Extended Spectrum- and Carbapenemase-Based β-Lactam Resistance in the Arabian Peninsula—A Descriptive Review of Recent Years

Abstract

Antimicrobial resistance (AMR) is a global problem that also includes countries of the Arabian Peninsula. Of particular concern, is the continuing development of extended-spectrum β-lactamases (ESBLs) in the countries of this region. Additionally, antibiotic treatment options for ESBL-producing bacteria are becoming limited, primarily due to the continuing development of carbapenem resistance (CR), carbapenems being frequently used to treat such infections. An overview of recent publications (2018–2021) indicates the presence of ESBL and/or CR in patients and hospitals in most countries of the Arabian Peninsula, although the delay between microbial isolation and publication inevitably makes an accurate analysis of the current situation rather difficult. However, there appears to be greater emphasis on CR (including combined ESBL and CR) in recent publications. Furthermore, although publications from Saudi Arabia are the most prevalent, this may simply reflect the increased interest in ESBL and CR within the country. Enhanced ESBL/CR surveillance is recommended for all countries in the Arabian Peninsula.

Antimicrobial Resistance Patterns and Risk Factors Associated with ESBL-Producing and MDR Escherichia coli in Hospital and Environmental Settings in Lusaka, Zambia: Implications for One Health, Antimicrobial Stewardship and Surveillance Systems

“…The increased ESBL-producing E. coli indicates a greater extent of resistance to antibiotics. Consequently, increased rates of ESBL producers limit treatment options [ 156 ].…”

Molecular characterization of antibiotic resistance and virulence genes on plasmids of Proteus mirabilis isolated from urine samples of Hospitals in Mosul City, Iraq

“…Until 2000, TEM-and SHV-type ESBLs were the predominant ESBL families. Today, the most commonly encountered ESBL types are phylogenetically distinct from the first β-lactamases that appeared in the early 1980s (Hays et al, 2022). CTX-M-type enzymes are the most commonly encountered ESBL types present in several members of the order Enterobacteriales (Yasmeen et al, 2023).…”

Domestic Pets in the United Arab Emirates as Reservoirs for Antibiotic-Resistant Bacteria: A Comprehensive Analysis of Extended-Spectrum Beta-Lactamase Producing Escherichia coli Prevalence and Risk Factors

“…Due to the limited options available for effective antimicrobial treatment against their infections in humans and animals, the World Health Organization (WHO) highlighted that Enterobacterales expressing extended-spectrum β-lactamases (ESBLs) were global priority pathogens [2]. ESBL enzymes enable bacteria to hydrolyze extendedspectrum cephalosporins, penicillins, and monobactams and require the use of β-lactamase inhibitors such as tazobactam and clavulanic acid [3]. Particularly, ESBL resistant (ESBL-R) Escherichia coli (E. coli) has been isolated from food, environment, livestock, wildlife, and companion animals and has been positively correlated with the extensive use of β-lactam antibiotics in veterinary settings [4].…”