Acquired carbapenemases in Gram-negative bacterial pathogens: Detection and surveillance issues

V. Miriagou, G. Cornaglia, M. Edelstein, I. Galani, C. G. Giske, M. Gniadkowski, E. Malamou-Lada, L. Martinez-Martinez, F. Navarro, P. Nordmann, L. Peixe, S. Pournaras, G. M. Rossolini, A. Tsakris, A. Vatopoulos, R. Cantón

Research output: Contribution to journalArticlepeer-review

Abstract

Acquired carbapenemases are emerging resistance determinants in Gram-negative pathogens, including . Enterobacteriaceae, . Pseudomonas aeruginosa and other Gram-negative non-fermenters. A consistent number of acquired carbapenemases have been identified during the past few years, belonging to either molecular class B (metallo-β-lactamases) or molecular classes A and D (serine carbapenemases), and genes encoding these enzymes are associated with mobile genetic elements that allow their rapid dissemination in the clinical setting. Therefore, detection and surveillance of carbapenemase-producing organisms have become matters of major importance for the selection of appropriate therapeutic schemes and the implementation of infection control measures. As carbapenemase production cannot be simply inferred from the resistance profile, criteria must be established for which isolates should be suspected and screened for carbapenemase production, and for which tests (phenotypic and/or genotypic) should be adopted for confirmation of the resistance mechanism. Moreover, strategies should be devised for surveillance of carbapenemase producers in order to enable the implementation of effective surveillance programmes. The above issues are addressed in this article, as a follow-up to an expert meeting on acquired carbapenemases that was recently organized by the ESCMID Study Group for Antibiotic Resistance Surveillance.

Original languageEnglish
Pages (from-to)112-122
Number of pages11
JournalClinical Microbiology and Infection
Volume16
Issue number2
DOIs
Publication statusPublished - Feb 2010

Keywords

  • β-Lactamases
  • Carbapenemases
  • Gram-negative bacteria
  • Laboratory detection
  • Review
  • Surveillance

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

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