Review article

Global spread of carbapenemase-producing bacteria

Marina Bubonja-Šonje orcid.org/0000-0001-6565-3377 ; Klinički zavod za kliničku mikrobiologiju,KBC Rijeka, Rijeka
Maja Abram orcid.org/0000-0003-4113-098X ; Zavod za mikrobiologiju i parazitologiju, Medicinski fakultet Sveučilišta u Rijeci, Rijeka

Abstract

Carbapenemases are clinically important enzymes because they hydrolyse and inactivate the broad-spectrum β-lactam antibiotics carbapenems. Carbapenemase-producing strains are resistant to carbapenems and to most of the other classes of β-lactams (penicillins, cephalosporins). The growing trend of the carbapenemase-producing strains between inpatient and outpatient isolates of gram-negative bacteria is becoming a global health threat. Infections caused by carbapenemase-producing strains often occur as outbreaks. In addition, carbapenemase- encoding genes are frequently transferred to other bacteria along with the genes responsible for resistance to other classes of antibiotics, such as quinolones and aminoglycosides. The most widespread carbapenemases are metallo-β-lactamase IMP, VIM and NDM-types. At the beginning of the third millennium we witnessed the global spread of KPC-producing, multidrugresistant Klebsiella pneumoniae. The emergence and spread of carbapenem-resistant Enterobacteriaceae, Pseudomonas and Acinetobacter strains leads to an increase in morbidity and mortality rates. Phenotypic methods based on cultivation are used for screening of carbapenemase- producing strains, however, enzyme production must be confirmed by phenotypic or molecular methods. Identification of specific carbapenemase-encoding genes is mainly based on molecular techniques. Low level resistance that can occur in a certain percentage of carbapenemase-producing strains complicates detection and laboratory tests interpretation. Due to the very limited choice of effective antibiotics early detection of carbapenemase-producing strains becomes of paramount importance. Strict infection control measures, including active surveillance for timely detection of colonised patients and prompt isolation of carriers are key steps for preventing the transmission of these bacteria in healthcare settings.

Keywords

antimicrobial drug resistance; carbapenemase; carbapenems; gram-negative bacteria

Hrčak ID:

121848

URI

https://hrcak.srce.hr/121848

Publication date:

2.6.2014.

Article data in other languages: croatian

Visits: 8.017 *