Antibiotic-resistant bacteria that are difficult or impossible to treat are becoming increasingly common and are causing a global health crisis. Antibiotic resistance is encoded by several genes, many of which can transfer between bacteria. New resistance mechanisms are constantly being described, and new genes and vectors of transmission are identified on a regular basis. This article reviews recent advances in our understanding of the mechanisms by which bacteria are either intrinsically resistant or acquire resistance to antibiotics, including the prevention of access to drug targets, changes in the structure and protection of antibiotic targets and the direct modification or inactivation of antibiotics.

Molecular mechanisms of antibiotic resistance.

Klebsiella pneumoniae carbapenemases (KPCs) were originally identified in the USA in 1996. Since then, these versatile β-lactamases have spread internationally among Gram-negative bacteria, especially K pneumoniae, although their precise epidemiology is diverse across countries and regions. The mortality described among patients infected with organisms positive for KPC is high, perhaps as a result of the limited antibiotic options remaining (often colistin, tigecycline, or aminoglycosides). Triple drug combinations using colistin, tigecycline, and imipenem have recently been associated with improved survival among patients with bacteraemia. In this Review, we summarise the epidemiology of KPCs across continents, and discuss issues around detection, present antibiotic options and those in development, treatment outcome and mortality, and infection control. In view of the limitations of present treatments and the paucity of new drugs in the pipeline, infection control must be our primary defence for now.

/pdf/clinical-epidemiology-of-the-global-expansion-of-klebsiella-hbqmomldb2.pdf

Clinical epidemiology of the global expansion of Klebsiella pneumoniae carbapenemases

Dr Benjamin A H Jensen Dr Aarabi Dr Mera A Ababneh Dr Albert Abaka-Yawson Dr Mohamed Salah Abassi Dr Getahun Abate Dr Tarek Mohamed Abd ElAziz Dr Rehab M Abd El-Baky Dr Amir Abdoli Dr Akebe Luther King Abia Dr Fatma Ben Abid Prof Dr Khaled M Aboshanab Mr Ashenafi Abossie Dr Abouelfetouh Dr Maja Abram Dr Sawsan Abuhammad Dr Abulebda Professor Ali Acar Mr Oliver Okoth Achila Dr Stefan Acosta Dr Azeez Adeboye Dr Sanjib Adhikari Prof Dr Muhammad Sohail Afzal Dr Fabio Aguiar-Alves Dr Thomas Agyarko-Poku Dr Irfan Ahmad Dr Suhail Ahmad Dr Hafiz Ahmad Dr Elham Ahmadi Dr Zahra Ahmadinejad Dr Ehsan Ahmadpour Dr Haroon Ahmed Dr Firoz Ahmed Dr Wan M Aizat Dr Abraham Ajayi Dr Ali Akbar Dr Sami Akbulut Dr Hashaam Akhtar Professor Ala-Eddin Al Moustafa Dr Al-Hasan Dr Ali Al-Jumaili Dr Alexandre Alanio Dr Eliana Alcaraz Dr Maria D Alcantar Curiel Dr Gaetano Alfano Prof Dr Abdelazeem Algammal Dr Iftikhar Ali Dr Musa Mohammed Ali Dr Ihsan Ali Dr Mohammad Javed Ali Dr Ali Muhsin Ali Dr Shahzad Ali Dr Sheikh Alif Professor Michael Alifrangis Dr Reem Aljindan Prof Dr Karel Allegaert Dr Rosalie Allison Dr Ammar Almaaytah Dr Dhary Alewy Almashhadany Dr Tarig Alnour Dr Bandar Alosaimi Mr Abdullah Alqarihi Dr Alian A Alrasheedy Dr Eduardo Amaral Dr Gul Ambreen Professor Gobena Ameni Dr Ahmed Ammar Dr Linda Amoah Professor Luca Ampollini Dr Edina Amponsah-Dacosta Dr Mirko Ancillotti Ms Motswedi Anderson Dr Angel Andrade Dr Sergio Angel Dr Angkasekwinai Dr Archana Angrup Dr Enoch Aninagyei Dr Shamshul Ansari Dr Beena Antony Dr Nopporn Apiwattanakul Dr Amjad Islam Aqib Professor Mohammad Arabestani Dr Sheila Araujo Teles Dr Balew Arega Dr Gunjan Arora Dr Muhammad Imran Arshad Dr Yasir Arshad Dr Kovy Arteaga-Livias Dr Mohd Hafiz Arzmi Dr Mohammad Reza Asadi Karam Dr Takanori Asakura Dr Prince Asare Dr Mohammad Asgharzadeh Dr Hossam Ashour Dr Abdullah Tarik Aslan Dr Alaa Atamna Dr Nur Atik Dr Meiji Soe Aung Dr Wah Wah Aung Professor Sergey Avdeev Dr Akshay Avula Dr Babafela Awosile Dr Gajendra Kumar Azad Dr Davood Azadi Mr Zelalem Nigussie Azene Dr Afzal Azim Mr Muhammad Majid Aziz Dr Martin Sima Dr Azer Ozad Duzgun Dr Kenan Cetin Dr Aysegul Copur Cicek Dr Ines Bado Dr Fang Bai Dr J Kevin Baird Dr Andrea Ballini Prof Dr Zulqarnain Baloch Dr Joseph Baruch Baluku Dr Banaei Prof Dr Tuhina Banerjee Dr Tuhina Banerjee Mr Agegnehu Bante Dr Humberto Barrios Camacho Dr Mazin Barry Dr Bruno Barsic Dr Christopher S von Bartheld Dr Dariusz Bartosik Dr Joseph Baruch Baluku Dr Rasha Barwa Dr Saurav Basu Dr George Bayliss

