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JournalofAntimicrobialChemotherapy(2005)56,451–454
doi:10.1093/jac/dki239
AdvanceAccesspublication8July2005
CTX-M:changingthefaceofESBLsintheUK
D.M.Livermore1andP.M.Hawkey2,3*
1AntibioticResistanceMonitoringandReferenceLaboratory,CentreforInfections,HealthProtectionAgency,
61ColindaleAvenue,LondonNW95HT,UK;2DivisionofImmunityandInfection,UniversityofBirmingham,
BirminghamB152TT,UK;3HealthProtectionAgencyWestMidlandsPublicHealthLaboratory,
BirminghamHeartlandsandSolihullNHSTrust,BordesleyGreenEast,BirminghamB95SS,UK
TheUKhasexperiencedasuddenriseinextended-spectrumb-lactamase(ESBL)rates,largelyduetothe
appearanceandspreadofEscherichiacoliproducingCTX-M-15typeb-lactamase.TheBritishSocietyfor
AntimicrobialChemotherapyorganizedtwoupdatemeetingsduring2004toreportanddiscusstherecog-
nition,clinicaldiagnosis,treatmentandcontrolofbacteriaproducingtheseb-lactamases.Thispaper
reportsthedataandreviewsmadebycontributorstotheconferences.Thehistoricaldistributionand
emergenceofESBLswasreviewedalongwiththeemergenceofplasmid-mediatedCTX-MESBLsfollowing
theirmobilizationfromthechromosomeofKluyveraspp.ThefirstsignificantoutbreakofCTX-Mproducers
intheUKoccurredin2001andinvolvedKlebsiellapneumoniaewithCTX-M-26atonesite,butby2003,
clonedanddiverseE.coliwithCTX-M-15werewidespread,withShropshireoneofthemostaffected
regions.ThespecificexperienceinShropshirewasreportedonandacomprehensivereviewmadeof
thelevelofawarenessoftheneedforESBLdetectioninlaboratoriesinEnglandandWales,together
with
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