Carbapenemases: A Problem in Waiting?

Curr Opin Microbiol. 2000 Oct;3(5):489-95. doi: 10.1016/s1369-5274(00)00128-4.

Abstract

Carbapenems are stable to most prevalent beta-lactamases, and chromosomal carbapenemases are restricted to Stenotrophomonas maltophilia, to a few Bacteroides fragilis, and to rare pathogens. Nevertheless, an acquired metallo-beta-lactamase called IMP-1 is beginning to emerge in Pseudomonas aeruginosa and Enterobacteriaceae isolates in Japan, and has also been found in isolates from Singapore. Furthermore, IMP-producing Acinetobacter spp. have been identified in Italy and Hong Kong. Recently a second group of acquired metallo-carbapenemases, the VIM types, has been recorded from P. aeruginosa isolates in five Eurasian countries. Weak carbapenemases belonging to molecular class D are emerging in A. baumannii world-wide, with two sub-groups apparent. A few acquired carbapenemases belonging to molecular class A also have been reported. Finally it has also been shown that enzymes with feeble carbapenemase activity (e.g. AmpC types and some SHV enzymes) may confer resistance in exceptionally impermeable strains; counterwise, even potent carbapenemases, such as IMP-1, may only give a small reduction in susceptibility in Enterobacteriaceae that lack permeability lesions. Is the emergence of carbapenemase a problem waiting to happen?

Publication types

  • Review

MeSH terms

  • Carbapenems / metabolism*
  • Carbapenems / therapeutic use*
  • Recombination, Genetic
  • Substrate Specificity
  • beta-Lactam Resistance* / genetics
  • beta-Lactamases / classification
  • beta-Lactamases / genetics
  • beta-Lactamases / metabolism*

Substances

  • Carbapenems
  • beta-Lactamases