Journal
CLINICAL MICROBIOLOGY REVIEWS
Volume 26, Issue 4, Pages 744-758Publisher
AMER SOC MICROBIOLOGY
DOI: 10.1128/CMR.00023-13
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Funding
- EU-FP7 R-Gnosis program
- EU-FP7 EvoTAR program
- OSEO-Nosobio
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In the last 10 years, extended-spectrum beta-lactamase-producing enterobacteria (ESBL-E) have become one of the main challenges for antibiotic treatment of enterobacterial infections, largely because of the current CTX-M enzyme pandemic. However, most studies have focused on hospitalized patients, though today it appears that the community is strongly affected as well. We therefore decided to devote our investigation to trends in ESBL-E fecal carriage rates and comprehensively reviewed data from studies conducted on healthy populations in various parts of the world. We show that (i) community ESBL-E fecal carriage, which was unknown before the turn of the millennium, has since increased significantly everywhere, with developing countries being the most affected; (ii) intercontinental travel may have emphasized and globalized the issue; and (iii) CTX-M enzymes, especially CTX-M-15, are the dominant type of ESBL. Altogether, these results suggest that CTX-M carriage is evolving toward a global pandemic but is still insufficiently described. Only a better knowledge of its dynamics and biology will lead to further development of appropriate control measures.
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