The Spread of 𝛽-Lactamases and Extended Spectrum 𝛽-Lactamase Enzymes among Bacteria: A Threat to Effective Health Care Delivery

Abstract

Antibiotic discovery continue to play a critical role in disease containment. Misuse and overuse of these drugs are the main drivers in the development of drug resistant pathogens. The World Health Organisation has declared that Antimicrobial resistance is one of the top 10 global public health threats facing humanity. There is the fears that if nothing is done, it might end the antibiotic era soon. In 2017 alone, over 9000 human deaths were caused by ESBL-producing Enterobacteriaceae in the USA. The ability of bacteria to develop newer strategies to acquire and disseminate resistance, can be traced as far back to 1940s when (R-factor) plasmid mediated antibiotic resistance was observed. They become resistant via the production of 𝛽-Lactamases and ESBLs enzymes which inactivate or modify antibiotics. Extended Spectrum 𝛽-Lactamases are enzymes whose rates of hydrolysis of the extended-spectrum 𝛽-Lactam antibiotics are >10 % than that for benzylpenicillin. Some bacteria may produce multiple ß-lactamases, which may reduce the effectiveness of ß-lactam/ ß-lactamase inhibitor combinations. These enzymes are susceptible to inhibition by 𝛽-Lactam inhibitors such as clavulanic acid, tazobactam, or sulbactam but have no hydrolytic activity against cephamycins and carbapenems. The production of acquired 𝛽-Lactamase and ESBL makes the choice of antibiotic treatment of infections caused by Gram-negative bacteria very limited, these have been the major causes of treatment failures, outbreaks of both community and hospital acquired infections, surgical failures, long hospital stay and huge economic losses, which continue to claim uncountable lives, especially in Nigeria and Africa where the health system are weak. The emergence of drug resistannt strains may be minimized by maintaining high levels of the drug in the tissues to inhibit mutants, administering two drugs that do not give cross-resistance, and by limiting the use of valuable second line ‘reserve drugs’ such .....

Detection of Carbapenemase Producing Enterobacteriaceae from Clinical Samples and their Susceptibility to Conventional Antibiotics and Medicinal Plant Extracts

“…These variations in the occurrence of this enzyme may be because not all strains or species of these isolates are capable of producing Carbapenamases. More so, it may be because the test isolates are clinical isolates and not all patients harbored these categories of isolates that produce Carbapenamases [2]. The work of Yusuf T, et al [4], which report the first cases of the circulation of Carbapenemase isolates in Kano also revealed that carbapenemase-producing isolates are in circulation in different parts of Kano, at varying levels and locations.…”

“…These enzymes are diverse and are in rapid circulation throughout the world [1]. Their health burden is coupled with the fact that the antibiotics which it renders inactive, are the ones regarded as the last resort treatment option against all serious bacterial infections caused by both Gram positive and Gram negative organisms [2]. To date, these enzymes are known to be Rabiu produced by only Gram negative Enterobacteriaceae such as Klebsiella pneumoniae, Pseudomonas aeruginosa, Escherichia coli, and Acinetobacter baumannii among others [2,3].…”

“…In Kano, Kaduna, Jigawa and other Northwestern states, different classes of Carbapenemase enzymes producing isolates have been reported to be in circulation. These enzymes are responsible for drug and surgical failures, prolong hospitalization, as well a high number of deaths [2].…”