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REVIEW
Extended-spectrum β-lactamases in North America, 1987–2006
K. BushJohnson & Johnson Pharmaceutical Research & Development L. L. C, Raritan, NJ, USA
Corresponding author and reprint requests: K. Bush, Johnson & Johnson Pharmaceutical Research & Development, 1000 Route 202, Raritan, NJ 08869, USA
E-mail: kbush@prdus.jnj.com
Abstract
Extended-spectrum β-lactamases (ESBLs) derived from the TEM-1 β-lactamase were first identified in the USA in outbreak strains of Klebsiella pneumoniae in the middle to late 1980s, together with the SHV-5 ESBL. The TEM-10, TEM-12 and TEM-26 enzymes have remained in US hospitals, but have been joined by other ESBLs that are variants of the SHV-1 broad-spectrum β-lactamase. In the most recent surveys from hospitals in the eastern part of the USA, the most prominent ESBLs have been the SHV-7 and SHV-12 enzymes. In Canada, a wider variety of ESBLs has been identified, with multiple members of the TEM, SHV and CTX-M classes being represented in surveillance isolates. SHV-type and CTX-M ESBLs have appeared in many Canadian isolates, with an outbreak of CTX-M-14-related enzymes from Calgary, but limited TEM-derived ESBLs. Surprisingly, few CTX-M ESBLs have yet been reported in the USA, in contrast to the rest of the world, where the CTX-M enzymes have become a predominant ESBL family.
REVIEW
Prevalence of extended-spectrum β-lactamases in South America
M. V. Villegas11International Center for Medical Research and Training (CIDEIM), Cali, Colombia, J. N. Kattan11International Center for Medical Research and Training (CIDEIM), Cali, Colombia, M. G. Quinteros22Hospital de Infecciosas F. J. Muñiz, Buenos Aires and J. M. Casellas33CIBIC Laboratory and Infectious Diseases Committee, Sanatorio Parque, Rosario, Argentina1International Center for Medical Research and Training (CIDEIM), Cali, Colombia, 2Hospital de Infecciosas F. J. Muñiz, Buenos Aires and 3CIBIC Laboratory and Infectious Diseases Committee, Sanatorio Parque, Rosario, Argentina
Corresponding author and reprint requests: Maria Virginia Villegas, Av 1# 3-03 Cali, Colombia
Tel.: (57-2) 6682164 E-mail: mariavirginia.villegas@gmail.com
Abstract
In South American countries, the class A extended-spectrum β-lactamases (ESBLs) so far recognised belong to the CTX-M, Pseudomonas Extended Resistance (PER), SHV and TEM families. ESBL rates in South America are among the highest in the world, probably due to multiple factors. SHV- and TEM-type ESBLs have been frequently encountered, but CTX-M is endemic and widely dominant. PER-type ESBLs seem to be restricted to the southern ‘cone’ of South America. Community-acquired ESBLs are starting to appear.
REVIEW
Prevalence and clonality of extended-spectrum β-lactamases in Asia
P. M. HawkeyDivision of Immunity and Infection, University of Birmingham, Birmingham and Health Protection Agency, West Midlands Public Health Laboratory, Birmingham Heart of England NHS Trust, Bordesley Green East, Birmingham, UK
Corresponding author and reprint requests: P. M. Hawkey, Division of Immunity and Infection, University of Birmingham, Birmingham B15 2TT and Health Protection Agency, West Midlands Public Health Laboratory, Birmingham Heart of England NHS Trust, Bordesley Green East, Birmingham B9 5SS, UK
E-mail: p.m.hawkey@bham.ac.uk
Abstract
Asia is almost certainly a part of the world in which extended-spectrum β-lactamases (ESBLs) have emerged de novo, with some early antimicrobial resistance studies showing high levels of the ESBL phenotype, particularly among Klebsiella, and most notably in China, Korea, Japan and India. There is a lack of genotyping studies but work from the late 1990s suggests that SHV-5 and SHV-12 were most common then, with only very rare reports of TEM-related ESBL genes. As in other parts of the world, quite marked differences have since been seen in the pattern of ESBL genes, particularly in relation to the CTX-M family. The early emergence of TOHO CTX-M-2 in Japan contrasted with CTX-M-3 and -14 in China and many other parts of the Far East, suggesting the separate transfer of genes from the genome of Kluyvera spp. to mobile genetic elements in human-associated Enterobacteriaceae. ESBL production rates are now very high compared with Europe. In most countries, there are mixtures of CTX-M types, with VEB appearing significantly in Vietnam and Thailand, and ESBL isolates from India being completely dominated by the presence of blaCTX-M-15 alone, with no other CTX-M types reported. With the total population of India and China being c. 2.4 billion and with faecal carriage rates of, probably, c. 10%, these countries represent major reservoirs of blaCTX-M genes. Increasing international travel and trade will lead to the movement of many of these ESBL genes. The high prevalence of ESBL genes in Asia means that the empirical treatment of serious infections with β-lactam antibiotics, except carbapenems, is seriously compromised.
[ 本帖最后由 David 于 2008-2-26 15:51 编辑 ]
ESBL-North America.pdf
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ESBL-South America.pdf
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ESBL-Asia.pdf
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发表于 2008-2-26 15:48
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