Carbapenemase-producing Gram-negative bacteria: current epidemics, antimicrobial susceptibility and treatment options. (March 2015)

• Record Type: Journal Article
• Authors: Jean, Shio-Shin; Lee, Wen-Sen; Lam, Carlos; Hsu, Chin-Wang; Chen, Ray-Jade; Hsueh, Po-Ren
• Is Part Of: Future microbiology. Volume 10:Number 3(2015:Mar.)
• Page Start: 407
• Page End: 425
• Publication Date: 2015-03
• Subjects: carbapenemase -- combination therapy -- dissemination -- Gram-negative bacteria -- resistance; Microbiology -- Research -- Periodicals; 616.9041
• DOI: 10.2217/fmb.14.135
• Languages: English
• ISSNs: 1746-0913

Abstract

ABSTRACT : Carbapenemases, with versatile hydrolytic capacity against β-lactams, are now an important cause of resistance of Gram-negative bacteria. The genes encoding for the acquired carbapenemases are associated with a high potential for dissemination. In addition, infections due to Gram-negative bacteria with acquired carbapenemase production would lead to high clinical mortality rates. Of the acquired carbapenemases, Klebsiella pneumoniae carbapenemase (Ambler class A), Verona integron-encoded metallo-β-lactamase (Ambler class B), New Delhi metallo-β-lactamase (Ambler class B) and many OXA enzymes (OXA-23-like, OXA-24-like, OXA-48-like, OXA-58-like, class D) are considered to be responsible for the worldwide resistance epidemics. As compared with monotherapy with colistin or tigecycline, combination therapy has been shown to effectively lower case-fatality rates. However, development of new antibiotics is crucial in the present pandrug-resistant era.