Unravelling AmpC Beta-Lactamases in Escherichia coli: Mechanisms, Resistance Patterns, and Implications for Diagnostic Strategies

Antibiotic resistance poses a global threat to public health in both humans and animals. Recently, attention has been focused on bacteria that produce Extended-spectrum Beta-lactamases (ESBL) or carbapenemases, rendering them resistant to commonly used antibiotics for severe infections. Escherichia coli, a common gut bacterium in humans, can develop resistance to antibiotics, including a mechanism known as AmpC Beta-lactamase. Currently, this specific resistance mechanism is not routinely tested for in the Netherlands, resulting in limited understanding of the current situation in the Netherlands.

This dissertation compiles several studies on AmpC Beta-lactamases in Escherichia coli. The research is aimed at laboratory methods for detecting this resistance mechanism and explores its prevalence among hospital patients. Furthermore, the genetic background of this resistance mechanism is studied to gain a deeper understanding of why the bacterium employs this mechanism. This research contributes to a more effective approach to antibiotic resistance and, as such, has direct implications for public health.