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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Redefining extended-spectrum β-lactamases: balancing science and clinical need</title><author><name sortKey="Giske, Christian G" sort="Giske, Christian G" uniqKey="Giske C" first="Christian G." last="Giske">Christian G. Giske</name><affiliation><nlm:aff id="af1"><addr-line>Clinical Microbiology</addr-line>,<institution>Karolinska University Hospital</institution>,<addr-line>Stockholm</addr-line>,<country>Sweden</country></nlm:aff></affiliation></author><author><name sortKey="Sundsfjord, Arnfinn S" sort="Sundsfjord, Arnfinn S" uniqKey="Sundsfjord A" first="Arnfinn S." last="Sundsfjord">Arnfinn S. Sundsfjord</name><affiliation><nlm:aff id="af2"><addr-line>Department of Microbiology and Infection Control</addr-line>,<institution>University Hospital of Northern Norway</institution>,<country>Norway</country></nlm:aff></affiliation><affiliation><nlm:aff id="af3"><addr-line>Section for Microbiology and Virology, Department of Medical Biology</addr-line>,<institution>University of Tromsø</institution>,<addr-line>Tromsø</addr-line>,<country>Norway</country></nlm:aff></affiliation></author><author><name sortKey="Kahlmeter, Gunnar" sort="Kahlmeter, Gunnar" uniqKey="Kahlmeter G" first="Gunnar" last="Kahlmeter">Gunnar Kahlmeter</name><affiliation><nlm:aff id="af4"><addr-line>Department of Clinical Microbiology</addr-line>,<institution>Central Hospital</institution>,<addr-line>Växjö</addr-line>,<country>Sweden</country></nlm:aff></affiliation></author><author><name sortKey="Woodford, Neil" sort="Woodford, Neil" uniqKey="Woodford N" first="Neil" last="Woodford">Neil Woodford</name><affiliation><nlm:aff id="af5"><addr-line>Antibiotic Resistance Monitoring and Reference Laboratory</addr-line>,<institution>Centre for Infections, Health Protection Agency</institution>,<addr-line>London</addr-line>,<country>UK</country></nlm:aff></affiliation></author><author><name sortKey="Nordmann, Patrice" sort="Nordmann, Patrice" uniqKey="Nordmann P" first="Patrice" last="Nordmann">Patrice Nordmann</name><affiliation><nlm:aff id="af6"><addr-line>Service de Bactériologie-Virologie</addr-line>,<institution>Hôpital de Bicêtre, Assistance Publique-Hôpitaux de Paris, Faculté de Médecine, Université Paris-Sud</institution>,<country>France</country></nlm:aff></affiliation></author><author><name sortKey="Paterson, David L" sort="Paterson, David L" uniqKey="Paterson D" first="David L." last="Paterson">David L. Paterson</name><affiliation><nlm:aff id="af7"><institution>University of Queensland Centre for Clinical Research and Royal Brisbane and Women's Hospital</institution>,<addr-line>Brisbane</addr-line>,<country>Australia</country></nlm:aff></affiliation></author><author><name sortKey="Cant N, Rafael" sort="Cant N, Rafael" uniqKey="Cant N R" first="Rafael" last="Cant N">Rafael Cant N</name><affiliation><nlm:aff id="af8"><addr-line>Servicio de Microbiología</addr-line>,<institution>Hospital Universitario Ramón y Cajal</institution>,<addr-line>Madrid</addr-line>,<country>Spain</country></nlm:aff></affiliation></author><author><name sortKey="Walsh, Timothy R" sort="Walsh, Timothy R" uniqKey="Walsh T" first="Timothy R." last="Walsh">Timothy R. Walsh</name><affiliation><nlm:aff id="af9"><addr-line>School of Medicine</addr-line>,<institution>Cardiff University</institution>,<addr-line>Cardiff, Wales</addr-line>,<country>UK</country></nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">18957393</idno><idno type="pmc">2721700</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2721700</idno><idno type="RBID">PMC:2721700</idno><idno type="doi">10.1093/jac/dkn444</idno><date when="2008">2008</date><idno