Global emergence of double and multi-carbapenemase producing organisms: epidemiology, clinical significance, and evolutionary benefits on antimicrobial resistance and virulence

• DOI: 10.1128/spectrum.00008-24
• Publication Date: 2024-06-11T14:04:46Z
• Authors: Pei-Bo Yuan; Li-Ting Dai; Qi-Ke Zhang; Yu-Xia Zhong; Wan-Ting Liu; Ling Yang; Ding-Qiang Chen
• Keywords: Clinical Relevance; 0303 health sciences; Virulence; clinical significance; bacterial benefits; carbapenem resistance; Microbial Sensitivity Tests; Microbiology; QR1-502; beta-Lactamases; Anti-Bacterial Agents; Klebsiella pneumoniae; 03 medical and health sciences; Bacterial Proteins; Carbapenems; Drug Resistance, Multiple, Bacterial; redundant carbapenemases-producing (RCP) bacteria; Humans; epidemiology; Research Article; Retrospective Studies; Plasmids

Redundant carbapenemase-producing (RCP) bacteria, which carry double or multiple carbapenemases, represent a new and concerning phenomenon. The objective of this study is to conduct comprehensive analysis the epidemiology genetic mechanisms RCP strains support targeted surveillance control measures. A retrospective was conducted using data from 277 articles. Statistical performed determine evaluate species prevalence, proportions antibiotic susceptibility profiles, sample information, patient outcomes. Complete plasmid sequencing were utilized investigate potential antimicrobial resistance virulence advantages that may gain acquiring redundant carbapenemases. bacteria are widely distributed globally, their prevalence increasing over time. Several countries, including China, India, Iran, Turkey, South Korea, have reported more than 100 strains. most commonly Klebsiella pneumoniae Acinetobacter baumannii, exhibit varying carbapenemase combinations. Certain species-carbapenemase combinations, such as K. carrying New Delhi metallo-β-lactamase (NDM) + oxacillinase (OXA) (56.76%) (KPC) Verona integron-encoded (VIM) (50.00%) associated with high mortality rates. In patients isolated bloodstream respiratory system, rates 58.70% 69.23%, respectively. Analysis plasmids suggests they acquire additional phenotypes factors. Carbapenem-resistant carbapenemases pose significant global health threat. This provides valuable insights into these supporting development effective prevention strategies mitigate transmission.IMPORTANCEThis examined distribution patterns 1,780 articles assessed clinical impact. presence increases chances co-resistance other classes antibiotics factors, further complicating management infections.