Carbapenemases are β-lactamase enzymes that hydrolyze a variety of β-lactams including carbapenem and belong to different Ambler classes (A, B, D). These enzymes can be encoded by plasmid or chromosomal-mediated genes. The major issues associated with carbapenemases-producing organisms are compromising the activity and increasing the resistance to carbapenems which are the last resort antibiotics used in treating serious infections. The global increase of pathogen, carbapenem-resistant
A. baumannii
has significantly threatened public health. Thus, there is a pressing need for a better understanding of this pathogen, to know the various carbapenem resistance encoding genes and dissemination of resistance genes from
A. baumannii
which help in developing strategies to overcome this problem. The horizontal transfer of resistant determinants through mobile genetic elements increases the incidence of multidrug, extensive drug, and Pan-drug resistant
A. baumannii
. Therefore, the current review aims to know the various mechanisms of carbapenem resistance, categorize and discuss carbapenemases encoding genes and various mobile genetic elements, and the prevalence of carbapenemase genes in recent years in
A. baumannii
from various geographical regions.
Introduction-Klebsiella pneumoniae have been identified as an important common pathogen for nosocomial pneumonia (7 to 14% of all cases), septicaemia (4 to 15% of all cases), wound infections (2 to 4% of all cases), neonatal septicaemia (3 to 30% of all cases). It also causes bacteremia and hepatic infections and have been isolated from a number of unusual infections including endocarditis, primary gascontaining mediastinal abscess, cholecyctitis, diarrhoea, peritonitis, crepitant myonecrosis, pyomyositis, necrotizing fasciitis, osteomyelitis, meningitis. β-lactam antimicrobial agents are most common treatment option for such infections. Results and observations-986 Clinical isolates of Klebsiella pneumonia were isolated from blood (254), urine (241), respiratory specimens (206), pus (215) and body fluids (70). Among 986 clinical isolated of K. pneumoniae 718 (72.81%) isolates were from inpatients (IPD) admitted in various wards of hospital and 268 (27.18%) were found to be out patients department (OPD). A significant difference in antimicrobial susceptibility was observed with 3 rd -generation cephalosporins between hospital and community strains. Of the 986 isolates of K. pneumoniae 284 (28.80%) were confirmed as ESBLs producers by phenotypic detection methods of ESBLs. Among 284 ESBLs 236 (83.09%) were hospital isolates while 48 (16.90%) were from community settings. Among 986 K. pneumoniae isolates 34 (3.44%) strains showed production of KPCs by phenotypic detection methods of KPCs. Out of 34 KPCs producers 26 were from hospital isolates and 8 were from community isolates. Hospital isolates were major ESBLs and KPCs producers. Conclusion-There is a serious need to accentuate on the rational use of antimicrobials and strictly adhere to the concept of the "reserve drug" to minimize the misuse of available antimicrobials. In addition regular antimicrobials susceptibility surveillance, knowledge and its application is essential to reduced current drug resistance rate in hospital as well as in community.
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