Infection and Drug Resistance

Carbapenem resistance is a major and an on-going public health problem globally. It occurs mainly among Gram-negative pathogens such as Klebsiella pneumoniae, Pseudomonas aeruginosa and Acinetobacter baumannii, and may be intrinsic or mediated by transferable carbapenemase-encoding genes. This type of resistance genes are already widespread in certain parts of the world, particularly Europe, Asia and South America, while the situation in other places such as sub-Saharan Africa is not well documented. In this paper, we provide an in-depth review of carbapenem resistance providing up-to-date information on the subject.

Carbapenem Resistance: A Review

The emergence of carbapenem-resistant Gram-negative pathogens poses a serious threat to public health worldwide. In particular, the increasing prevalence of carbapenem-resistant Klebsiella pneumoniae is a major source of concern. Klebsiella pneumoniae carbapenemases (KPC) and carbapenemases of the oxacillinase-48 (OXA-48) type have been reported worldwide. New Delhi metallo--lactamase (NDM) carbapenemases were originally identified in Sweden in 2008 and have spread worldwide rapidly. In this review, we summarize the epidemiology of K. pneumoniae producing three carbapenemases (KPCs, NDMs, and OXA-48-like). Although the prevalence of each resistant strain varies geographically, K. pneumoniae producing KPCs, NDMs, and OXA-48-like carbapenemases have become rapidly disseminated. In addition, we used recently published molecular and genetic studies to analyze the mechanisms by which these three carbapenemases, and major K. pneumoniae clones, such as ST258 and ST11, have become globally prevalent. Because carbapenemase-producing K. pneumoniae are often resistant to most -lactam antibiotics and many other non--lactam molecules, the therapeutic options available to treat infection with these strains are limited to colistin, polymyxin B, fosfomycin, tigecycline, and selected aminoglycosides. Although combination therapy has been recommended for the treatment of severe carbapenemase-producing K. pneumoniae infections, the clinical evidence for this strategy is currently limited, and more accurate randomized controlled trials will be required to establish the most effective treatment regimen. Moreover, because rapid and accurate identification of the carbapenemase type found in K. pneumoniae may be difficult to achieve through phenotypic antibiotic susceptibility tests, novel molecular detection techniques are currently being developed.

