Insights into Carbapenem Resistance in Vibrio Species: Current Status and Future Perspectives

Abstract

The increasing prevalence of resistance in carbapenems is an escalating concern as carbapenems are reserved as last-line antibiotics. Although indiscriminate antibiotic usage is considered the primary cause for resistance development, increasing evidence revealed that inconsequential strains without any direct clinical relevance to carbapenem usage are harboring carbapenemase genes. This phenomenon indirectly implies that environmental microbial populations could be the 'hidden vectors' propelling carbapenem resistance. This work aims to explore the carbapenem-resistance profile of Vibrio species across diverse settings. This review then proceeds to identify the different factors contributing to the dissemination of the resistance traits and defines the transmission pathways of carbapenem resistance. Deciphering the mechanisms for carbapenem resistance acquisition could help design better prevention strategies to curb the progression of antimicrobial resistance development. To better understand this vast reservoir selecting for carbapenem resistance in non-clinical settings, Vibrio species is also prospected as one of the potential indicator strains for carbapenem resistance in the environment.

Keywords: Vibrio; antibiotics; antimicrobial; carbapenem; environmental; indicator strain; mechanism; resistance.

Figure 1

Molecular structures of the conventional and newer antimicrobials in the carbapenem class: Imipenem, Panipenem, Meropenem, Ertapenem, Doripenem, Biapenem, Razupenem, Sanfatenip, Tebipenem, and Tomopenem. Red: carbapenem structure; blue: moiety that confers steric hindrance towards the action of β-lactamases; green: 1-ß methyl group that confers resistance against DHP-1 hydrolysis.

Figure 2

The vicious cycle of carbapenem resistance dissemination.