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Redefining extended-spectrum β-lactamases: balancing science and clinical need

Giske, C. G., Sundsfjord, A. S., Kahlmeter, G., Woodford, N., Nordmann, P., Paterson, D. L., Canton, R. and Walsh, Timothy Rutland 2008. Redefining extended-spectrum β-lactamases: balancing science and clinical need. Journal of Antimicrobial Chemotherapy 63 (1) , pp. 1-4. 10.1093/jac/dkn444

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The current β-lactamase classifications have reached a high level of complexity, making them less accessible to clinicians, infection control professionals, hospital management and politicians. From the clinical perspective, a revised comprehensible nomenclature scheme is therefore needed. The term extended-spectrum β-lactamases (ESBLs) has reached a broader audience over time, but is currently restricted to functional class 2be/molecular class A, clavulanic acid inhibited enzymes with activity against extended-spectrum cephalosporins. The proposed new classification expands the definition of ESBL to other clinically important acquired β-lactamases with activity against extended-spectrum cephalosporins and/or carbapenems. The classical class A ESBLs have been designated ESBLA in this classification, whereas plasmid-mediated AmpC and OXA-ESBLs are classed as miscellaneous ESBLs (ESBLM). Lastly, the carbapenemases have been designated ESBLCARBA, ESBLs with hydrolytic activity against carbapenems. We believe that this simplified classification may encourage new groups of healthcare professionals to engage in the effort to prevent the spread of acquired β-lactamases.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Medicine
Systems Immunity Research Institute (SIURI)
Subjects: R Medicine > R Medicine (General)
Uncontrolled Keywords: classification, ESBLs, metallo-β-lactamases, OXA, KPC
Publisher: Oxford University Press
ISSN: 0305-7453
Last Modified: 04 Jun 2017 03:47

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