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
 
** Resistance to 2nd and 3rd generation cephalosporins
 
** 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.
+
** Common in ''[[E. coli]]'', ''[[Klebsiella]]'', and ''[[Proteus]]'' spp.
 
* '''Class B''': metallobetalactamases
 
* '''Class B''': metallobetalactamases
  +
** Examples include New Delhi metallo-beta-lactamase (NDM-1)
 
* '''Class C''': ampC
 
* '''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
 
* '''Class D''': OXA
  +
** Common in ''[[Acinetobacter]]''
   
 
== Management ==
 
== Management ==

Revision as of 18:23, 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
  • Class D: OXA

Management

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