Surveillance review reveals the expansion of extended-spectrum beta-lactamases across European clinical cohorts, highlighting co-selection risks with other antimicrobial classes.
Key Points
To review the epidemiological shifts, molecular mechanisms, and resistance profiles driving the increasing dissemination of extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae across Europe.
Synthesized European surveillance and epidemiological data on ESBL-producing Enterobacteriaceae from 1983 onward.
Tracked trends in dominant bacterial pathogens, enzymatic families (TEM, SHV, CTX-M), plasmid transmission, and cross-resistance mechanisms across healthcare and community environments.
Identified a major epidemiological transition from nosocomial Klebsiella pneumoniae outbreaks driven by TEM and SHV enzymes to community-acquired Escherichia coli infections dominated by CTX-M enzymes.
Demonstrated that the spread of specific bacterial clones and epidemic plasmids carrying TEM, SHV, and CTX-M variants drives high-level dissemination, frequently amplified by co-selection with fluoroquinolone, aminoglycoside, and sulfonamide resistance.