Β-lactamases: Difference between revisions

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Β-lactamases
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== Classification ==
== Classification ==


* Class A
* '''Class A'''
** Constitutively expressed plasmid
** Constitutively expressed plasmid
** Most common ESBL in Gram-negative bacteria
** Most common ESBL in Gram-negative bacteria
** Resistance to 2nd and 3rd generation cephalosporins
** Resistance to 2nd and 3rd generation cephalosporins
** Common in ''E. coli'', ''Klebsiella'', and ''Proteus'' spp.
** Common in ''E. coli'', ''Klebsiella'', and ''Proteus'' spp.
* Class C
* '''Class B''': metallobetalactamases
* '''Class C''': ampC
** Inducible AmpC gene present in the genome
** Inducible AmpC gene present in the genome
** Common in ''Citrobacter'', ''Serratia'', and ''Enterobacter''
** Common in ''Citrobacter'', ''Serratia'', and ''Enterobacter''
* '''Class D''': OXA


== Management ==
== Management ==

Revision as of 22:19, 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
    • Common in E. coli, Klebsiella, and Proteus spp.
  • Class B: metallobetalactamases
  • Class C: ampC
    • Inducible AmpC gene present in the genome
    • Common in Citrobacter, Serratia, and Enterobacter
  • Class D: OXA

Management

  • Antibiotic therapy tailored to the resistance pattern
  • Carbapenems, aminoglycosides, fluoroquinolones, and Septra typically work well

References

  1. ^  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.