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extended spectrum beta lactamase (ESBL)

In reference to bacteria that produce beta-lactamase(s) resistant to extended spectrum antibiotics. Epidemiology: - Enterobacteriaceae with carbapenemases decreased more from 2006-1015 than the extended spectrum beta lactamase phenotype [3] Management: - carbapenems are appropriate for empiric therapy of infections due to extended spectrum beta-lactamase producing gram-negative bacteria - ventilator-associated pneumonia[1] - piperacillin tazobactam (Zosyn) inferior to meropenem [4] - maintain contact precautions throughout hospitalization after 1st detected [2]

Related

antibiotic resistance

General

beta lactamase

References

  1. Medical Knowledge Self Assessment Program (MKSAP) 17, 18, 19. American College of Physicians, Philadelphia 2015, 2018, 2021.
  2. Banach DB, Bearman G, Barnden M et al Duration of Contact Precautions for Acute-Care Settings. Infection Control & Hospital Epidemiology. Jan 11, 2018 PMID: 29321078 https://www.cambridge.org/core/journals/infection-control-and-hospital-epidemiology/article/duration-of-contact-precautions-for-acutecare-settings/94E38FDCE6E1823BD613ABE4E8CB5E56
  3. Woodworth KR, Walters MS, Weiner LM, et al. Vital Signs: Containment of Novel Multidrug-Resistant Organisms and Resistance Mechanisms - United States, 2006-2017. MMWR Morb Mortal Wkly Rep. ePub: 3 April 2018. https://www.cdc.gov/mmwr/volumes/67/wr/mm6713e1.htm
  4. Harris PNA, Tambyah PA, Lye DC et al Effect of Piperacillin-Tazobactam vs Meropenem on 30-Day Mortality for Patients With E coli or Klebsiella pneumoniae Bloodstream Infection and Ceftriaxone Resistance. A Randomized Clinical Trial. JAMA. 2018;320(10):984-994. Sept 11, 2018 PMID: 30208454 https://jamanetwork.com/journals/jama/fullarticle/2702145 - Hayden MK, Won SY. Carbapenem-Sparing Therapy for Extended-Spectrum beta-lactamase- producing E coli and Klebsiella pneumoniae Bloodstream Infection: The Search Continues. JAMA. 2018;320(10):979-981. Sept 11, 2018 PMID: 30208439 https://jamanetwork.com/journals/jama/fullarticle/2702126