Emerging carbapenemases in Gram-negative aerobes.

By P. Nordmann, L. Poirel. Clinical Microbiology and Infection, 2002

723 citations recorded by the source corpus.

Carbapenemases may be defined as beta-lactamases that significantly hydrolyze at least imipenem or/and meropenem. Carbapenemases involved in acquired resistance are of Ambler molecular classes A, B, and D. Class A, clavulanic acid-inhibited carbapenemases are rare. They are either chromosomally encoded (NMC-A, Sme-1 to Sme-3, IMI-1) in Enterobacter cloacae and Serratia marcescens, or plasmid encoded, such as KPC-1 in Klebsiella pneumoniae and GES-2 in Pseudomonas aeruginosa, the latter being a point-mutant of the clavulanic acid-inhibited extended-spectrum beta-lactamase GES-1. The class B enzymes are the most clinically significant carbapenemases. They are metalloenzymes of the IMP or VIM series. They have been reported worldwide but mostly from South East Asia and Europe. Metalloenzymes, whose genes are plasmid and integron located, hydrolyze virtually all beta-lactams except aztreonam. Finally, the class D carbapenemases are increasingly reported in Acinetobacter baumannii but compromise imipenem and meropenem susceptibility only marginally. The sources of the acquired carbapenemase genes remain unknown, as does the relative importance of the spread of epidemic strains as opposed to the spread of plasmid- or integron-borne genes. Because most of these carbapenemases confer only reduced susceptibility to carbapenems in Enterobacteriaceae, they may remain underestimated as a consequence of the lack of their detection.

Subfields: Endocrinology, Molecular Medicine

View Paper: https://www.semanticscholar.org/paper/b86f04729a08f9d9c5e84635a7e8e1cbae085b6e

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In Endocrinology

1. L. Poirel
2. P. Nordmann
3. K. Bush
4. P. Bradford
5. P. Bennett
6. A. Potron
7. Y. Doi
8. D. van Duin

In Molecular Medicine

1. L. Poirel
2. P. Nordmann
3. K. Bush
4. P. Bradford
5. Y. Doi
6. D. van Duin
7. A. Potron
8. P. Bennett

Citations in the corpus

• Carbapenem resistance in Acinetobacter baumannii: mechanisms and epidemiology. (2006, background): “Although metallo-b-lactamases (MBLs) are powerful carbapenemases [16], oxacillinases possessing the ability to hydrolyse imipenem (but not always meropenem) are grouped in a particular subgroup of b-lactamases termed carbapenemhydrolysing oxacillinases (CHDLs) [17].”
• Bad bugs, no drugs: no ESKAPE! An update from the Infectious Diseases Society of America. (2009, neutral): “United States and Europe [64–69].”
• Emerging broad-spectrum resistance in Pseudomonas aeruginosa and Acinetobacter baumannii: Mechanisms and epidemiology. (2015, background): “Although VIM enzymes share <40% amino acid identity with the IMP-type enzymes, they share the same hydrolytic spectrum [186].”
• Antibacterial resistance worldwide: causes, challenges and responses (2004, background): “Of particular note is the increase in strains bearing metallo-β-lactamases that inactivate carbapenems—drugs that are often the 'last resort' in serious infections of Gram-negative bacteri”
• Pseudomonas aeruginosa: resistance and therapeutic options at the turn of the new millennium. (2007, background): “, aminoglycoside-inactivating enzymes) [51,55,56], so that these isolates will show co-resistance phenotypes.”
• Detection of aerolysin and hemolysin genes in Aeromonas spp.isolated from environmental and shellfish sources bypolymerase chain reaction (2007, background): “Aeromonas spp. are Gram-negative, rod shaped, mainly motile, facultative anaerobic, oxidase positive and glucose fermenting bacteria (Nordmann and Poirel, 2002).”
• Mechanisms of multidrug resistance in Acinetobacter species and Pseudomonas aeruginosa. (2006, neutral): “virtually all b-lactams except monobactams [93].”
• β-Lactams and β-Lactamase Inhibitors: An Overview. (2016, background): “2001) and, to a lesser extent, serine carbapenemases (Nordmann and Poirel 2002; Yigit et al. 2003).”
• Guidelines for the management of adults with hospital-acquired, ventilator-associated, and healthcare-associated pneumonia. (2008, background): “More than 85% of isolates are susceptible to carbapenems, but resistance is increasing due either to IMP-type metalloenzymes or carbapenemases of the OXA type (49).”
• Plasmid encoded antibiotic resistance: acquisition and transfer of antibiotic resistance genes in bacteria (2008, background): “…resistance gene cassettes include those that encode the metallo-b-lactamases IMP and VIM (Laraki et al., 1999; Lauretti et al., 1999; Poirel et al., 2000; Riccio et al., 2000; Nordmann and Poirel, 2002) (Figure 8), which confer resistance to the potent carbapenem b-lactams imipenem and meropenem.”
• The global epidemiology of carbapenemase-producing Enterobacteriaceae (2017, background): “belong to 3 of them: Class A, Class B, and Class D.(19)”