期刊
MEDICINAL RESEARCH REVIEWS
卷 32, 期 1, 页码 216-232出版社
WILEY
DOI: 10.1002/med.20210
关键词
extended-spectrum ss-lactamases; new definition; antimicrobial resistance
资金
- National Research Foundation of Korea (NRF)
- Ministry of Education, Science and Technology [2011-0027928]
- KORDI in-house program [PE98402]
- Marine & Extreme Genome Research Center of the Ministry of Land, Transport, and Maritime Affairs, Republic of Korea
- National Korea Science and Engineering Foundation (KOSEF)
- Korea Government (MEST)
Although there is no consensus of the precise definition of ESBL, three kinds of ESBL definitions have been proposed. First, the classical definition includes variants derived from TEM-1, TEM-2, or SHV-1; K1 (KOXY) of Klebsiella oxytoca. Second, the broadened definition has stretched the classical definition of ESBL to include: (1) beta-lactamases (CTX-M-ESBLs, GES-ESBLs, and VEB-ESBLs), with spectra similar to those of TEM and SHV variants (designated as TEM- and SHV-ESBLs, respectively) but derived from other sources; (2) TEM and SHV variants with borderline ESBL activity; e.g., TEM-12; and (3) various beta-lactamases conferring wider resistance than their parent types but not meeting the definition for group 2be; e.g., OXA-types (OXA-ESBLs) and mutant AmpC-types (AmpC-ESBLs), with increased activity against oxyimino-cephalosporins and with resistance to clavulanic acid. Third, the all-inclusive definition includes: (1) ESBLA (named for class A ESBLs); (2) ESBLM (miscellaneous ESBLs), which has been subdivided into ESBLM-C (class C; plasmid-mediated AmpC) and ESBLM-D (class D); and (3) ESBLCARBA (ESBLs with hydrolytic activity against carbapenems), which has been subdivided into ESBLCARBA-A (class A carbapenemases), ESBLCARBA-B (class B carbapenemases), and ESBLCARBA-D (class D carbapenemases). The consensus view about the ESBL definition is that the classical ESBL definition must be expanded to class A non-TEM- and non-SHV-ESBLs (CTX-M-, GES-, VEB-ESBLs, etc.). However, these three definitions evoke rational debate on the question Which would be included in the category of ESBLs among AmpC-ESBLs, OXA-ESBLs, and/or carbapenemases? Therefore, there is a great need for consensus in the precise definition of ESBL. (C) 2010 Wiley Periodicals, Inc. Med Res Rev 32:216-232, 2012
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