The Intriguing Carbapenemases of Pseudomonas aeruginosa: Current Status, Genetic Profile, and Global Epidemiology.

IF 2.5 3区 工程技术 Q2 BIOLOGY
Yale Journal of Biology and Medicine Pub Date : 2022-12-01
Dalal Hammoudi Halat, Carole Ayoub Moubareck
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引用次数: 0

Abstract

Worldwide, Pseudomonas aeruginosa remains a leading nosocomial pathogen that is difficult to treat and constitutes a challenging menace to healthcare systems. P. aeruginosa shows increased and alarming resistance to carbapenems, long acknowledged as last-resort antibiotics for treatment of resistant infections. Varied and recalcitrant pathways of resistance to carbapenems can simultaneously occur in P. aeruginosa, including the production of carbapenemases, broadest spectrum types of β-lactamases that hydrolyze virtually almost all β-lactams, including carbapenems. The organism can produce chromosomal, plasmid-encoded, and integron- or transposon-mediated carbapenemases from different molecular classes. These include Ambler class A (KPC and some types of GES enzymes), class B (different metallo-β-lactamases such as IMP, VIM, and NDM), and class D (oxacillinases with carbapenem-hydrolyzing capacity like OXA-198) enzymes. Additionally, derepression of chromosomal AmpC cephalosporinases in P. aeruginosa contributes to carbapenem resistance in the presence of other concomitant mechanisms such as impermeability or efflux overexpression. Epidemiologic and molecular evidence of carbapenemases in P. aeruginosa has been long accumulating, and reports of their existence in different geographical areas of the world currently exist. Such reports are continuously being updated and reveal emerging varieties of carbapenemases and/or new genetic environments. This review summarizes carbapenemases of importance in P. aeruginosa, highlights their genetic profile, and presents current knowledge about their global epidemiology.

Abstract Image

铜绿假单胞菌的碳青霉烯酶:现状、遗传特征和全球流行病学。
在世界范围内,铜绿假单胞菌仍然是一种难以治疗的主要医院病原体,对卫生保健系统构成了具有挑战性的威胁。铜绿假单胞菌对碳青霉烯类抗生素的耐药性增强且令人震惊,碳青霉烯类抗生素长期以来被认为是治疗耐药感染的最后手段。P. aeruginosa对碳青霉烯类的多种抗性途径可以同时发生,包括碳青霉烯酶的产生,这是最广泛的β-内酰胺酶类型,几乎可以水解所有β-内酰胺类,包括碳青霉烯类。生物体可以产生来自不同分子类别的染色体、质粒编码和整合子或转座子介导的碳青霉烯酶。这些包括Ambler A类(KPC和某些类型的GES酶),B类(不同的金属β-内酰胺酶,如IMP, VIM和NDM)和D类(具有碳青霉烯水解能力的OXA-198酶)酶。此外,铜绿假单胞菌染色体AmpC头孢菌素酶的抑制有助于碳青霉烯耐药,存在其他伴随机制,如不渗透性或外排过表达。铜绿假单胞菌中碳青霉烯酶的流行病学和分子证据已经积累了很长时间,目前在世界不同地理区域都有它们存在的报道。这些报告不断更新,揭示了碳青霉烯酶的新品种和/或新的遗传环境。本文综述了碳青霉烯酶在铜绿假单胞菌中的重要性,强调了它们的遗传谱,并介绍了它们的全球流行病学的最新知识。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Yale Journal of Biology and Medicine
Yale Journal of Biology and Medicine Biochemistry, Genetics and Molecular Biology-General Biochemistry,Genetics and Molecular Biology
CiteScore
5.00
自引率
0.00%
发文量
41
期刊介绍: The Yale Journal of Biology and Medicine (YJBM) is a graduate and medical student-run, peer-reviewed, open-access journal dedicated to the publication of original research articles, scientific reviews, articles on medical history, personal perspectives on medicine, policy analyses, case reports, and symposia related to biomedical matters. YJBM is published quarterly and aims to publish articles of interest to both physicians and scientists. YJBM is and has been an internationally distributed journal with a long history of landmark articles. Our contributors feature a notable list of philosophers, statesmen, scientists, and physicians, including Ernst Cassirer, Harvey Cushing, Rene Dubos, Edward Kennedy, Donald Seldin, and Jack Strominger. Our Editorial Board consists of students and faculty members from Yale School of Medicine and Yale University Graduate School of Arts & Sciences. All manuscripts submitted to YJBM are first evaluated on the basis of scientific quality, originality, appropriateness, contribution to the field, and style. Suitable manuscripts are then subject to rigorous, fair, and rapid peer review.
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