Global epidemiology of CTX-M β-lactamases: temporal and geographical shifts in genotype

Edward Bevan, Annie M. Jones, Peter Hawkey

Research output: Contribution to journalReview articlepeer-review

230 Citations (Scopus)


Globally, rates of ESBL-producing Enterobacteriaceae are rising. We undertook a literature review, and present the temporal trends in blaCTX-M epidemiology, showing that blaCTX-M-15 and blaCTX-M-14 have displaced other genotypes in many parts of the world. Explanations for these changes can be attributed to: (i) horizontal gene transfer (HGT) of plasmids; (ii) successful Escherichia coli clones; (iii) ESBLs in food animals; (iv) the natural environment; and (v) human migration and access to basic sanitation. We also provide explanations for the changing epidemiology of blaCTX-M-2 and blaCTX-M-27. Modifiable anthropogenic factors, such as poor access to basic sanitary facilities, encourage the spread of blaCTX-M and other antimicrobial resistance (AMR) genes, such as blaNDM, blaKPC and mcr-1. We provide further justification for novel preventative and interventional strategies to reduce transmission of these AMR genes.

Original languageEnglish
Pages (from-to)2145-2155
Number of pages11
JournalJournal of Antimicrobial Chemotherapy
Issue number8
Early online date25 May 2017
Publication statusPublished - 1 Aug 2017


  • Animals
  • Disease Transmission, Infectious
  • Enterobacteriaceae/enzymology
  • Enterobacteriaceae Infections/epidemiology
  • Gene Transfer, Horizontal
  • Genotype
  • Global Health
  • Humans
  • Molecular Epidemiology
  • Phylogeography
  • Spatio-Temporal Analysis
  • beta-Lactamases/genetics


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