Monografias de Especialização
Beta-lactamases de espectro ampliado (ESBL) produzido por enterobactérias: mecanismo de ação, diagnóstico e controle
Fecha
2015-03-16Autor
Ailton Antônio da Silva
Institución
Resumen
The antimicrobial resistance has increased in Brazil and wordwide in the last years. The extended spectrum beta-lactamases (ESBL) is an important mechanism among a great variety of resistance mechanisms. This study is aimed to describe the ESBL resistance mechanism, phenotypic detection methods for epidemiology, and measures for control and prevention of multidrug-resistance bacteria dissemination. This paper aims to describe the ESBL 's resistance mechanism, present phenotypic detection methods for epidemiological purposes and control measures to prevent the spread of multidrug-resistant bacteria. The extended spectrum beta-lactamases (ESBL) produced by Gram negative rods (mainly Klebsiella pneumoniae and Escherichia coli) become highly effective in inactivating penicillins, cephalosporins and monobactans. Moreover, ESBL-producing Enterobacteriaceae are often resistant to multiple classes of non-beta-lactam antibiotics impairing the infections treatment. Phenotypic tests for ESBL detection as a proxy discs, Etest, combined disk can be still used for epidemiological studies. The CLSI 2014 established new breakpoints considering the pharmacokinetic and pharmacodynamics properties based on specific doses. The results should be reported in the antibiogram reports as tested and not edited for resistant as was done previously. To prevent transmission of infectious agents in the hospital is recommended by ANVISA control measures. They must be clear and available for health professionals.