Carbapenemases in Enterobacteriaceae: Detection and Antimicrobial Therapy

Abstract

Carbapenem-resistant Enterobacteriaceae (CRE) have spread rapidly around the world in the past few years, posing great challenges to human health. The plasmid-mediated horizontal transmission of carbapenem-resistance genes is the main cause of the surge in the prevalence of CRE. Therefore, the timely and accurate detection of CRE, especially carbapenemase-producing Enterobacteriaceae, is very important for the clinical prevention and treatment of these infections. A variety of methods for the rapid detection of CRE phenotypes and genotypes have been developed for use in clinical microbiology laboratories. To overcome the lack of efficient antibiotics, CRE infections are often treated with combination therapies. Moreover, novel drugs and emerging strategies appeared successively and in various stages of development. In this article, we summarized the global distribution of various carbapenemases. And we focused on summarizing and comparing the advantages and limitations of the detection methods and the therapeutic strategies of CRE primarily.

Keywords: CRE; carbapenem-resistant Enterobacteriaceae; prevalence; rapid detection; treatment.

FIGURE 1

The global distribution of various carbapenemases in CPE. Carbapenemases have emerged in majority regions all over the world. KPCs are the most common carbapenemases and mainly prevalent in China, the Unite States, Italy, and the majority regions of South America; NDMs are mainly prevalent in China, Pakistan, India, and Bangladesh, and widely spread around the world; IMPs are mainly prevalent in Japan and Taiwan, China; VIMs are mainly prevalent in Greece; OXA mainly refers to OXA-48, and is mainly prevalent in Turkey, Morocco, and European countries (France, Germany, Netherlands, Italy, the United Kingdom, and so on); and various carbapenemases locally spread in Europe.