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Emerging carbapenemases: Bringing a step closer to extremely drug resistant bacteria

Author: 
Atul Garg, Jaya Garg, Anand swaroop, Sanjay Kala, Yashwant K Rao, Anand Kumar, RK Singh, and Piyush Tripathi
Subject Area: 
Life Sciences
Abstract: 

Carbapenemases are β- lactamases that confer resistance to the carbapenems (e.g., imipenem, meropenem, ertapenem, and doripenem). Most often these enzymes confer resistance to the other b-lactam agents as well, including extended-spectrum cephalosporins. The enzymes are usually found in bacterial isolates that are already resistant to nearly all other antimicrobial agents, and treatment options for infections caused by them are significantly limited. This important mechanism of resistance is emerging in the USA include Klebsiella pneumonia carbapenemases (KPC), while in India it is New Delhi metalo betalactamase (NDM) and in spain it is Verona imipenem hydrolyzing enzyme (VIM). Prevention and control of this emerging resistance is complicated by the occurrence of low-level carbapenem resistance isolates that are hard to detect in the clinical microbiology laboratory. This article will review the epidemiology, diagnostic methods and therapeutic options of emerging carbapenemases.

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