Beta-lactamases in Enterobacteriaceae infections in children

Moxon, Christopher Alan and Paulus, Stephane ORCID: 0000-0002-0703-9114 (2016) Beta-lactamases in Enterobacteriaceae infections in children. JOURNAL OF INFECTION, 72. S41-S49.

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Abstract

Multi-drug resistance in Gram negative bacteria, particularly in Enterobacteriaceae, is a major clinical and public health challenge. The main mechanism of resistance in Enterobacteriaceae is linked to the production of beta-lactamase hydrolysing enzymes such as extended spectrum beta-lactamases (ESBL), AmpC beta-lactamases and carbapenemases (Carbapenemase Producing Enterobacteriaceae (CPE)). ESBL and CPE resistance genes are located on plasmids, which can be transmitted between Enterobacteriaceae, facilitating their spread in hospitals and communities. These plasmids usually harbour multiple additional co-resistance genes, including to trimethoprim-sulfamethoxazole, aminoglycosides, and fluoroquinolones, making these infections challenging to treat. Asymptomatic carriage in healthy children as well as community acquired infections are increasingly reported, particularly with ESBL. Therapeutic options are limited and previously little used antimicrobials such as fosfomycin and colistin have been re-introduced in clinical practice. Paediatric experience with these agents is limited hence there is a need to further examine their clinical efficacy, dosage and toxicity in children. Antimicrobial stewardship along with strict infection prevention and control practices need to be adopted widely in order to preserve currently available antimicrobials. The future development of novel agents effective against beta-lactamases producers and their applicability in children is urgently needed to address the challenge of multi-resistant Gram negative infections.

Item Type:	Article
Additional Information:	publisher: Elsevier articletitle: Beta-lactamases in Enterobacteriaceae infections in children journaltitle: Journal of Infection articlelink: http://dx.doi.org/10.1016/j.jinf.2016.04.021 content_type: article copyright: © 2016 The British Infection Association. Published by Elsevier Ltd. All rights reserved.
Uncontrolled Keywords:	Antimicrobial resistance, Enterobacteriaceae, Paediatrics, Extended beta-lactamase producers, AmpC beta-lactamases, Carbapenemase producing Enterobacteriaceae
Depositing User:	Symplectic Admin
Date Deposited:	20 Jul 2016 07:44
Last Modified:	19 Jan 2023 07:33
DOI:	10.1016/j.jinf.2016.04.021
Related URLs:	Author Publisher
URI:	https://livrepository.liverpool.ac.uk/id/eprint/3002443