title: Carbapenemase-producing Gram-negative bacteria: current epidemics, antimicrobial susceptibility and treatment options.
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.
authors: Department of Emergency Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.
authors: Shio-Shin
authors: SS
authors: Jean
authors: Wen-Sen
authors: WS
authors: Lee
authors: Carlos
authors: C
authors: Lam
authors: Chin-Wang
authors: CW
authors: Hsu
authors: Ray-Jade
authors: RJ
authors: Chen
authors: Po-Ren
authors: PR
authors: Hsueh
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology* / Q000627:therapeutic use*; D001426:Bacterial Proteins / Q000235:genetics* / Q000378:metabolism*; D004359:Drug Therapy, Combination; D006090:Gram-Negative Bacteria / Q000187:drug effects / Q000201:enzymology* / Q000235:genetics / Q000472:pathogenicity; D016905:Gram-Negative Bacterial Infections / Q000188:drug therapy* / Q000453:epidemiology / Q000382:microbiology; D006801:Humans; D007711:Klebsiella pneumoniae / Q000187:drug effects / Q000201:enzymology / Q000235:genetics; D008826:Microbial Sensitivity Tests; D018440:beta-Lactam Resistance / Q000235:genetics; D001618:beta-Lactamases / Q000235:genetics* / Q000378:metabolism*
chemical_list: D000900:Anti-Bacterial Agents; D001426:Bacterial Proteins; D001618:beta-Lactamases; C552864:beta-lactamase NDM-1; C063912:carbapenemase
keywords: Gram-negative bacteria; carbapenemase; combination therapy; dissemination; resistance