Redefining extended-spectrum -lactamases: balancing science and clinical need
Open Access
- 18 October 2008
- journal article
- research article
- Published by Oxford University Press (OUP) in Journal of Antimicrobial Chemotherapy
- Vol. 63 (1), 1-4
- https://doi.org/10.1093/jac/dkn444
Abstract
The current β-lactamase classifications have reached a high level of complexity, making them less accessible to clinicians, infection control professionals, hospital management and politicians. From the clinical perspective, a revised comprehensible nomenclature scheme is therefore needed. The term extended-spectrum β-lactamases (ESBLs) has reached a broader audience over time, but is currently restricted to functional class 2be/molecular class A, clavulanic acid inhibited enzymes with activity against extended-spectrum cephalosporins. The proposed new classification expands the definition of ESBL to other clinically important acquired β-lactamases with activity against extended-spectrum cephalosporins and/or carbapenems. The classical class A ESBLs have been designated ESBLA in this classification, whereas plasmid-mediated AmpC and OXA-ESBLs are classed as miscellaneous ESBLs (ESBLM). Lastly, the carbapenemases have been designated ESBLCARBA, ESBLs with hydrolytic activity against carbapenems. We believe that this simplified classification may encourage new groups of healthcare professionals to engage in the effort to prevent the spread of acquired β-lactamases.Keywords
This publication has 12 references indexed in Scilit:
- Breakpoints for intravenously used cephalosporins in Enterobacteriaceae—EUCAST and CLSI breakpointsClinical Microbiology & Infection, 2008
- Carbapenemases: Molecular Diversity and Clinical ConsequencesFuture Microbiology, 2007
- Ertapenem resistance among Klebsiella and Enterobacter submitted in the UK to a reference laboratoryInternational Journal of Antimicrobial Agents, 2007
- First Detection of the Ambler Class C 1 AmpC β-Lactamase in Citrobacter freundii by a New, Simple Double-Disk Synergy TestJournal of Clinical Microbiology, 2006
- Inhibitor-Based Methods for Detection of Plasmid-Mediated AmpC β-Lactamases in Klebsiella spp., Escherichia coli , and Proteus mirabilisJournal of Clinical Microbiology, 2005
- Detection of Plasmid-Mediated AmpC β-Lactamase Genes in Clinical Isolates by Using Multiplex PCRJournal of Clinical Microbiology, 2002
- A functional classification scheme for beta-lactamases and its correlation with molecular structureAntimicrobial Agents and Chemotherapy, 1995
- Extended-spectrum beta-lactamasesAntimicrobial Agents and Chemotherapy, 1989
- Extended Broad-Spectrum -Lactamases Conferring Transferable Resistance to Newer -Lactam Agents in Enterobacteriaceae: Hospital Prevalence and Susceptibility PatternsClinical Infectious Diseases, 1988
- Chemical Structure of Bacterial PenicillinasesNature, 1969