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2016 ; 29
(ä): 30-46
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The rapid spread of carbapenem-resistant Enterobacteriaceae
#MMPMID27912842
Potter RF
; D'Souza AW
; Dantas G
Drug Resist Updat
2016[Nov]; 29
(ä): 30-46
PMID27912842
show ga
Carbapenems, our one-time silver bullet for multidrug resistant bacterial
infections, are now threatened by widespread dissemination of
carbapenem-resistant Enterobacteriaceae (CRE). Successful expansion of
Enterobacteriaceae clonal groups and frequent horizontal gene transfer of
carbapenemase expressing plasmids are causing increasing carbapenem resistance.
Recent advances in genetic and phenotypic detection facilitate global
surveillance of CRE diversity and prevalence. In particular, whole genome
sequencing enabled efficient tracking, annotation, and study of genetic elements
colocalized with carbapenemase genes on chromosomes and on plasmids. Improved
characterization helps detail the co-occurrence of other antibiotic resistance
genes in CRE isolates and helps identify pan-drug resistance mechanisms. The
novel ?-lactamase inhibitor, avibactam, combined with ceftazidime or aztreonam,
is a promising CRE treatment compared to current colistin or tigecycline
regimens. To halt increasing CRE-associated morbidity and mortality, we must
continue quality, cooperative monitoring and urgently investigate novel
treatments.