Extraintestinal pathogenic Escherichia coli: an update on antimicrobial resistance, laboratory diagnosis and treatment

• Published in: Expert review of anti-infective therapy Vol. 10; no. 10; pp. 1165 - 1176
• Main Author: Pitout, Johann DD
• Format: Journal Article
• Language: English
• Published: England Informa Healthcare 01.10.2012; Taylor & Francis; Expert Reviews Ltd
• Subjects: Anti-Bacterial Agents - pharmacology; Anti-Bacterial Agents - therapeutic use; Antibiotics; Bacterial Proteins - genetics; Bacterial Proteins - metabolism; beta-Lactam Resistance; beta-Lactamases - genetics; beta-Lactamases - metabolism; carbapenemases; Care and treatment; Cephalosporins - pharmacology; Cephalosporins - therapeutic use; CTX-M-β-lactamases; Diagnosis; Drug resistance in microorganisms; Drug Resistance, Bacterial; Drug Resistance, Multiple, Bacterial; Escherichia coli; Escherichia coli - drug effects; Escherichia coli - enzymology; Escherichia coli - genetics; Escherichia coli - isolation & purification; Escherichia coli Infections - diagnosis; Escherichia coli Infections - drug therapy; Escherichia coli Proteins - genetics; Escherichia coli Proteins - metabolism; ExPEC; extraintestinal pathogenic Escherichia coli; Fluoroquinolones - pharmacology; Fluoroquinolones - therapeutic use; Health aspects; Humans; KPC; laboratory detection; Microbial Sensitivity Tests; NDM; OXA-48; plasmid-mediated AmpC β-lactamases; Risk factors; treatment options; Urinary tract infections
• ISSN: 1478-7210; 1744-8336
• DOI: 10.1586/eri.12.110

Escherichia coli remains one of the most frequent causes of nosocomial and community-acquired bacterial infections including urinary tract infections, enteric infections and systemic infections in humans. Extraintestinal pathogenic E. coli (ExPEC) had emerged during the 2000s as an important player in the resistance to antibiotics, especially to the cephalosporins and fluoroquinolones. Most importantly, among ExPEC is the increasing recognition of isolates producing 'newer β-lactamases' that consist of plasmid-mediated AmpC β-lactamases (e.g., CMY), extended-spectrum β-lactamases (e.g., CTX-M) and carbapenemases (e.g., New Delhi metallo-β-lactamase, Klebsiella pneumonaie carbapenemase and OXA-48). This review will highlight recent aspects on antimicrobial resistance in ExPEC, including the laboratory detection of these isolates, and describe some treatment options for infections due to antimicrobial-resistant isolates.