Extended-spectrum beta-lactamases: implications for the clinical microbiology laboratory, therapy, and infection control

J Infect. 2003 Nov;47(4):273-95. doi: 10.1016/s0163-4453(03)00096-3.


Extended-spectrum beta-lactamase (ESBL) producing gram-negative bacilli are a growing concern in human medicine today. When producing these enzymes, organisms (mostly K. pneumoniae and E. coli) become highly efficient at inactivating the newer third-generation cephaloporins (such as cefotaxime, ceftazidime, and ceftriaxone). In addition, ESBL-producing bacteria are frequently resistant to many classes of non-beta-lactam antibiotics, resulting in difficult-to-treat infections. This review gives an introduction into the topic and is focused on various aspects of ESBLs; it covers the current epidemiology, the problems of ESBL detection and the clinical relevance of infections caused by ESBL-producing organisms. Therapeutic options and potential strategies for dealing with this growing problem are also discussed in this article.

Publication types

  • Review

MeSH terms

  • Gram-Negative Bacteria / drug effects*
  • Gram-Negative Bacteria / enzymology*
  • Gram-Negative Bacterial Infections / drug therapy*
  • Humans
  • Infection Control
  • Microbial Sensitivity Tests
  • Risk Factors
  • beta-Lactam Resistance / physiology
  • beta-Lactamases / physiology*
  • beta-Lactams / pharmacology*


  • beta-Lactams
  • beta-Lactamases