Peterson L R
Department of Pathology and Laboratory Medicine, Division of Clinical Microbiology, and Department of Medicine, Division of Infectious Diseases, Evanston Northwestern Healthcare and Northwestern University, Evanston, IL 60201,USA.
Clin Microbiol Infect. 2008 Jan;14 Suppl 1:181-4. doi: 10.1111/j.1469-0691.2007.01864.x.
Therapy of infections caused by extended-spectrum beta-lactamase (ESBL)-producing bacteria with an antimicrobial to which they are resistant results in treatment failure, higher cost and increased mortality. The CLSI recommends reporting ESBL-producing strains of Escherichia coli, Klebsiella spp. and Proteus spp. as resistant to all penicillin, true cephalosporin and monobactam antimicrobials, but as susceptible to beta-lactam-beta-lactamase inhibitor combinations, including piperacillin-tazobactam, when they test as such. Current literature supports the action of piperacillin-tazobactam against susceptible strains of ESBL-producing bacteria based on the structure-activity relationship between inhibitors and the ESBLs, as well as on recent clinical outcome studies.
使用对产超广谱β-内酰胺酶（ESBL）细菌耐药的抗菌药物治疗此类细菌引起的感染会导致治疗失败、成本增加和死亡率上升。临床和实验室标准协会（CLSI）建议，对于产ESBL的大肠埃希菌、克雷伯菌属和变形杆菌属菌株，若其药敏试验结果如此，则应报告为对所有青霉素、真正的头孢菌素和单环β-内酰胺类抗菌药物耐药，但对β-内酰胺-β-内酰胺酶抑制剂复方制剂敏感，包括哌拉西林-他唑巴坦。基于抑制剂与ESBL之间的构效关系以及近期的临床疗效研究，当前文献支持哌拉西林-他唑巴坦对产ESBL细菌敏感菌株的作用。
