The world-wide spread of carbapenem-resistant Enterobacterales

Introduction. Gram-negative bacilli belonging to the order Enterobacterales are normal inhabitants of the human gut, which also are the most common causative agents of both nosocomial and community-acquired infections in patients of all ages. Although not even a century has passed since Fleming...

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Autores principales: Arjana TAMBIC ANDRASEVIC, Ivana ANTAL ANTUNOVIC
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Publicado: Asociatia de Biosiguranta si Biosecuritate 2021
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spelling oai:doaj.org-article:4bfa1478aea64dfba3882e3f03dad7112021-12-02T18:15:13ZThe world-wide spread of carbapenem-resistant Enterobacterales10.38045/ohrm.2021.1.012887-34582587-3466https://doaj.org/article/4bfa1478aea64dfba3882e3f03dad7112021-04-01T00:00:00Zhttps://journal.ohrm.bba.md/index.php/journal-ohrm-bba-md/article/view/92/72https://doaj.org/toc/2887-3458https://doaj.org/toc/2587-3466Introduction. Gram-negative bacilli belonging to the order Enterobacterales are normal inhabitants of the human gut, which also are the most common causative agents of both nosocomial and community-acquired infections in patients of all ages. Although not even a century has passed since Fleming's discovery of penicillin, the scientists have been alarmed by the fact that the "last resort antibiotics" viz. carbapenems have been compromised. Material and methods. The analysis of fifty-two articles and documents regarding this topic was performed. Results. The main mechanism of resistance to carbapenems in Enterobacterales is the production of carbapenemases, being enzymes that destroy all or almost all β-lactam antibiotics including carbapenems. According to Ambler’s classification β-lactamases can be distributed into four classes (A, B, C, and D) being based on primary amino acid sequence homology. The most important carbapenemases produced by Enterobacterales belong to class A (KPC), class B (metallo-β-lactamases NDM, VIM, IMP) and class D (OXA-48-like). Unlike other mechanisms of resistance, carbapenemase production is easily spread via plasmids making carbapenemase-producing Enterobacterales (CPE) a global challenge for healthcare providers. Conclusions. CPE is not readily detected in the laboratory but the ability to detect carbapenemase production in Enterobacterales has very important infection control implications and therefore is essential for local infection control programs and national and international surveillance systems. Furthermore, local epidemiology of multidrug-resistant organisms has a major influence on the development of national clinical guidelines for antimicrobial use.Arjana TAMBIC ANDRASEVICIvana ANTAL ANTUNOVICAsociatia de Biosiguranta si Biosecuritatearticlecarbapenem-resistant klebsiella pneumoniaecarbapenem-resistant enterobaacteralescarbapenemscarbapenemasesMedicineRScienceQENFRRORUOne Health & Risk Management, Vol 2, Iss 1, Pp 4-12 (2021)
institution DOAJ
collection DOAJ
language EN
FR
RO
RU
topic carbapenem-resistant klebsiella pneumoniae
carbapenem-resistant enterobaacterales
carbapenems
carbapenemases
Medicine
R
Science
Q
spellingShingle carbapenem-resistant klebsiella pneumoniae
carbapenem-resistant enterobaacterales
carbapenems
carbapenemases
Medicine
R
Science
Q
Arjana TAMBIC ANDRASEVIC
Ivana ANTAL ANTUNOVIC
The world-wide spread of carbapenem-resistant Enterobacterales
description Introduction. Gram-negative bacilli belonging to the order Enterobacterales are normal inhabitants of the human gut, which also are the most common causative agents of both nosocomial and community-acquired infections in patients of all ages. Although not even a century has passed since Fleming's discovery of penicillin, the scientists have been alarmed by the fact that the "last resort antibiotics" viz. carbapenems have been compromised. Material and methods. The analysis of fifty-two articles and documents regarding this topic was performed. Results. The main mechanism of resistance to carbapenems in Enterobacterales is the production of carbapenemases, being enzymes that destroy all or almost all β-lactam antibiotics including carbapenems. According to Ambler’s classification β-lactamases can be distributed into four classes (A, B, C, and D) being based on primary amino acid sequence homology. The most important carbapenemases produced by Enterobacterales belong to class A (KPC), class B (metallo-β-lactamases NDM, VIM, IMP) and class D (OXA-48-like). Unlike other mechanisms of resistance, carbapenemase production is easily spread via plasmids making carbapenemase-producing Enterobacterales (CPE) a global challenge for healthcare providers. Conclusions. CPE is not readily detected in the laboratory but the ability to detect carbapenemase production in Enterobacterales has very important infection control implications and therefore is essential for local infection control programs and national and international surveillance systems. Furthermore, local epidemiology of multidrug-resistant organisms has a major influence on the development of national clinical guidelines for antimicrobial use.
format article
author Arjana TAMBIC ANDRASEVIC
Ivana ANTAL ANTUNOVIC
author_facet Arjana TAMBIC ANDRASEVIC
Ivana ANTAL ANTUNOVIC
author_sort Arjana TAMBIC ANDRASEVIC
title The world-wide spread of carbapenem-resistant Enterobacterales
title_short The world-wide spread of carbapenem-resistant Enterobacterales
title_full The world-wide spread of carbapenem-resistant Enterobacterales
title_fullStr The world-wide spread of carbapenem-resistant Enterobacterales
title_full_unstemmed The world-wide spread of carbapenem-resistant Enterobacterales
title_sort world-wide spread of carbapenem-resistant enterobacterales
publisher Asociatia de Biosiguranta si Biosecuritate
publishDate 2021
url https://doaj.org/article/4bfa1478aea64dfba3882e3f03dad711
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