A review of Carbapenems Resistance in the Current World

Abstract

Carbapenems are a subgroup of beta-lactam antibiotics, which have been effective in treating Gram-negative bacteria. These groups of drugs are particularly effective for resistant Gram-negative bacteria that are multi-drug resistant mainly to all types of penicillins and cephalosporins. It is a reality now that there is a looming crisis due to emergence of resistance to these groups of drugs. Efforts to fight resistance is by new therapies that are combining cephalosporins with inhibitors such as vaborbactam, avibactam and relebactam. However, already resistance has been noted against ceftazidime-avibactam according to recent studies. The effectiveness of carbapenems has gone down due to beta-lactamases, production of efflux pumps and target modification. Commonly encountered carbapenemases conferring resistance to this group of drugs include KPCs (Klebsiella pneumoniae carbapenemases), which are class A beta lactamases, NDMs, in full New Dehli metallo-β-lactamases, VIM (Verona Integron encoded metallo-β-lactamases), IMPs (Iminpenemases) which are class B metallo-β-lactamases and OXA-48 (oxacillinases) which are Class D β-lactamases. This review gives a global distribution overview and the evolution of carbapenemases, which are spreading at a fast rate. There are measures to overcome this menace such as enhancing infection prevention control (IPC) measures. Another approach is implementing and upholding diagnosis and antibiotic stewardship especially in Low-middle-come-countries (LMICs).