Extended Spectrum Betalactamase Research mapping; a 32-year Temporal and geographical perspective.

Abstract Background β-lactam inactivating enzymes like Extended Spectrum β-lactamases (ESBL) have been the focus of the scientific community for decades. The current study assesses the scientific focus on ESBLs based on the temporal succession of ESBL producing pathogens, ESBL types, the blaESBL gene, antibacterial agents, co-existence of resistance determinants, and clonal lineages over a 32-year period. Method Bibliometric indices of publications between 1990 and 2022 were assessed. Network mapping, visualizations and text mining were rendered with Bibliometrix package in R- studio and Visualization of Similarities (VOS) Viewer software. Results A total of 8890 documents were retrieved, with 6246 (70.3 percent) articles in the Medical and Health Sciences category. Despite being the most productive country, with 956 (10.8%) articles published, none of the top 20 institutions were from the United States. Four Spanish and three French institutions made the top ten. Despite the fact that the number and type of antimicrobial agents indicated against ESBL producing organisms changed over time, the preference for Piperacillin/Tazobactam remained consistent for decades. Pseudomonas aeruginosa, Klebsiella pneumonia, and Escherichia coli were the most frequently encountered pathogens of clinical and veterinary importance. E. coli clones (ST(s) 131, 117, 69, 73, 95, 410, 648, 10 and ST38) and K. pneumoniae clones (ST(s) 101, 15, 307, 147, 11, 405, 16 and 23) were the most frequently reported. Previous research also highlighted 'Emerging therapy' based on a 'new ESBL gene' and 'globalization of CTX-M'. Recent top-cited studies focused on 'hypervirulence' and MDR in invasive Klebsiella sp ', 'newer β-lactam/β-lactamase inhibitor (BLBLI) combinations,' and a 'new ultra-broad-spectrum' β-lactamase inhibitor of serine metallo-β-lactamases (QPX7728). Another notable subtheme has been the spread of ESBL and 'Carbapenemase Encoding Genes' in the 'natural aquatic environment'. Conclusion ESBLs are highly researched members of the beta-lactamase family with over 256,980 citations and counting. The scientific community is focused on the mitigation of plasmid mediated spread of ESBLs especially blaCTX−M gene. Reducing mortality by the development of a clinical cure for ESBL infections is a major trend in human and veterinary medicine. Workable multi-country research collaborations are compulsory to consolidate regional guidelines for AMR into a global one.