• See Also
  1. Enterobacteriaceae
  • Pathophysiology
  • General
  1. Enterobacteriaceae are Facultative Anaerobic Gram Negative Rods and are common human pathogens
    1. Cause Meningitis, Pneumonia, peritonitis, cystitis and other bacteremia
  2. Enterobacteriaceae are grouped into subtypes
    1. EKP: Escherichia coli, Klebsiella, Proteus
    2. ESP: Enterobacter (Aerobacter), Serratia, Providencia (often grouped with Proteus)
    3. SS: Salmonella, Shigella
    4. Other: Citrobacter (Escherichia freundii), Morganella, Yersinia, Erwinia
  3. ESBL (Extended-Spectrum Beta-Lactamase) Producing Enterobacteriaceae
    1. ESBL Bacteria produce enzymes to inactivate Penicillins, Cephalosporins and Aztreonam
    2. Resistance to Ceftriaxone is typically used as a marker of ESBL producing organisms
    3. Organisms most commonly found to be ESBL producers (EKP Enterobacteriaceae)
      1. Escherichia coli
      2. Klebsiella Pneumoniae
      3. Klebsiella oxytoca
      4. Proteus Mirabilis
  • Management
  1. Antibiotic selection is based on culture sensitivities
  2. Antibiotics that typically maintain activity against ESBL:
    1. Carbapenems
    2. Trimethoprim-Sulfamethoxazole
    3. Fluoroquinolones (Antibiotic Resistance increasing)
    4. Ceftolozane and Tazobactam
  • References
  1. Tamma (2023) Clin Infect Dis +PMID: 37463564 [PubMed]