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The epidemiology and molecular evolution of the CTX-M beta-lactamases

Hawkey, Peter Michael (2017)
Ph.D. thesis, University of Birmingham.

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The widespread usage of extended spectrum cephalosporins in the 1980s led to the emergence of β-lactamases capable of destroying them. Extended spectrum β-lactamases (ESBL) are the most common β-lactamases in some parts of the world and represent a pandemic of CTX-M ESBLs. Work examining the epidemiology and distribution of specific genotypes both in the UK and across the world particularly in China and India is presented. The faecal carriage by humans and dispersal into the environment is described. The environment and release of CTX-M producing Enterobacteriaceae into the environment following sewage treatment is reported and that arising from fish and poultry production. The work describes the isolation and characterization of the second most important CTX-M genotype (CTX-M-14) and the development of novel methods for the characterisation of genotypes. The publications were important in the recognition of the significance of CTX-M and drew attention to the characteristic genotype distribution around the world. The importance of faecal carriage as a dispersion mechanism and the association of specific genotypes with ethnic groups was a novel finding. The work also was the first to genotype ESBLs in India identifying that CTXM-15 was the only CTX-M genotype carried by one of the world's largest populations.

Type of Work:Ph.D. thesis.
Supervisor(s):Henderson, Ian
School/Faculty:Colleges (2008 onwards) > College of Medical & Dental Sciences
Department:Institute of Microbiology
Additional Information:

Please note: This is a PhD by prior publication. Some articles have been redacted from the electronic version of this thesis, DOIs and abstracts for each article remain in the electronic version.
To view thesis without redactions please consult the hardbound copy of this thesis which is available as a reference only item in the library.

Subjects:QR Microbiology
RA0421 Public health. Hygiene. Preventive Medicine
Institution:University of Birmingham
ID Code:7268
This unpublished thesis/dissertation is copyright of the author and/or third parties. The intellectual property rights of the author or third parties in respect of this work are as defined by The Copyright Designs and Patents Act 1988 or as modified by any successor legislation. Any use made of information contained in this thesis/dissertation must be in accordance with that legislation and must be properly acknowledged. Further distribution or reproduction in any format is prohibited without the permission of the copyright holder.
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