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Trends Mol Med. 2012 May;18(5):263-72. doi: 10.1016/j.molmed.2012.03.003. Epub 2012 Apr 3.

Carbapenem resistance in Enterobacteriaceae: here is the storm!

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Service de Bactériologie-Virologie, INSERM U914 Emerging Resistance to Antibiotic, Hôpital de Bicêtre, Assistance Publique/Hôpitaux de Paris, Faculté de Médecine Paris Sud, K.-Bicêtre, 94275 Le Kremlin-Bicêtre Cedex, France. nordmann.patrice@bct.aphp


The current worldwide emergence of resistance to the powerful antibiotic carbapenem in Enterobacteriaceae constitutes an important growing public health threat. Sporadic outbreaks or endemic situations with enterobacterial isolates not susceptible to carbapenems are now reported not only in hospital settings but also in the community. Acquired class A (KPC), class B (IMP, VIM, NDM), or class D (OXA-48, OXA-181) carbapenemases, are the most important determinants sustaining resistance to carbapenems. The corresponding genes are mostly plasmid-located and associated with various mobile genetic structures (insertion sequences, integrons, transposons), further enhancing their spread. This review summarizes the current knowledge on carbapenem resistance in Enterobacteriaceae, including activity, distribution, clinical impact, and possible novel antibiotic pathways.

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