Extended-Spectrum β-Lactamases (ESBL): Challenges and Opportunities

Abstract

The rise of antimicrobial resistance, particularly from extended-spectrum β-lactamase producing Enterobacteriaceae (ESBL-E), poses a significant global health challenge as it frequently causes the failure of empirical antibiotic therapy, leading to morbidity and mortality. The E. coli- and K. pneumoniae-derived CTX-M genotype is one of the major types of ESBL. Mobile genetic elements (MGEs) are involved in spreading ESBL genes among the bacterial population. Due to the rapidly evolving nature of ESBL-E, there is a lack of specific standard examination methods. Carbapenem has been considered the drug of first choice against ESBL-E. However, carbapenem-sparing strategies and alternative treatment options are needed due to the emergence of carbapenem resistance. In South Asian countries, the irrational use of antibiotics might have played a significant role in aggravating the problem of ESBL-induced AMR. Superbugs showing resistance to last-resort antibiotics carbapenem and colistin have been reported in South Asian regions, indicating a future bleak picture if no urgent action is taken. To counteract the crisis, we need rapid diagnostic tools along with efficient treatment options. Detailed studies on ESBL and the implementation of the One Health approach including systematic surveillance across the public and animal health sectors are strongly recommended. This review provides an overview of the background, associated risk factors, transmission, and therapy of ESBL with a focus on the current situation and future threat in the developing countries of the South Asian region and beyond.

Antimicrobial Resistance and Virulence Potential of Bacterial Species from Captive Birds of Prey—Consequences of Falconry for Public Health

“…[ 68 , 69 ]. As for ESBL production, strains with this ability show resistance to most β-lactam antibiotics and are frequently associated with the failure of antibiotic therapy [ 70 ].…”

“…[68,69]. As for ESBL production, strains with this ability show resistance to most β-lactam antibiotics and are frequently associated with the failure of antibiotic therapy [70]. A study conducted in a European zoological park described that, in healthy raptors, all the isolates obtained from cloacal and conjunctival swabs were multidrug-resistant [71].…”

High prevalence of multidrug-resistant Enterobacterales carrying extended-spectrum beta-lactamase and AmpC genes isolated from neonatal sepsis in Ahvaz, Iran

“…Overall, in clinical settings, AmpC and ESBLs producing gram-negative pathogens cause many health problems, including treatment failure, increased hospitalization time and treatment costs, and ultimately increased mortality [ 10 ]. Another important problem in the clinical field is that AmpC carriers are considered as a hidden warehouse for ESBLs and cause problems in their detection.…”

Antibacterial Effect of Indian Gooseberry (Phyllanthus emblica L.) Extract Against ESBL Producing Multi-Drug Resistant Bacteria

“…The persistent exposure of bacteria to β-lactam agents induces active and continuous production and mutation of βlactamases in bacteria, and further expand their activity even against newly developed β-lactam antibiotics. These enzymes are known as extended-spectrum β-lactamases (ESBLs) [1,2]. These enzymes in bacteria hydrolyses the β-lactam antibiotics by opening of the β-lactam ring, making antibiotics inactive.…”