Carbapenem resistance Bacteria and
Extended Spectrum Beta-Lactamase Challenge
Carbapenems, such as imipenem and meropenem, are often used to treat infections caused by
extended-spectrum beta-lactamase (ESBL)-producing Gram-negative bacteria. A new class of
bacterial enzymes capable of inactivating carbapenems, known as Klebsiella pneumoniae
carbapenemases (KPCs), rapidly spread in the United States and continues to be extensively
reported elsewhere in the world.
It causes infections associated with significant
morbidity and mortality. KPCs are class A
carbapenemases that reside on transferable
plasmids and can hydrolyze all penicillins,
cephalosporins, and carbapenems. The
epidemiology of KPC-producing organisms
continues to evolve. Although most KPCs are
detected in isolates of Klebsiella and Escherichia
coli, KPCs have been extensively reported in
other genera of the Enterobacteriaceae family,
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28850 - Torrejón de Ardoz, Madrid - ESPAÑA
such as Proteus, Serratia, Salmonella, and Citrobacter.
Although KPCs do not represent the first or the
sole mechanism of carbapenem resistance, they
are remarkable because they are often not
detected by routine susceptibility screening and
possess
an
exceptional
potential
for
dissemination. In addition to the infection
control challenges that have arisen, infections
Tel. +34 91 761 02 00
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caused by these organisms present clinicians
with serious treatment challenges, due to
limited antibiotic options
KPC-producing bacteria are often misidentified
by routine microbiological susceptibility
testing and incorrectly reported as sensitive to
carbapenems; however, resistance to the
carbapenem antibiotic is common and a better
indicator of the presence of KPCs.
The
best
therapeutic
approach
to
KPC-producing organisms has yet to be
defined; however, common treatments based
on in vitro susceptibility testing are the
polymyxins, tigecycline, and less frequently
aminoglycoside antibiotics.
KPC-producing bacteria present a big
challenges to clinicians. These include the
need for special techniques for microbiological
detection, the potential for nosocomial
transmission, and therapeutic challenges
related to limited antimicrobial treatment
options.
Bibliography
Ryan S. Arnold, MD, Kerri A. Thom, MD, MS, [...], and Daniel J. Morgan,
MD Emergence of Klebsiella pneumoniae Carbapenemase
(KPC)-Producing Bacteria
Martín-Gil J, Villa FM, Ramos-Sánchez MC, Martín-Gil FJ. “Studies on
beta-lactam
antibiotics
Differential
thermal-analysis
of
Cephalosporins”. J. Thermal Anal Cal, 1984, 29 (6): 1351-1357.
Hope R, et al. Prevalence of Mechanisms Responsible for Cephalosporin
Resistance in Enterobacteriaceae from Southeast England. (poster) 45th Interscience Conference on Antimicrobial Agents and
Chemotherapy; 2005 Dec; Washington, USA
KPC
Cat. 2063
Robinson E, et al. A comparison of the detection and reporting practices
of ESBL-producing E. coli infections in English microbiology laboratories
between 2002-3 and 2004-5. (poster) Health Protection Agency
Annual Conference; 2005 Sep; Warwick, UK
Harada S, Ishii Y, Yamaguchi K Extended-spectrum beta-lactamases:
implications for the clinical laboratory and therapy. Korean J Lab Med.
2008 Dec;28(6):401-12. doi: 10.3343/kjlm.2008.28.6.401
Turner PJ. Extended-spectrum beta-lactamases Clin Infect Dis. 2005
Aug 15;41 Suppl 4:S273-5.
Deshpande P, Rodrigues C, Shetty A, Kapadia F, Hedge A, Soman R.
New Delhi Metallo-beta lactamase (NDM-1) in Enterobacteriaceae:
treatment options with carbapenems compromised J Assoc Physicians
India. 2010 Mar;58:147-9
CONDA efforts are underway to address this
clinical challenge and has developed ESBL Cat.
2062 which allows early detection of ESBL
(Extended
Spectrum
Beta-Lactamase)
-producing bacteria and KPC Cat. 2063 for
detection of gram-negative bacteria with a
reduced susceptibility to most of the
carbapenem agents. The early and well identified detection of these bacteria
minimizes the impact and the spread of
infections and customize therapeutic patient
treatment.
www.condalab.com
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tech.export@condalab.com
.
28850 - Torrejón de Ardoz, Madrid - ESPAÑA
Tel. +34 91 761 02 00
Fax +34 91 656 82 28