The KPC type beta-lactamases: new enzymes that confer resistance to carbapenems in Gram-negative bacilli.

Abstract

Antimicrobial resistance due to the continuous selective pressure from widespread use of antimicrobials in humans, animals and agriculture has been a growing problem for last decades. KPC β-lactamases hydrolyzed β-lactams of all classes. Especially, carbapenem antibiotics are hydrolyzed more efficiency than other β-lactam antibiotics. The KPC enzymes are found most often in Enterobacteriaceae. Recently, these enzymes have been found in isolates of Pseudomonas aeruginosa and Acinetobacter spp. The observations of bla KPC genes isolated from different species in other countries indicate that these genes from common but unknown ancestor may have been mobilized in these areas or that bla KPC -carrying bacteria may have been passively by many vectors. The emergence of carbapenem resistance in Gram-negative bacteria is worrisome because the carbapenem resistance often may be associated with resistance to many β-lactam and non-β-lactam antibiotics. Treatment of infections caused by KPC-producing bacteria is extremely difficult because of their multidrug resistance, which results in high mortality rates. Therapeutic options to treat infections caused by multiresistant Gram-negative bacteria producing KPC-carbapenemases could be used polymyxin B or tigecycline.

Emergence of Proteus mirabilis Harboring bla KPC-2 and qnrD in a Chinese Hospital

“…Since the first report of Klebsiella pneumoniae carbapenemase (KPC) in North Carolina in 2001, bla KPC has spread worldwide (10). In our hospital, bla KPC was found in most Enterobacteriaceae, including K. pneumoniae (2), Escherichia coli (2), Serratia marcescens (22), Enterobacter cloacae (1), and Citrobacter freundii (21).…”

Direct Detection and Genotyping of Klebsiella pneumoniae Carbapenemases from Urine by Use of a New DNA Microarray Test

“…Knowing which variant is present might open new treatment options in the future, especially under strict antibiotic stewardship. The difference in resistance profiles and their effects on beta-lactam inhibitors were demonstrated directly in clinical samples and transformants with KPC variants and through comparisons of hydrolytic activities (1,27,28,37,45). Robledo et al (36) reported a variation of antimicrobial susceptibility to carbapenems depending on the KPC variant during a 1-year study based on KPC-producing isolates taken from 6 Puerto Rico Medical Center hospitals.…”

First clonal spread of KPC-producing Pseudomonas aeruginosa in Buenos Aires, Argentina

“…KPC enzymes hydrolyze at significant levels penicillins, cephalosporins, monobactams and carbapenems, and are weakly inhibited by clavulanic acid and tazobactam (Sacha et al, 2009;Walsh, 2010). Since the first detection of KPC-1/2 in Klebsiella pneumoniae in 2001 in USA, they have been encountered in many other Enterobacteriaceae from the Americas, Europe, Asia and Middle East (Yigit et al, 2001;Nordmann et al, 2009).…”