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first report of the emergence of ctx-m-type extended-spectrum beta-lactamases (esbls) as the predominant esbl isolated in a u.s. health care system.ctx-m-type extended-spectrum beta-lactamases (esbls) have become increasingly common worldwide, with the notable exception of the united states, where tem- and shv-type esbls have appeared to predominate. we have noted the emergence of esbls in our health care system (the university health system in san antonio, tx), especially in escherichia coli isolates, that preferentially hydrolyze cefotaxime rather than ceftazidime, suggesting the possibility of ctx-m-type enzymes. microbiology laboratory ...200717724160
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