Double- and multi-carbapenemase-producers: the excessively armored bacilli of the current decade

Abstract

Multidrug-resistant (MDR) and extensively drug-resistant (XDR) Gram-negative nosocomial pathogens commonly carry one carbapenemase gene conferring resistance to carbapenems and other beta-lactam antibiotics. However, increasing reports show that double-carbapenemase-producing (DCP) and even multi-carbapenemase-producing (MCP) bacteria are emerging in some parts of the world, diminishing further, in some cases, the already limited treatment options. In the present review, the up-to-date reports of DCP and MCP isolates are summarized and concerns regarding their emergence are discussed.

Escherichia coli Overexpressing a Baeyer-Villiger Monooxygenase from Acinetobacter radioresistens Becomes Resistant to Imipenem

“…Predictably, this increase in carbapenem consumption has been accompanied by the emergence of carbapenem-resistant Gram-negative bacterial pathogens (43). The initial and seemingly unstoppable success of antibiotics has been countered by an escalation of resistance mechanisms in bacteria, with the emergence of many genera of bacteria that are resistant to all antibiotics (44)(45)(46). The genus Acinetobacter epitomizes this trend and deserves close attention.…”

Multihospital Occurrence of Pan-Resistant Klebsiella pneumoniae Sequence Type 147 with an IS Ecp1 -Directed bla OXA-181 Insertion in the mgrB Gene in the United Arab Emirates

“…Enterobacteriaceae possessing two carbapenemases have previously been observed worldwide (16) and in the region as well (6,17,18). It is of particular concern that representatives of the K. pneumoniae ST147 clone, well known for its epidemic potential (4,6), not only are present in the UAE as dual-carbapenemase-producing isolates but also develop resistance to the last-resort antibiotic, colistin, by insertion of a functional carbapenemase gene into the mgrB gene.…”

Genome Sequence of an Acinetobacter baumannii Strain Carrying Three Acquired Carbapenemase Genes

“…Carbapenem-resistant Acinetobacter strains possessing a single acquired carbapenemase gene have become widespread throughout the world. During the past decade, multiple carbapenemase producers have emerged (6). Multiple carbapenemase-containing strains raise a serious concern because they tend to show higher β-lactam resistance, leaving fewer treatment options.…”

“…The emergence of Acinetobacter strains carrying two acquired carbapenemase genes has been limited to a limited number of countries, such as Greece (6). To the best of our knowledge, this is the first report of an Acinetobacter strain carrying three acquired carbapenemase genes.…”