Extended-Spectrum Beta-Lactamase Production in Enterobacteriaceae

Extended‐spectrum β‐lactamases (ESBLs) are enzymes produced by members of the family Enterobacteriaceae—principally Escherichia coli and Klebsiella pneumoniae—that hydrolyse a broad range of β‐lactam antibiotics, including third‐generation cephalosporins and monobactams. Their emergence has been driven by the selective pressure of widespread antibiotic use in hospitals and the community, leading to a global rise in infections that are increasingly difficult to treat. ESBL‐producing strains often carry additional resistance determinants against aminoglycosides, fluoroquinolones and sulfonamides, resulting in multidrug‐resistant phenotypes. Transmission occurs both by clonal spread of successful bacterial lineages and by horizontal transfer of resistance genes on mobile genetic elements such as plasmids. The clinical impact is profound: ESBL‐producing Enterobacteriaceae are associated with higher morbidity, longer hospital stays, increased healthcare costs and limited therapeutic options, prompting renewed interest in infection control measures, antimicrobial stewardship and novel diagnostic methods to detect and contain their spread.

Research from Nature Portfolio

Recent studies have illuminated the dynamics of ESBL gene transmission between healthcare and community settings. Whole‐genome sequencing of ESBL‐producing Escherichia coli isolates from hospital patients and their household contacts revealed short‐term sharing of closely related strains, underpinned by a common resistome. Over the longer term, however, horizontal transfer of resistance genes carried on IncF and IncY plasmids was shown to sustain dissemination across ecological niches. Predominant gene variants such as blaCTX-M-15 and blaOXA-1 were identified on conjugative plasmids, highlighting the role of mobile elements in linking clinical and community reservoirs and reinforcing the need for integrated surveillance strategies that address both bacterial lineages and the plasmids they harbour.

Extended-Spectrum Beta-Lactamase Production in Enterobacteriaceae publication trend

The graph below shows the total number of articles in extended-spectrum beta-lactamase production in enterobacteriaceae across all publications each year (not limited to Nature Index journals).

Technical terms

Extended‐Spectrum β‐Lactamase (ESBL): Enzymes produced by Gram-negative bacteria that hydrolyse extended-spectrum cephalosporins and monobactams, conferring resistance to these β-lactam antibiotics.

Horizontal Gene Transfer: The movement of genetic material between organisms by mechanisms other than vertical inheritance, notably via plasmids, transposons or bacteriophages.

Plasmid: A mobile, self-replicating, extrachromosomal DNA element that often carries antibiotic resistance genes and can be transferred between bacteria.

Resistome: The collection of all antibiotic resistance genes and their precursors in both pathogenic and non-pathogenic bacteria within a particular environment or microbiome.

References

1. Prevalence of Carbapenemase and Extended-Spectrum β-Lactamase Producing Enterobacteriaceae: A Cross-Sectional Study. Antibiotics (2023).
2. Prevalence and molecular characterization of ESBL-producing Enterobacteriaceae in Egypt: a systematic review and meta-analysis of hospital and community-acquired infections. Antimicrobial Resistance & Infection Control (2024).
3. Whole strains vs MGEs in short and longterm transmission of ESBL genes between healthcare and community settings in Uganda. Scientific Reports (2023).
4. Extended Spectrum Beta-lactamases: Definition, Classification and Epidemiology.. Current Issues in Molecular Biology (2014).