Extended-Spectrum-Betalaktamasen (ESBL): gestern ESBL – heute ESBL, Carbapenemase-Bildner und multiresistente Bakterien

Zusammenfassung

Extended-Spectrum-Betalaktamasen (ESBL), welche die Resistenz gegenüber 3. Generation Cephalosporine vermitteln, veranschaulichen, wie schnell sich Resistenzmechanismen entwickeln können. Diese Enzyme wurden in wenigen Isolaten Ende der 1980er Jahre entdeckt. Nun zeigen sie weltweit signifikante Zunahmen in Krankenhäusern und außerhalb von Gesundheitseinrichtungen. Verschiedene ESBL-Enzymvarianten (TEM, SHV, CTX-M) wurden identifiziert, und diese schwächen den Nutzen der letzten Generation von Cephalosporinen und engen die Therapieoptionen für Patienten mit gramnegativen bakteriellen Infektionen ein. In der jüngsten Vergangenheit häuften sich Berichte über die weite Verbreitung von ESBL-bildenden Erregern bei Frühgeborenen, Nutztieren und in Lebensmitteln. Mittlerweile erleben wir die weltweite Verbreitung bestimmter ESBL-Varianten in epidemiologisch erfolgreichen Enterobacteriaceae-Stämmen.

Abstract

Extended-spectrum beta-lactamases (ESBLs), which confer resistance to third generation cephalosporins, demonstrate how rapidly resistance mechanisms can evolve. These enzymes were discovered in few isolates in the late 1980s. They have now reached significant levels in hospitals and the community worldwide. Different ESBL enzyme variants (TEM, SHV, CTX-M) have been identified. They now substantially impair the utility of the later generation of cephalosporins and narrow the therapy options for patients with Gram-negative infections. Recently, reports on the wide dissemination of ESBL-producing bacteria in newborns, livestock, and in food accumulated. Meanwhile the worldwide dissemination of particular ESBL variants in epidemiologically successful Enterobacteriaceae strains has occurred.

Schlüsselwörter

Extended-Spectrum- Betalaktamasen - ESBL - multiresistente Enterobacteriaceae - Multiresistenz - Carbapenemase

Keywords

extended-spectrum beta-lactamases - ESBL - multidrug-resistant enterobacteriaceae - multiresistance - carbapenemase

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