Antibiotic resistance and extended spectrum beta-lactamases: Types, epidemiology and treatment

Abstract

Antibiotic resistance is a problem of deep scientific concern both in hospital and community settings. Rapid detection in clinical laboratories is essential for the judicious recognition of antimicrobial resistant organisms. Production of extended-spectrum β-lactamases (ESBLs) is a significant resistance-mechanism that impedes the antimicrobial treatment of infections caused by Enterobacteriaceae and is a serious threat to the currently available antibiotic armory. ESBLs are classified into several groups according to their amino acid sequence homology. Proper infection control practices and barriers are essential to prevent spread and outbreaks of ESBL producing bacteria. As bacteria have developed different strategies to counter the effects of antibiotics, the identification of the resistance mechanism may help in the discovery and design of new antimicrobial agents. The carbapenems are widely regarded as the drugs of choice for the treatment of severe infections caused by ESBL-producing Enterobacteriaceae, although comparative clinical trials are scarce. Hence, more expeditious diagnostic testing of ESBL-producing bacteria and the feasible modification of guidelines for community-onset bacteremia associated with different infections are prescribed.

Novel drug delivery systems to combat antimicrobial resistance

“…β-lactamase inhibitors (BLI) and ESBLs can render penicillins, carbapenems, monobactams and cephalosporins susceptible to bacterialdriven inactivation and resistance. These enzymes can also be secreted from bacterial cells, hydrolyzing the drug even before it reaches the bacteria [47]. In an effort to combat antibiotic inactivating enzymes such as β-lactamase, adjuvants, which first appeared in the 1970s and have little to no independent antibacterial activity, can be delivered with the antibiotic to inhibit and counter enzymes like β-lactamases by irreversibly binding to β-lactamases, protecting the drugs from breaking down [46] (Figure 4).…”

Implicancias Estructurales y Fisiológicas de la Célula Bacteriana en los Mecanismos de Resistencia Antibiótica

“…La familia Enterobacteriaceae asociadas al ambiente nosocomial, presenta una alta prevalencia para este tipo de mecanismo de resistencia, sin embargo está presente una amplia gama de bacterias desde Gram positivos a Gram negativos (Borges et al;Santajit & Indrawattana, 2016). En este grupo se destacan las β-lactamasas de espectro extendido (BLEE), con capacidad de resistencia a todas las penicilinas, monobactámicos y cefalosporinas de primera, segunda, tercera y cuarta generación, permitiendo el uso apenas de los β-lactámicos cefamicinas y carbapenémicos (Shaikh et al, 2015). Se les clasifica de diversas formas, algunos de ellos son según el mecanismo de acción existen cuatro grandes clases de estas enzimas β-lactamasas, las de clase A, C y D tienen serina en su sitio activo y las clase B son metaloenzimas (Sheldon).…”

“…Algunas bacterias pueden utilizar el potencial de óxido-reducción como mecanismo de evasión del efecto antimicrobiano, como ocurre con la oxidación del antibiótico tetraciclina por la enzima TetX presente en Streptomyces virginiae, agente productor de antibiótico M1 del tipo A estreptogramina virginiamicina. La bacteria se protege de su propio antibiótico mediante la reducción de un grupo cetona a un alcohol crítico (Dzdic et al;Shaikh et al, 2015).…”

Antibacterial Activity of Red Pigment Isolated From Coastal Endophytic Fungi Against Multi-Drug Resistant Bacteria

“…Enterobacteriaceae members are known as gram negative pathogenic bacteria such as E. coli, Proteus, Salmonella and Shigella (Shaikh et al 2015;Dutta et al 2016;CLSI 2016). These pathogenic bacteria cause urinary tract infection, nosocomial infection, blood stream infection and meningitis, causing death to human (Harrish et al 2015;Shaikh et al 2015;Iqbal et al 2016).…”

“…These pathogenic bacteria cause urinary tract infection, nosocomial infection, blood stream infection and meningitis, causing death to human (Harrish et al 2015;Shaikh et al 2015;Iqbal et al 2016). Based on the result of antibacterial assay, red pigment had activity to combat clinical MDR gram-negative bacteria.…”