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Antibiotic-resistant organisms: three powerful screening tests for ESBLs, VRE and MRSA

Recently, measures have been introduced which aim to combat the spread of hospital-acquired infections. Now, Oxoid’s range of Brilliance chromogenic media has been extended to complement the very latest infection control procedures.

April this year saw the introduction of routine methicillin-resistant Staphylococcus aureus (MRSA) screening of all elective admissions in English hospitals, a measure that aims to reduce the incidence of MRSA, thus saving lives and reducing costs associated with the infection. Although MRSA is the most notable healthcare-associated infection, new dangers as serious as or potentially more serious than MRSA are on the horizon. Extended-spectrum beta-lactamase (ESBL)-producing organisms and vancomycin-resistant enterococci (VRE) are increasingly causing concern worldwide as antibiotic resistant organisms. To accompany Brilliance MRSA agar, two new chromogenic media – Brilliance ESBL and Brilliance VRE – have been added to the Oxoid Brilliance resistance screening range, providing microbiologists with quick and easy screening tests for all three problematic organisms.
 
ESBL-producing organisms
Extended-spectrum beta-lactamases are enzymes that are able to hydrolyse third- and fourth-generation cephalosporins but which may be inhibited by clavulanic acid. Unlike MRSA or VRE, the resistance mechanisms of ESBLs are not limited to one or even two species but rather a whole family of organisms, the Enterobacteriaceae.

Enterobacteriaceae have become one of the most important causes of nosocomial and community-acquired infections. The main therapeutic choices to treat such infections are ?-lactam antibiotics (mainly broad-spectrum penicillins and cephalosporins); however, ESBLs confer resistance to these compounds.

The presence of an infection caused by an ESBL-producing Enterobacteriaceae severely limits treatment options. In addition, ESBL resistance genes are encoded on freely transmissible genetic elements, greatly increasing the risk of spread to other organisms. This lack of treatment options, combined with the transmissible nature of ESBL resistance mechanisms and the alarming rate at which they have spread, results in a significant threat to global public health.

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