The spread of CTX-M-type extended-spectrum beta-lactamases

Clin Microbiol Infect. 2008 Jan:14 Suppl 1:33-41. doi: 10.1111/j.1469-0691.2007.01867.x.

Abstract

CTX-M-type enzymes are a group of class A extended-spectrum beta-lactamases (ESBLs) that are rapidly spreading among Enterobacteriaceae worldwide. More that 50 allotypes are known, clustered into six sub-lineages. The CTX-M-encoding genes have been captured from the chromosome of Kluyvera spp. on conjugative plasmids that mediate their dissemination among pathogenic enterobacteria. CTX-M-type ESBLs exhibit powerful activity against cefotaxime and ceftriaxone but generally not against ceftazidime, which has important implications for laboratory detection. However, several CTX-M variants with enhanced ceftazidimase activity have been detected. The rapid and massive spread of CTX-M-type ESBLs is rapidly changing the ESBL epidemiology and, in some geographical areas, these enzymes are now the most prevalent ESBLs in Enterobacteriaceae.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Anti-Bacterial Agents / metabolism
  • Anti-Bacterial Agents / pharmacology*
  • Cefotaxime / metabolism
  • Cefotaxime / pharmacology
  • Ceftazidime / metabolism
  • Ceftazidime / pharmacology
  • Ceftriaxone / metabolism
  • Ceftriaxone / pharmacology
  • Cephalosporins / metabolism
  • Cephalosporins / pharmacology*
  • Enterobacteriaceae / drug effects
  • Enterobacteriaceae / enzymology*
  • Enterobacteriaceae / genetics
  • Enterobacteriaceae Infections / epidemiology*
  • Enterobacteriaceae Infections / microbiology
  • Humans
  • Models, Molecular
  • Prevalence
  • beta-Lactam Resistance* / genetics
  • beta-Lactamases* / chemistry
  • beta-Lactamases* / genetics
  • beta-Lactamases* / metabolism

Substances

  • Anti-Bacterial Agents
  • Cephalosporins
  • Ceftriaxone
  • Ceftazidime
  • beta-Lactamases
  • Cefotaxime