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      Extended-spectrum β-lactamase-producing Enterobacteriaceae: an emerging public-health concern

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      The Lancet Infectious Diseases

      Elsevier BV

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          Abstract

          The medical community relies on clinical expertise and published guidelines to assist physicians with choices in empirical therapy for system-based infectious syndromes, such as community-acquired pneumonia and urinary-tract infections (UTIs). From the late 1990s, multidrug-resistant Enterobacteriaceae (mostly Escherichia coli) that produce extended-spectrum beta lactamases (ESBLs), such as the CTX-M enzymes, have emerged within the community setting as an important cause of UTIs. Recent reports have also described ESBL-producing E coli as a cause of bloodstream infections associated with these community-onset UTIs. The carbapenems are widely regarded as the drugs of choice for the treatment of severe infections caused by ESBL-producing Enterobacteriaceae, although comparative clinical trials are scarce. Thus, more rapid diagnostic testing of ESBL-producing bacteria and the possible modification of guidelines for community-onset bacteraemia associated with UTIs are required.

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          Author and article information

          Journal
          The Lancet Infectious Diseases
          The Lancet Infectious Diseases
          Elsevier BV
          14733099
          March 2008
          March 2008
          : 8
          : 3
          : 159-166
          Article
          10.1016/S1473-3099(08)70041-0
          18291338
          © 2008

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