type="wicri:Area/Pmc/Corpus">001906</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">001906</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Redefining extended-spectrum β-lactamases: balancing science and clinical need</title><author><name sortKey="Giske, Christian G" sort="Giske, Christian G" uniqKey="Giske C" first="Christian G." last="Giske">Christian G. Giske</name><affiliation><nlm:aff id="af1"><addr-line>Clinical Microbiology</addr-line>,<institution>Karolinska University Hospital</institution>,<addr-line>Stockholm</addr-line>,<country>Sweden</country></nlm:aff></affiliation></author><author><name sortKey="Sundsfjord, Arnfinn S" sort="Sundsfjord, Arnfinn S" uniqKey="Sundsfjord A" first="Arnfinn S." last="Sundsfjord">Arnfinn S. Sundsfjord</name><affiliation><nlm:aff id="af2"><addr-line>Department of Microbiology and Infection Control</addr-line>,<institution>University Hospital of Northern Norway</institution>,<country>Norway</country></nlm:aff></affiliation><affiliation><nlm:aff id="af3"><addr-line>Section for Microbiology and Virology, Department of Medical Biology</addr-line>,<institution>University of Tromsø</institution>,<addr-line>Tromsø</addr-line>,<country>Norway</country></nlm:aff></affiliation></author><author><name sortKey="Kahlmeter, Gunnar" sort="Kahlmeter, Gunnar" uniqKey="Kahlmeter G" first="Gunnar" last="Kahlmeter">Gunnar Kahlmeter</name><affiliation><nlm:aff id="af4"><addr-line>Department of Clinical Microbiology</addr-line>,<institution>Central Hospital</institution>,<addr-line>Växjö</addr-line>,<country>Sweden</country></nlm:aff></affiliation></author><author><name sortKey="Woodford, Neil" sort="Woodford, Neil" uniqKey="Woodford N" first="Neil" last="Woodford">Neil Woodford</name><affiliation><nlm:aff id="af5"><addr-line>Antibiotic Resistance Monitoring and Reference Laboratory</addr-line>,<institution>Centre for Infections, Health Protection Agency</institution>,<addr-line>London</addr-line>,<country>UK</country></nlm:aff></affiliation></author><author><name sortKey="Nordmann, Patrice" sort="Nordmann, Patrice" uniqKey="Nordmann P" first="Patrice" last="Nordmann">Patrice Nordmann</name><affiliation><nlm:aff id="af6"><addr-line>Service de Bactériologie-Virologie</addr-line>,<institution>Hôpital de Bicêtre, Assistance Publique-Hôpitaux de Paris, Faculté de Médecine, Université Paris-Sud</institution>,<country>France</country></nlm:aff></affiliation></author><author><name sortKey="Paterson, David L" sort="Paterson, David L" uniqKey="Paterson D" first="David L." last="Paterson">David L. Paterson</name><affiliation><nlm:aff id="af7"><institution>University of Queensland Centre for Clinical Research and Royal Brisbane and Women's Hospital</institution>,<addr-line>Brisbane</addr-line>,<country>Australia</country></nlm:aff></affiliation></author><author><name sortKey="Cant N, Rafael" sort="Cant N, Rafael" uniqKey="Cant N R" first="Rafael" last="Cant N">Rafael Cant N</name><affiliation><nlm:aff id="af8"><addr-line>Servicio de Microbiología</addr-line>,<institution>Hospital Universitario Ramón y Cajal</institution>,<addr-line>Madrid</addr-line>,<country>Spain</country></nlm:aff></affiliation></author><author><name sortKey="Walsh, Timothy R" sort="Walsh, Timothy R" uniqKey="Walsh T" first="Timothy R." last="Walsh">Timothy R. Walsh</name><affiliation><nlm:aff id="af9"><addr-line>School of Medicine</addr-line>,<institution>Cardiff University</institution>,<addr-line>Cardiff, Wales</addr-line>,<country>UK</country></nlm:aff></affiliation></author></analytic><series><title level="j">Journal of Antimicrobial Chemotherapy</title><idno type="ISSN">0305-7453</idno><idno type="eISSN">1460-2091</idno><imprint><date when="2008">2008</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>The current β-lactamase