title: Prevalence and emergence of carbapenemases-producing Gram-negative bacteria in Mediterranean basin.
abstract: The emergence and the global spread of carbapenemases concern to health services worldwide. Their celestial rise among Gram-negative bacilli has challenged both the scientific and pharmaceutical sectors. Indeed, infections caused by these bacteria have limited treatment options and have been associated with high mortality and morbidity rates. Carbapenemase producers are mainly identified among Klebsiella pneumoniae, Escherichia coli, Pseudomonas aeruginosa, and Acinetobacter baumannii and still mostly in hospital settings and rarely in the community. They are closely related to KPC, VIM, IMP, NDM, and OXA-48 types. The encoding genes are mostly plasmid located and associated with various mobile genetic elements. The Mediterranean area is of interest due to a great diversity and population mixing. The prevalence of carbapenemases is particularly high and variant among countries, partially depending on the population exchange relationship between the regions and the possible reservoirs of each carbapenemase. This review described the epidemiology of carbapenemases in this region of the world highlighting the worrisome situation and the need to screen and detect these enzymes to prevent and control their dissemination especially as it is clear that very few novel antibiotics will be introduced in the next few years, making the dissemination of carbapenem-resistant Gram-negative bacteria of crucial importance worldwide.
authors.affiliation: a Université Tunis El-Manar, Faculté des Sciences de Tunis, Laboratoire des Microorganismes et Biomolécules Actives , Campus Universitaire , El-Manar II , Tunisia.|b Unité de recherche sur les maladies infectieuses et tropicales émergentes (URMITE), UM 63, CNRS 7278, IRD 198, INSERM 1095, IHU Méditerranée Infection, Faculté de Médecine et de Pharmacie , Aix-Marseille-Université , Marseille , France.|c Université de Carthage, Institut Supérieur des Sciences et Technologies de l'Environnement de Borj-Cedria , Technopôle de Borj-Cedria, BP-1003 , Hammam-Lif , Tunisia.
authors.forename: Najla
authors.initials: N
authors.lastname: Mathlouthi
authors.affiliation: b Unité de recherche sur les maladies infectieuses et tropicales émergentes (URMITE), UM 63, CNRS 7278, IRD 198, INSERM 1095, IHU Méditerranée Infection, Faculté de Médecine et de Pharmacie , Aix-Marseille-Université , Marseille , France.
authors.forename: Charbel
authors.initials: C
authors.lastname: Al-Bayssari
authors.affiliation: b Unité de recherche sur les maladies infectieuses et tropicales émergentes (URMITE), UM 63, CNRS 7278, IRD 198, INSERM 1095, IHU Méditerranée Infection, Faculté de Médecine et de Pharmacie , Aix-Marseille-Université , Marseille , France.
authors.forename: Sofiane
authors.initials: S
authors.lastname: Bakour
authors.affiliation: b Unité de recherche sur les maladies infectieuses et tropicales émergentes (URMITE), UM 63, CNRS 7278, IRD 198, INSERM 1095, IHU Méditerranée Infection, Faculté de Médecine et de Pharmacie , Aix-Marseille-Université , Marseille , France.
authors.forename: Jean Marc
authors.initials: JM
authors.lastname: Rolain
authors.affiliation: a Université Tunis El-Manar, Faculté des Sciences de Tunis, Laboratoire des Microorganismes et Biomolécules Actives , Campus Universitaire , El-Manar II , Tunisia.|c Université de Carthage, Institut Supérieur des Sciences et Technologies de l'Environnement de Borj-Cedria , Technopôle de Borj-Cedria, BP-1003 , Hammam-Lif , Tunisia.
authors.forename: Chedly
authors.initials: C
authors.lastname: Chouchani
mesh_terms: D001426:Bacterial Proteins / Q000235:genetics / Q000378:metabolism*; D006090:Gram-Negative Bacteria / Q000145:classification / Q000201:enzymology* / Q000235:genetics / Q000302:isolation & purification*; D016905:Gram-Negative Bacterial Infections / Q000453:epidemiology / Q000382:microbiology*; D006801:Humans; D019083:Mediterranean Region / Q000453:epidemiology; D001618:beta-Lactamases / Q000235:genetics / Q000378:metabolism*
chemical_list: D001426:Bacterial Proteins; D001618:beta-Lactamases; C063912:carbapenemase
keywords: Carbapenemases; Gram-negative bacteria; Mediterranean countries