/pdf/global-dissemination-of-carbapenemase-producing-klebsiella-4qyejl7z34.pdf

Global Dissemination of Carbapenemase-Producing Klebsiella pneumoniae: Epidemiology, Genetic Context, Treatment Options, and Detection Methods

Objectives Klebsiella pneumoniae carbapenemase (KPC)-producing Klebsiella pneumoniae has spread rapidly in China. In this study, we aimed to investigate the molecular epidemiology of KPC-producing K. pneumoniae isolates in China. Methods Ninety-five carbapenem-resistant K. pneumoniae isolates from 13 hospitals in nine cities covering five provinces in China were analysed. Antibiotic susceptibility was determined by the Etest. Multilocus sequence typing (MLST) and PFGE were used for epidemiological analysis. The genetic structure around bla(KPC) and the encoding genes of extended-spectrum β-lactamases and plasmid-mediated AmpC enzymes were detected by PCR and sequencing. Plasmids were analysed by transformation, restriction and Southern blot. Results All isolates harboured the bla(KPC-2) gene. Seven sequence types (STs) were obtained. The dominant clone was ST11 (61/95), which was identified in isolates from Zhejiang province (four hospitals in Hangzhou and one hospital in Ningbo), Jiangsu province (one hospital in Nanjing) and Anhui province (one hospital in Hefei). Isolates with ST11 showed >80% similarity in PFGE patterns. Plasmids from 14 selected transformants, their original isolates representing different STs and/or regions, had a diversity of HindIII restriction maps. Conclusions The dominant clone of KPC-producing K. pneumoniae in China is ST11, which is closely related to ST258, which has been reported worldwide.

/pdf/st11-the-dominant-clone-of-kpc-producing-klebsiella-lntprwo5hk.pdf

ST11, the dominant clone of KPC-producing Klebsiella pneumoniae in China

Molecular characterization of a hypermucoviscous, hypervirulent and carbapenem resistant ST15/K19 Klebsiella pneumoniae clone from human infection.

Handle everyday research tasks with reliable, citation-backed results

Your personal Research Agent to handle research tasks with citation-backed results

Popular Tasks used by Researchers

How can I help with your research?

Meet SciSpace

Get more enhanced response by uploading the PDFs you want me to reference.

No relevant PDFs in your library

SciSpace is the AI research assistant for academics. Run systematic literature reviews on 280M+ papers, and write papers with cited sources. Trusted by 1M+ students, PhDs & researchers.

SciSpace | AI for Research

Analyze PDFs

Code & Manuscripts

Funding & Grants

Literature & Patents

Medical & Clinical Data

Systematic Review

Visualize & Present

Web & Data

Build a Google Scholar-like website for your research.

Build a website

Create charts and images for your research

Create a Chart

Write a paper for submission to a journal

Draft a manuscript

Patent Search

Design eye-catching scientific posters in minutes.

Scientific Poster Generation

Systematic Literature Review

One task is running at the moment. Your messages will be shown right after.

Drag and drop or click here to browse

Loved by <highlight>1 million+</highlight> researchers

Extract a list of specific topics and their sources from unstructured text

Topics

Compare and analyze relevant papers that matches with your search

Papers

Get insights from PDFs and bookmarked papers from your library

My library

Recent searches

Try searching for:

Catch AI-generated content in scholarly and non-scholarly content

{ai} Detector

Ai Writer

Get PDF Summaries, highlighted text explanations 

Chat with PDF

Effortlessly create in-text citations and bibliographies in APA and 2,500 other formats

Citation generator

Get explanations, summaries, and answers on academic papers

Ease up your research workflow with {scispace}'s cohort of exciting AI tools

Elevate your academic writing skills and convey your ideas the way you want

Paraphraser

Explore our range of reading and writing tools

Your file is being prepared and should be ready in a few minutes. If it's a large file, it might take a bit longer. You can close this window, and we'll email you the file when it's done.

You have reached a maximum limit of <strong>{limit}</strong> columns in the table. Remove at least <strong>1</strong> column to add or create another one.

Yan Qi

Author Tools

Chat about Author

Papers

ST11, the dominant clone of KPC-producing Klebsiella pneumoniae in China

Molecular characterization of a hypermucoviscous, hypervirulent and carbapenem resistant ST15/K19 Klebsiella pneumoniae clone from human infection.