classifications have reached a high level of complexity, making them less accessible to clinicians, infection control professionals, hospital management and politicians. From the clinical perspective, a revised comprehensible nomenclature scheme is therefore needed. The term extended-spectrum β-lactamases (ESBLs) has reached a broader audience over time, but is currently restricted to functional class 2be/molecular class A, clavulanic acid inhibited enzymes with activity against extended-spectrum cephalosporins. The proposed new classification expands the definition of ESBL to other clinically important acquired β-lactamases with activity against extended-spectrum cephalosporins and/or carbapenems. The classical class A ESBLs have been designated ESBL<sub>A</sub> in this classification, whereas plasmid-mediated AmpC and OXA-ESBLs are classed as miscellaneous ESBLs (ESBL<sub>M</sub>). Lastly, the carbapenemases have been designated ESBL<sub>CARBA</sub>, ESBLs with hydrolytic activity against carbapenems. We believe that this simplified classification may encourage new groups of healthcare professionals to engage in the effort to prevent the spread of acquired β-lactamases.</p></div></front></TEI><pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<front><journal-meta><journal-id journal-id-type="nlm-ta">J Antimicrob Chemother</journal-id><journal-id journal-id-type="publisher-id">jac</journal-id><journal-id journal-id-type="hwp">jac</journal-id><journal-title-group><journal-title>Journal of Antimicrobial Chemotherapy</journal-title></journal-title-group><issn pub-type="ppub">0305-7453</issn><issn pub-type="epub">1460-2091</issn><publisher><publisher-name>Oxford University Press</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">18957393</article-id><article-id pub-id-type="pmc">2721700</article-id><article-id pub-id-type="doi">10.1093/jac/dkn444</article-id><article-id pub-id-type="publisher-id">dkn444</article-id><article-categories><subj-group subj-group-type="heading"><subject>Leading Articles</subject></subj-group></article-categories><title-group><article-title>Redefining extended-spectrum β-lactamases: balancing science and clinical need</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Giske</surname><given-names>Christian G.</given-names></name><xref ref-type="aff" rid="af1">1</xref><xref ref-type="corresp" rid="cor1">*</xref></contrib><contrib contrib-type="author"><name><surname>Sundsfjord</surname><given-names>Arnfinn S.</given-names></name><xref ref-type="aff" rid="af2">2</xref><xref ref-type="aff" rid="af3">3</xref></contrib><contrib contrib-type="author"><name><surname>Kahlmeter</surname><given-names>Gunnar</given-names></name><xref ref-type="aff" rid="af4">4</xref></contrib><contrib contrib-type="author"><name><surname>Woodford</surname><given-names>Neil</given-names></name><xref ref-type="aff" rid="af5">5</xref></contrib><contrib contrib-type="author"><name><surname>Nordmann</surname><given-names>Patrice</given-names></name><xref ref-type="aff" rid="af6">6</xref></contrib><contrib contrib-type="author"><name><surname>Paterson</surname><given-names>David L.</given-names></name><xref ref-type="aff" rid="af7">7</xref></contrib><contrib contrib-type="author"><name><surname>Cantón</surname><given-names>Rafael</given-names></name><xref ref-type="aff" rid="af8">8</xref></contrib><contrib contrib-type="author"><name><surname>Walsh</surname><given-names>Timothy R.