“…Carbapenems, including the longest established imipenem, meropenem, and ertapenem, and the recently developed doripenem, biapenem, panipenem, razupenem, and tomopenem [ 17 ], in addition to resist the inactivating action of the first generations of ESSBLEs, demonstrated their ability to also act as inhibitors for many ESSBLEs [ 18 , 19 , 20 ]. However, the excessive and inappropriate continued use of BLAs has selected, in the past, decade bacteria that is also resistant to carbapenems, including doripenem, ertapenem, imipenem, and meropenem [ 8 , 21 , 22 ], due to their capability to produce both new ESSBLEs capable to also hydrolyse carbapenems and carbapenem-hydrolysing MBLEs of group B [ 23 , 24 , 25 ]. Additionally, the reduction of membrane porins, the improvement in number of efflux pumps [ 23 ], the alteration of PBPs (PBP2 or PBP3), and the hyperexpression of class C AmpCs are supplementary processes involved in the resistance of bacteria to carbapenems [ 26 , 27 ].…”