[Carbapenemases of gram-negative bacteria]

Lijec Vjesn. 2014 Mar-Apr;136(3-4):94-103.
[Article in Croatian]

Abstract

Carbapenems are often antibiotics of last resort for the treatment of severe infections. They are stable to most beta-lactamases produced by gram-negative bacteria. However, bacterial enzymes named carbapenemases can efficiently hydrolyze carbapenems. They are produced most frequently by Enterobacteriaceae and non-fermentative bacteria such as Pseudomonas aeruginosa and Acinetobacter baumannnii. They belong to group A (KPC, SME, IMI, NMC), B (VIM, IMP, SPM, GIM, NDM, SIM, DIM, AIM) and D (OXA-23, OXA-24, OXA-48, OXA-58, OXA-143). The accurate and rapid laboratory identification of carbapenem-resistant isolates is important to prevent spread of such multidrug resistant strains and to avoid therapeutic failures. Therapeutic options are often limited because carbapenemases are encoded on mobile genetic elements which often harbour resistance genes to other groups of antibiotics. Thus, colistin is often the only therapeutic option.

MeSH terms

  • Bacterial Proteins / drug effects
  • Bacterial Proteins / metabolism*
  • Carbapenems / therapeutic use
  • Drug Resistance, Microbial / drug effects*
  • Enterobacter cloacae / enzymology
  • Enterobacteriaceae / enzymology*
  • Gram-Negative Bacterial Infections / drug therapy*
  • Gram-Negative Bacterial Infections / microbiology*
  • Humans
  • Klebsiella pneumoniae / enzymology
  • Pseudomonas aeruginosa / enzymology
  • beta-Lactamases / drug effects
  • beta-Lactamases / metabolism*

Substances

  • Bacterial Proteins
  • Carbapenems
  • beta-Lactamases
  • carbapenemase