Medical Journal of Peking Union Medical College Hospital 2025;16(5):1102-1119
doi:10.12290/xhyxzz.2025-0494
Expert Consensus on Clinical Management Strategies for Infections Caused by Extended-Spectrum β-Lactamase-Producing Enterobacterales(2025)
Chao ZHUO
1
;
Yingchun XU
2
;
Yunsong YU
3
Affiliations
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1. Department of Infectious Diseases, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China;
2. Department of Clinical Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China;
3. Department of Infectious Diseases, Zhejiang Provincial People's Hospital, Hangzhou 310014, China;
Keywords
extended-spectrum β-lactamase;
ESBL-producing Enterobacterales;
antimicrobial agents;
targeted therapy;
stratified treatment;
consensus
Abstract
Enterobacterales are important pathogens responsible for hospital-acquired infections and can cause various severe infectious diseases. Since their first report, extended-spectrum β-lactamase-producing Enterobacterales(ESBL-E) have become widely prevalent worldwide. These strains often exhibit multidrug resistance, significantly increasing the risk of treatment failure and patient mortality. In China, the prevention and control of ESBL-E face numerous challenges, including high prevalence rates, significant regional distribution disparities, uneven laboratory testing capabilities, and variations in antimicrobial stewardship and prescribing practices. To address these issues, Professors Zhuo Chao, Xu Yingchun and Yu Yunsong initiated the developmentof the Expert Consensus on Clinical Management Strategies for Infections Caused by Extended-Spectrum β-Lactamase-Producing Enterobacterales (2025), in collaboration with multidisciplinary experts. This consensus systematically reviews the global and domestic epidemiological characteristics of ESBL-E, clinical laboratory detection techniques, treatment principles and key therapeutic agents, as well as infection prevention and control measures. Furthermore, it elaborates on the microbiological features and stratified treatment strategies for different infection sources (including bloodstream infections, intracranial infections, respiratory and mediastinal infections, intra-abdominal infections, and urinary tract infections) and special populations (such as neutropenic patients with fever, emergency patients, and pediatric patients). The consensus aims to enhance the detection capacity of clinical laboratories for ESBL-E, standardize diagnosis and treatment strategies in healthcare settings, and provide scientific guidance to curb the spread of ESBL-E in China, thereby reducing associated morbidity and mortality.