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Review
. 2016 Jan-Mar;8(1):41-50.
doi: 10.4103/0974-777X.176149.

Laboratory Detection and Clinical Implication of Oxacillinase-48 like Carbapenemase: The Hidden Threat

Yamuna Devi Bakthavatchalam  1 , Shalini Anandan  1 , Balaji Veeraraghavan  1
Affiliations
Review

Laboratory Detection and Clinical Implication of Oxacillinase-48 like Carbapenemase: The Hidden Threat

Yamuna Devi Bakthavatchalam et al. J Glob Infect Dis. 2016 Jan-Mar.

Abstract

Carbapenemase producing Gram-negative pathogen is of great concern for physician. The challenging aspects are treatment option and infection control. Monitoring of respective carbapenemase resistance mechanism is necessary to prevent the outbreaks. Currently, the rapid emergence of oxacillinase (OXA-48) like is alarming. Increasing frequency of OXA-48 is seen than the classical carbapenemase (KPC, NDM, IMP, and VIM) across the world. The bla OXA-48 gene is commonly identified in Escherichia coli and Klebsiella pneumoniae. The transferrable plasmid of OXA-48 is associated with rapid spread and inter-species dissemination. In general, OXA-48-like enzymes weakly hydrolyzes both carbapenem and broad spectrum cephalosporins. Except OXA-163, which effectively hydrolyze cephalosporin. This poor hydrolytic profile obscures the detection of OXA-48-like. It may go undetected in routine diagnosis and complicates the treatment option. Co-production of OXA-48-like with CTX-M-15 and other carbapenemase (NDM, VIM) leads to the emergence of multidrug resistant strains.

Keywords: Carbapenemase; OXA-48; OXA-48-like; noscomial.

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Figures

Figure 1
Figure 1
Schematic representation of oxacillinase-48 and its transposons, (a) schematic representation of Tn1999 identified with oxacillinase-48 gene, (b) schematic representation of Tn1999.2 identified with oxacillinase-48 gene, (c) schematic representation of Tn1999.3 identified with oxacillinase-48 gene. Horizontal arrowsrepresent the orientation of gene and their transcription. Ä Indicate the interruption of an element/gene by insertion sequence
See this image and copyright information in PMC

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