The emerging threat of acquired carbapenemases in Gram-negative bacteria.

摘要

Since their introduction into clinical practice, carbapenems have been among the most powerful antibiotics for treating serious infections caused by Gram-negative nosocomial pathogens, including Enterobactericeae, Pseudomonas aeruginosa and Acinetobacter baumannii [I]. Remarkable stability towards most beta-lactamases, including the extended-spectrum beta-lacta-mases (ESBLs), is one of the features accounting for the unprecedented broad spectrum of activity exhibited by carbapenems. Therefore, the emergence of beta-lactamases with carbapenem-hydrolyzing activity (carbapenemases)-which can confer resistance to carbapenems in major Gram-negative pathogens-is of major clinical concern. This concern is further reinforced by the awareness that carbapenems are the most effective agents for treatment of serious infections caused by ESBL-producing Enterobacteria-ceae [2,3], which are undergoing a massive increase both in hospitals and in community settings [4].