</given-names></name><xref ref-type="aff" rid="af9">9</xref></contrib></contrib-group><aff id="af1"><label>1</label><addr-line>Clinical Microbiology</addr-line>,<institution>Karolinska University Hospital</institution>,<addr-line>Stockholm</addr-line>,<country>Sweden</country></aff><aff id="af2"><label>2</label><addr-line>Department of Microbiology and Infection Control</addr-line>,<institution>University Hospital of Northern Norway</institution>,<country>Norway</country></aff><aff id="af3"><label>3</label><addr-line>Section for Microbiology and Virology, Department of Medical Biology</addr-line>,<institution>University of Tromsø</institution>,<addr-line>Tromsø</addr-line>,<country>Norway</country></aff><aff id="af4"><label>4</label><addr-line>Department of Clinical Microbiology</addr-line>,<institution>Central Hospital</institution>,<addr-line>Växjö</addr-line>,<country>Sweden</country></aff><aff id="af5"><label>5</label><addr-line>Antibiotic Resistance Monitoring and Reference Laboratory</addr-line>,<institution>Centre for Infections, Health Protection Agency</institution>,<addr-line>London</addr-line>,<country>UK</country></aff><aff id="af6"><label>6</label><addr-line>Service de Bactériologie-Virologie</addr-line>,<institution>Hôpital de Bicêtre, Assistance Publique-Hôpitaux de Paris, Faculté de Médecine, Université Paris-Sud</institution>,<country>France</country></aff><aff id="af7"><label>7</label><institution>University of Queensland Centre for Clinical Research and Royal Brisbane and Women's Hospital</institution>,<addr-line>Brisbane</addr-line>,<country>Australia</country></aff><aff id="af8"><label>8</label><addr-line>Servicio de Microbiología</addr-line>,<institution>Hospital Universitario Ramón y Cajal</institution>,<addr-line>Madrid</addr-line>,<country>Spain</country></aff><aff id="af9"><label>9</label><addr-line>School of Medicine</addr-line>,<institution>Cardiff University</institution>,<addr-line>Cardiff, Wales</addr-line>,<country>UK</country></aff><author-notes><corresp id="cor1"><label>*</label>Corresponding author. Tel: <phone>+46-8-517-73574</phone>; Fax: <fax>+46-8-30-8099</fax>; E-mail: <email>christian.giske@karolinska.se</email></corresp></author-notes><pub-date pub-type="ppub"><month>1</month><year>2009</year></pub-date><pub-date pub-type="epub"><day>28</day><month>10</month><year>2008</year></pub-date><volume>63</volume><issue>1</issue><fpage>1</fpage><lpage>4</lpage><permissions><copyright-statement>© The Author 2008. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org</copyright-statement></permissions><abstract><p>The current β-lactamase classifications have reached a high level of complexity, making them less accessible to clinicians, infection control professionals, hospital management and politicians. From the clinical perspective, a revised comprehensible nomenclature scheme is therefore needed. The term extended-spectrum β-lactamases (ESBLs) has reached a broader audience over time, but is currently restricted to functional class 2be/molecular class A, clavulanic acid inhibited enzymes with activity against extended-spectrum cephalosporins. The proposed new classification expands the definition of ESBL to other clinically important acquired β-lactamases with activity against extended-spectrum cephalosporins and/or carbapenems. The classical class A ESBLs have been designated ESBL<sub>A</sub> in this classification, whereas plasmid-mediated AmpC and OXA-ESBLs are classed as miscellaneous ESBLs (ESBL<sub>M</sub>). Lastly, the carbapenemases have been designated ESBL<sub>CARBA</sub>, ESBLs with hydrolytic activity against carbapenems. We believe that this simplified classification may encourage new groups of healthcare professionals to engage in the effort to prevent the spread of acquired β-lactamases.</p></abstract><kwd-group><title>Keywords</title><kwd>classification</kwd><kwd>ESBLs</kwd><kwd>metallo-β-lactamases</kwd><kwd>OXA</kwd><kwd>KPC</kwd></kwd-group></article-meta></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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