Beta-Lactamase Production among Uropathogens: An Overview of Consistent Triggers and Current Epidemiological Scenario

The natural process of acquiring antibiotic resistance by micro-organisms is a gradual phenomenon. However, the rampant and indiscriminative usage of antibiotics have profusely accelerated this process and laid a profound impact in the world of infectious diseases. Common infections like urinary tract infections, which were once regarded as harmless and non-complicated diseases, have now emerged in its most dreadful form due to increasing evidence of antibiotic resistance among pathogens. This unpleasant scenario is further alleviated with the help of β-lactam antibiotic hydrolysing enzymes such as Extended Spectrum β-lactamases (ESBLs) and Metallo β-lactamases (MBLs). Since β-lactam antibiotics are still widely used, the emergence of β-lactamase producers has become a matter of serious concern. ESBL enzymes that were first identified in the 1980s have now spread throughout the world, especially by nosocomial routes. In most cases, carbapenems are considered as agents of last resort antibiotics for the treatment of infections due to ESBL producers. However, with its increased and sometimes unnecessary use, we have actually triggered the resistant mechanisms against these antibiotics leading to the emergence of carbapenemase producers. Due to such continuous evolution of antibiotic resistance, regular monitoring of the same has become extremely necessary. A study of the general pattern of antibiotic resistance in a community may improve predictions of their susceptibilities which will be helpful in implementing treatment measures in emergency situations and during epidemics.
Considering the problem of evolving antibiotic resistance, this review article highlights the problems associated with β-lactamase producers, its molecular complexity and facilitated transferability that has together led to its enduring success