Multiresistant Enterobacteriaceae: new threat of an old problem

Abstract

The Enterobacteriaceae are among the most important causes of serious nosocomial and community-onset bacterial infections in humans, and resistance to antimicrobial agents in these species has become an increasingly relevant problem for healthcare providers. β-lactam and fluoroquinolone antibiotics are important drug classes used to treat infections caused by Enterobacteriaceae. Emerging resistance mechanisms against these agents have recently been described in Enterobacteriaceae and include the production of newer β-lactamases and plasmid-mediated quinolone resistance. The newer β-lactamases consist of the following: plasmid-mediated AmpC β-lactamases (e.g., ephamycin [CMY], CMY types), extended-spectrum β-lactamases (e.g., cefotaxime [CTX], CTX-M first isolated at Munich) and carbapenem-hydrolyzing enzymes (e.g., Klebsiella pneumoniae carbapenemase [KPC], KPC types and the metallo-β-lactamases). Recent developments in the epidemiology, clinical relevance and laboratory detection of infections caused by multiresistant Enterobacteriaceae with these new types of resistance mechanisms will be addressed in this review.

Keywords::

• carbapenem-hydrolyzing enzyme
• extended-spectrum β-lactamase
• multiresistant Enterobacteriaceae
• newer β-lactamase
• plasmid-mediated Amp C β-lactamase
• plasmid-mediated quinolone resistance

Financial & competing interests disclosure

The author has no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.