Prevalence and spread of extended-spectrum beta-lactamase-producing Enterobacteriaceae in Europe

Clin Microbiol Infect. 2008 Jan;14 Suppl 1:144-53. doi: 10.1111/j.1469-0691.2007.01850.x.


Extended-spectrum beta-lactamases (ESBLs) represent a major threat among resistant bacterial isolates. The first types described were derivatives of the TEM-1, TEM-2 and SHV-1 enzymes during the 1980s in Europe, mainly in Klebsiella pneumoniae associated with nosocomial outbreaks. Nowadays, they are mostly found among Escherichia coli isolates in community-acquired infections, with an increasing occurrence of CTX-M enzymes. The prevalence of ESBLs in Europe is higher than in the USA but lower than in Asia and South America. However, important differences among European countries have been observed. Spread of mobile genetic elements, mainly epidemic plasmids, and the dispersion of specific clones have been responsible for the increase in ESBL-producing isolates, such as those with TEM-4, TEM-24, TEM-52, SHV-12, CTX-M-9, CTX-M-14, CTX-M-3, CTX-M-15 and CTX-M-32 enzymes.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Carrier State / epidemiology
  • Carrier State / microbiology
  • Carrier State / transmission
  • Community-Acquired Infections / epidemiology
  • Community-Acquired Infections / microbiology
  • Community-Acquired Infections / transmission
  • Cross Infection / epidemiology
  • Cross Infection / microbiology
  • Cross Infection / transmission
  • DNA Transposable Elements / genetics
  • Drug Resistance, Multiple, Bacterial
  • Enterobacteriaceae / classification
  • Enterobacteriaceae / drug effects*
  • Enterobacteriaceae / enzymology*
  • Enterobacteriaceae / genetics
  • Enterobacteriaceae Infections / epidemiology*
  • Enterobacteriaceae Infections / microbiology
  • Enterobacteriaceae Infections / transmission*
  • Europe / epidemiology
  • Humans
  • Plasmids / genetics
  • Prevalence
  • beta-Lactamases / biosynthesis
  • beta-Lactamases / classification*
  • beta-Lactamases / genetics*


  • DNA Transposable Elements
  • beta-Lactamases