Broad-spectrum β-lactamase in Enterobacteriaceae: detection, prevalence, and source tracking

Enterobacteriaceae can cause a wide variety of infections ranging from gastrointestinal syndromes to urinary tract infections. These infections have significant mortality rates. Many classes of antibiotics are used to treat these infections. In particular, third-generation cephalosporins are used as part of empiric treatment world-wide in case of severe infections that may be caused by Enterobacteriaceae. The emergence of multi-resistant Enterobacteriaceae, especially those carrying extended-spectrum beta-lactamases (ESBLs) and carbapenemases pose a threat to public health. In chapter 2, 3, and 4 new new detection methods of ESBLs are described. In chapter 5 a bacterial typing method is evaluated. In chapter 6 are the previously described techniques, among others, used to detect the prevalence of ESBLs in the Netherlands. In chapter 7 and 8 the possibility of poultry and poultry meat as a source for humans for ESBL bacteria is investigated.