The global epidemiology of carbapenemase-producing Enterobacteriaceae

Abstract

Carbapenemase-producing Enterobacteriaceae (CPE) are an important and increasing threat to global health. Both clonal spread and plasmid-mediated transmission contribute to the ongoing rise in incidence of these bacteria. Among the 4 classes of β-lactamases defined by the Ambler classification system, the carbapenemases that confer carbapenem resistance in Enterobacteriaceae belong to 3 of them: Class A (K. pneumoniae carbapenemases, KPC), Class B (metallo-β-lactamases, MBL including New Delhi metallo-β-lactamases, NDM) and Class D (OXA-48-like carbapenemases). KPC-producing CPE are the most commonly occurring CPE in the United States. MBL-producing CPE have been most commonly associated with the Indian Subcontinent as well as with specific countries in Europe, including Romania, Denmark, Spain, and Hungary. The epicenter of OXA-48-like-producing is in Turkey and surrounding countries. Detailed knowledge of the epidemiology and molecular characteristics of CPE is essential to stem the spread of these pathogens.

Perirectal Screening for Carbapenem-Resistant Enterobacteriaceae Obtained From 100 Consecutive Healthy Pregnant Women in Labor at a Brooklyn Hospital: Results and Risk Factors

“…However, CRE have been identified in Europe, India and Pakistan, Israel, and the Middle East, South and Central America, China, and Africa. 7 Many studies describe CRE prevalence and CRE outbreaks in hospitals. Risk factors for CRE carriage include healthcare exposures such as short-stay and long-term acute-care hospitalization, long-term care facilities, surgical procedures, indwelling devices, and travel to endemic areas.…”

“…However, few studies have investigated the presence of hypervirulent strains of C. difficile in developing countries, particularly in Latin America. 6,7 Here, we make the first report of the detection of the hypervirulent C. difficile strain in Brazil.…”

High burden of Carbapenem-resistant Enterobacteriaceae (CRE) fecal carriage at a teaching hospital: cost-effectiveness of screening in low-resource setting

“…Multidrug-resistant gram-negative bacteria (MDR-GNB) particularly Carbapenem-resistant Enterobacteriaceae (CRE) have become a threat to health institution globally [1, 2]. The Centers for Disease Control and Prevention (CDC) noted continuous increase of disease caused by the CRE [3].…”

“…The Centers for Disease Control and Prevention (CDC) noted continuous increase of disease caused by the CRE [3]. Since its emergence in 1996, CRE infections are now endemic in parts of the United States and Europeans countries [1, 4]. …”

Novel Beta-Lactamase Inhibitors: Unlocking Their Potential in Therapy

“…Carbapenemases have a global distribution with substantial regional variability. [5] KPC-producing Enterobacteriaceae predominate in the United States, Italy, Greece, Italy and South America, while MBL are most commonly found within the Indian Subcontinent and in particular specific countries in Europe including Romania, Denmark, Spain, and Hungary. [5] The distribution of OXA-48 is centered in Turkey and its surrounding counties.…”