their increasing deployment has spurred emergence of carbapenem‐resistant organisms, undermining last-line defences. Surveillance studies reveal rising community and hospital prevalence, varying by region but converging towards similar resistance profiles and clonal lineages. Diagnostic advances, including rapid molecular assays and improved susceptibility testing, have begun to inform targeted therapy and stewardship interventions. Nevertheless, effective management relies on integrated efforts spanning antimicrobial stewardship, infection control and the development of novel β‐lactamase inhibitors or non-β‐lactam alternatives to preserve clinical efficacy and curb further dissemination.
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Antimicrobial Resistance in Extended-Spectrum β-Lactamase-Producing Bacteria publication trend
The graph below shows the total number of articles in antimicrobial resistance in extended-spectrum β-lactamase-producing bacteria across all publications each year (not limited to Nature Index journals).
Technical terms
Extended‐spectrum β‐lactamase (ESBL): An enzyme that hydrolyses a wide range of β‐lactam antibiotics, notably third-generation cephalosporins and monobactams.
Carbapenem: A class of broad-spectrum β‐lactam antibiotics often reserved as last-line agents against multidrug-resistant Gram-negative bacteria.
Cephamycin: A subgroup of cephalosporin‐related β‐lactam antibiotics (e.g., cefoxitin) with intrinsic stability to some ESBLs.
Integron: A genetic element capable of capturing and expressing gene cassettes, frequently involved in the dissemination of antibiotic resistance determinants.
Plasmid: A circular, extra‐chromosomal DNA molecule that can carry and transfer resistance genes between bacteria by conjugation.
References
- Cefoxitin versus carbapenems as definitive treatment for extended-spectrum β-lactamase-producing Klebsiella pneumoniae bacteremia in intensive care unit: a propensity-matched retrospective analysis. Critical Care (2023).
- Gut colonization and subsequent infection of neonates caused by extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella pneumoniae. Frontiers in Cellular and Infection Microbiology (2024).
- Multidrug-Resistant ESBL-Producing E. coli in Clinical Samples from the UK. Antibiotics (2023).
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