II. Pathophysiology: General
-
Enterobacteriaceae are Facultative Anaerobic Gram Negative Rods and are common human pathogens
- Cause Meningitis, Pneumonia, peritonitis, cystitis and other bacteremia
-
Enterobacteriaceae are grouped into subtypes
- EKP: Escherichia coli, Klebsiella, Proteus
- ESP: Enterobacter (Aerobacter), Serratia, Providencia (often grouped with Proteus)
- SS: Salmonella, Shigella
- Other: Citrobacter (Escherichia freundii), Morganella, Yersinia, Erwinia
- ESBL (Extended-Spectrum Beta-Lactamase) Producing Enterobacteriaceae
- ESBL Bacteria produce enzymes to inactivate Penicillins, Cephalosporins and Aztreonam
- Resistance to Ceftriaxone is typically used as a marker of ESBL producing organisms
- Organisms most commonly found to be ESBL producers (EKP Enterobacteriaceae)
- Escherichia coli
- KlebsiellaPneumoniae
- Klebsiella oxytoca
- Proteus mirabilis
III. Management
- Antibiotic selection is based on culture sensitivities
-
Antibiotics that typically maintain activity against
- Carbapenems
- Trimethoprim-Sulfamethoxazole