Lucet J C, Régnier B
Unité d'Hygiène et de Lutte contre l'Infection Nosocomiale, Hôpital Bichat-Claude Bernard, Paris, France.
Pathol Biol (Paris). 1998 Apr;46(4):235-43.
Extended-spectrum beta-lactamases (ESBL) were first observed in 1983. Since then, the number and variety of ESBLs have increased rapidly, particularly in France, and their distribution is now worldwide. The number of ESBLs has now reached more than 30, some of them spreading largely in several countries, such as SHV-4 in France. Intensive care units were first involved. Patients from nursing homes may recirculate ESBLs into acute care units. ESBL clinical epidemiology does not differ from other enterobacteriaceae. Digestive tract is the main reservoir, hands are the route of transmission. Infection develops in about 50% of colonized patients, more than one-half being urinary tract infections. Risk factors for colonization or infection are length of exposure to an epidemic strain and frequency of health-care-worker contact. Strategies for containing spreading of ESBL-producing strains include use of barrier precautions for carriers. Judicious use of antimicrobial agents is also important, by decreasing antibiotic selective pressure.
超广谱β-内酰胺酶（ESBL）于1983年首次被发现。从那时起，ESBL的数量和种类迅速增加，尤其是在法国，现在其分布已遍及全球。目前ESBL的数量已超过30种，其中一些在多个国家广泛传播，例如法国的SHV-4。重症监护病房最早受到影响。疗养院的患者可能会将ESBL传播到急症护理病房。ESBL的临床流行病学与其他肠杆菌科细菌并无不同。消化道是主要储存库，手是传播途径。约50%的定植患者会发生感染，其中一半以上是尿路感染。定植或感染的危险因素是接触流行菌株的时间长短和医护人员接触的频率。控制产ESBL菌株传播的策略包括对携带者采取屏障预防措施。通过降低抗生素选择压力，明智地使用抗菌药物也很重要。
