The Difficult-To-Control Spread of Carbapenemase Producers Among Enterobacteriaceae Worldwide

Clin Microbiol Infect. 2014 Sep;20(9):821-30. doi: 10.1111/1469-0691.12719.


The spread of carbapenemase producers in Enterobacteriaceae has now been identified worldwide. Three main carbapenemases have been reported; they belong to three classes of β-lactamases, which are KPC, NDM, and OXA-48. The main reservoirs of KPC are Klebsiella pneumoniae in the USA, Israel, Greece, and Italy, those of NDM are K. pneumoniae and Escherichia coli in the Indian subcontinent, and those of OXA-48 are K. pneumoniae and Escherichia coli in North Africa and Turkey. KPC producers have been mostly identified among nosocomial isolates, whereas NDM and OXA-48 producers are both nosocomial and community-acquired pathogens. Control of their spread is still possible in hospital settings, and relies on the use of rapid diagnostic techniques and the strict implemention of hygiene measures.

Keywords: Carbapenemase; Enterobacteriaceae; KPC; NDM; OXA-48.

Publication types

  • Review

MeSH terms

  • Bacterial Proteins / classification
  • Bacterial Proteins / metabolism*
  • Cross Infection / epidemiology
  • Cross Infection / microbiology
  • Escherichia coli / enzymology*
  • Escherichia coli / isolation & purification
  • Escherichia coli Infections / epidemiology*
  • Escherichia coli Infections / microbiology*
  • Global Health
  • Humans
  • Infection Control
  • Klebsiella Infections / epidemiology*
  • Klebsiella Infections / microbiology*
  • Klebsiella pneumoniae / enzymology*
  • Klebsiella pneumoniae / isolation & purification
  • Pandemics
  • beta-Lactamases / classification
  • beta-Lactamases / metabolism*


  • Bacterial Proteins
  • beta-Lactamases
  • carbapenemase