Nosocomial Outbreaks of Multiresistant Bacteria: Extended-Spectrum Beta-Lactamases Have Arrived in North America
Authors: Antone A. Medeiros
Journal: Annals of Internal Medicine (1993)

Editorials1 September 1993Nosocomial Outbreaks of Multiresistant Bacteria: Extended-Spectrum Beta-Lactamases Have Arrived in North AmericaAntone A. Medeiros, MDAntone A. Medeiros, MDThe Miriam Hospital, Providence, RI 02906.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-119-5-199309010-00015 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail The history of the antibiotic era shows that widespread use of new antibiotics fosters emergence of resistant clinical isolates, often possessing novel antimicrobial resistance mechanisms. Clinical use of oxyimino--lactams, particularly ceftazidime and cefotaxime, skyrocketed during the last 15 years. In 1983 plasmid-mediated enzymes that confer resistance to oxyimino--lactamsextended-spectrum -lactamases (ESBL)were first observed in Germany. Since then, the number and variety of these -lactamases have increased rapidly and their distribution is now worldwide.Most of the ESBLs derive from TEM-1 or 2 and SHV-1, the common plasmid-determined -lactamases that confer resistance to penicillins and early-generation cephalosporins. Substitution of a single amino ...References1. Jacoby GA, Medeiros AA. More extended-spectrum -lactamases. Antimicrob Agents Chemother. 1991; 35:1697-704. Google Scholar2. Naumovski L, Quinn JP, Miyashiro D, Patel M, Bush K, Singer SB, et al. Outbreak of ceftazidime resistance due to a novel extended-spectrum -lactamase in isolates from cancer patients. Antimicrob Agents Chemother. 1992; 36:1991-6. Google Scholar3. Liu PY, Gur D, Hall LM, Livermore DM. Survey of the prevalence of -lactamases amongst 1000 gram-negative bacilli isolated consecutively at the Royal London Hospital. J Antimicrob Chemother. 1992; 30:429-47. Google Scholar4. 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Google Scholar Author, Article, and Disclosure InformationAffiliations: The Miriam Hospital, Providence, RI 02906.Corresponding Author: Antone A. Medeiros, MD, The Miriam Hospital, 164 Summit Avenue, Providence, RI 02906. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoNosocomial Outbreak of Klebsiella Infection Resistant to Late-Generation Cephalosporins Kenneth S. Meyer , Carl Urban , Janet A. Eagan , Barbara J. Berger , and James J. 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