Β-lactamases: Difference between revisions
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Β-lactamases
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** Most common ESBL in Gram-negative bacteria |
** Most common ESBL in Gram-negative bacteria |
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** Resistance to 2nd and 3rd generation cephalosporins |
** Resistance to 2nd and 3rd generation cephalosporins |
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** Examples include penicillinase, TEM-1 (common in GNBs), CTX-M, ''K. pneumoniae'' carbapenemase (KPC) family |
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** Common in ''E. coli'', ''Klebsiella'', and ''Proteus'' spp. |
** Common in ''[[E. coli]]'', ''[[Klebsiella]]'', and ''[[Proteus]]'' spp. |
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* '''Class B''': metallobetalactamases |
* '''Class B''': metallobetalactamases |
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** Examples include New Delhi metallo-beta-lactamase (NDM-1) |
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* '''Class C''': ampC |
* '''Class C''': ampC |
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** Inducible AmpC gene present in the genome |
** Inducible AmpC gene present in the genome |
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** Common in ''Citrobacter'', ''Serratia'', and ''Enterobacter'' |
** Common in ''[[Citrobacter]]'', ''[[Serratia]]'', and ''[[Enterobacter]]'' |
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* '''Class D''': OXA |
* '''Class D''': OXA |
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** Common in ''[[Acinetobacter]]'' |
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== Management == |
== Management == |
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Revision as of 22:23, 1 February 2020
Definition
- Bacteria containing a plasmid that codes for an extended-spectrum beta-lactamase (ESBL)
- Most common with Escherichia coli and Klebsiella
Classification
- Class A
- Constitutively expressed plasmid
- Most common ESBL in Gram-negative bacteria
- Resistance to 2nd and 3rd generation cephalosporins
- Examples include penicillinase, TEM-1 (common in GNBs), CTX-M, K. pneumoniae carbapenemase (KPC) family
- Common in E. coli, Klebsiella, and Proteus spp.
- Class B: metallobetalactamases
- Examples include New Delhi metallo-beta-lactamase (NDM-1)
- Class C: ampC
- Inducible AmpC gene present in the genome
- Common in Citrobacter, Serratia, and Enterobacter
- Class D: OXA
- Common in Acinetobacter
Management
- Antibiotic therapy tailored to the resistance pattern
- Carbapenems, aminoglycosides, fluoroquinolones, and Septra typically work well
References
- ^ R. Cantón, M.I. Morosini, O. Martin, S. de la Maza, E. Gomez G. de la Pedrosa. IRT and CMT β-lactamases and inhibitor resistance. Clinical Microbiology and Infection. 2008;14:53-62. doi:10.1111/j.1469-0691.2007.01849.x.
