Present and Future of Carbapenem-resistant <i>Enterobacteriaceae</i> (CRE) Infections
Carbapenem-resistant <i>Enterobacteriaceae</i> (CRE) have become a public health threat worldwide. There are three major mechanisms by which <i>Enterobacteriaceae</i> become resistant to carbapenems: enzyme production, efflux pumps and porin mutations. Of these, enzyme produc...
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| Format: | Article |
| Language: | English |
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MDPI AG
2019-08-01
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| Series: | Antibiotics |
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| Online Access: | https://www.mdpi.com/2079-6382/8/3/122 |
| _version_ | 1811277947966849024 |
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| author | Beatriz Suay-García María Teresa Pérez-Gracia |
| author_facet | Beatriz Suay-García María Teresa Pérez-Gracia |
| author_sort | Beatriz Suay-García |
| collection | DOAJ |
| description | Carbapenem-resistant <i>Enterobacteriaceae</i> (CRE) have become a public health threat worldwide. There are three major mechanisms by which <i>Enterobacteriaceae</i> become resistant to carbapenems: enzyme production, efflux pumps and porin mutations. Of these, enzyme production is the main resistance mechanism. There are three main groups of enzymes responsible for most of the carbapenem resistance: KPC (<i>Klebsiella pneumoniae </i>carbapenemase) (Ambler class A), MBLs (Metallo-ß-Lactamases) (Ambler class B) and OXA-48-like (Ambler class D). KPC-producing <i>Enterobacteriaceae </i>are endemic in the United States, Colombia, Argentina, Greece and Italy. On the other hand, the MBL NDM-1 is the main carbapenemase-producing resistance in India, Pakistan and Sri Lanka, while OXA-48-like enzyme-producers are endemic in Turkey, Malta, the Middle-East and North Africa. All three groups of enzymes are plasmid-mediated, which implies an easier horizontal transfer and, thus, faster spread of carbapenem resistance worldwide. As a result, there is an urgent need to develop new therapeutic guidelines to treat CRE infections. Bearing in mind the different mechanisms by which <i>Enterobacteriaceae</i> can become resistant to carbapenems, there are different approaches to treat infections caused by these bacteria, which include the repurposing of already existing antibiotics, dual therapies with these antibiotics, and the development of new ß-lactamase inhibitors and antibiotics. |
| first_indexed | 2024-04-13T00:25:59Z |
| format | Article |
| id | doaj.art-b755b511116e498c916542af6443fa3a |
| institution | Directory Open Access Journal |
| issn | 2079-6382 |
| language | English |
| last_indexed | 2024-04-13T00:25:59Z |
| publishDate | 2019-08-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Antibiotics |
| spelling | doaj.art-b755b511116e498c916542af6443fa3a2022-12-22T03:10:37ZengMDPI AGAntibiotics2079-63822019-08-018312210.3390/antibiotics8030122antibiotics8030122Present and Future of Carbapenem-resistant <i>Enterobacteriaceae</i> (CRE) InfectionsBeatriz Suay-García0María Teresa Pérez-Gracia1Área de Microbiología, Departamento de Farmacia, Instituto de Ciencias Biomédicas, Facultad de Ciencias de la Salud, Universidad Cardenal Herrera-CEU, C/ Santiago Ramón y Cajal, 46115 Alfara del Patriarca, Valencia, SpainÁrea de Microbiología, Departamento de Farmacia, Instituto de Ciencias Biomédicas, Facultad de Ciencias de la Salud, Universidad Cardenal Herrera-CEU, C/ Santiago Ramón y Cajal, 46115 Alfara del Patriarca, Valencia, SpainCarbapenem-resistant <i>Enterobacteriaceae</i> (CRE) have become a public health threat worldwide. There are three major mechanisms by which <i>Enterobacteriaceae</i> become resistant to carbapenems: enzyme production, efflux pumps and porin mutations. Of these, enzyme production is the main resistance mechanism. There are three main groups of enzymes responsible for most of the carbapenem resistance: KPC (<i>Klebsiella pneumoniae </i>carbapenemase) (Ambler class A), MBLs (Metallo-ß-Lactamases) (Ambler class B) and OXA-48-like (Ambler class D). KPC-producing <i>Enterobacteriaceae </i>are endemic in the United States, Colombia, Argentina, Greece and Italy. On the other hand, the MBL NDM-1 is the main carbapenemase-producing resistance in India, Pakistan and Sri Lanka, while OXA-48-like enzyme-producers are endemic in Turkey, Malta, the Middle-East and North Africa. All three groups of enzymes are plasmid-mediated, which implies an easier horizontal transfer and, thus, faster spread of carbapenem resistance worldwide. As a result, there is an urgent need to develop new therapeutic guidelines to treat CRE infections. Bearing in mind the different mechanisms by which <i>Enterobacteriaceae</i> can become resistant to carbapenems, there are different approaches to treat infections caused by these bacteria, which include the repurposing of already existing antibiotics, dual therapies with these antibiotics, and the development of new ß-lactamase inhibitors and antibiotics.https://www.mdpi.com/2079-6382/8/3/122<i>Enterobacteriaceae</i>carbapenem-resistantCREantibiotic resistanceantimicrobials |
| spellingShingle | Beatriz Suay-García María Teresa Pérez-Gracia Present and Future of Carbapenem-resistant <i>Enterobacteriaceae</i> (CRE) Infections Antibiotics <i>Enterobacteriaceae</i> carbapenem-resistant CRE antibiotic resistance antimicrobials |
| title | Present and Future of Carbapenem-resistant <i>Enterobacteriaceae</i> (CRE) Infections |
| title_full | Present and Future of Carbapenem-resistant <i>Enterobacteriaceae</i> (CRE) Infections |
| title_fullStr | Present and Future of Carbapenem-resistant <i>Enterobacteriaceae</i> (CRE) Infections |
| title_full_unstemmed | Present and Future of Carbapenem-resistant <i>Enterobacteriaceae</i> (CRE) Infections |
| title_short | Present and Future of Carbapenem-resistant <i>Enterobacteriaceae</i> (CRE) Infections |
| title_sort | present and future of carbapenem resistant i enterobacteriaceae i cre infections |
| topic | <i>Enterobacteriaceae</i> carbapenem-resistant CRE antibiotic resistance antimicrobials |
| url | https://www.mdpi.com/2079-6382/8/3/122 |
| work_keys_str_mv | AT beatrizsuaygarcia presentandfutureofcarbapenemresistantienterobacteriaceaeicreinfections AT mariateresaperezgracia presentandfutureofcarbapenemresistantienterobacteriaceaeicreinfections |