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lüll The spread of CTX-M-type extended-spectrum beta-lactamases Rossolini GM; D'Andrea MM; Mugnaioli CClin Microbiol Infect 2008[Jan]; 14 Suppl 1 (ä): 33-41CTX-M-type enzymes are a group of class A extended-spectrum beta-lactamases (ESBLs) that are rapidly spreading among Enterobacteriaceae worldwide. More that 50 allotypes are known, clustered into six sub-lineages. The CTX-M-encoding genes have been captured from the chromosome of Kluyvera spp. on conjugative plasmids that mediate their dissemination among pathogenic enterobacteria. CTX-M-type ESBLs exhibit powerful activity against cefotaxime and ceftriaxone but generally not against ceftazidime, which has important implications for laboratory detection. However, several CTX-M variants with enhanced ceftazidimase activity have been detected. The rapid and massive spread of CTX-M-type ESBLs is rapidly changing the ESBL epidemiology and, in some geographical areas, these enzymes are now the most prevalent ESBLs in Enterobacteriaceae.|*beta-Lactam Resistance/genetics[MESH]|*beta-Lactamases/chemistry/genetics/metabolism[MESH]|Anti-Bacterial Agents/metabolism/*pharmacology[MESH]|Cefotaxime/metabolism/pharmacology[MESH]|Ceftazidime/metabolism/pharmacology[MESH]|Ceftriaxone/metabolism/pharmacology[MESH]|Cephalosporins/metabolism/*pharmacology[MESH]|Enterobacteriaceae Infections/*epidemiology/microbiology[MESH]|Enterobacteriaceae/drug effects/*enzymology/genetics[MESH]|Humans[MESH]|Models, Molecular[MESH]|Prevalence[MESH] |