“This paper summarizes the current knowledge on expanded-spectrum ß-lactamases that may hydrolyze all ß-lactamas including carbapenems”

This paper summarizes the current knowledge on expanded-spectrum ß-lactamases that may hydrolyze all ß-lactamas including carbapenems. This is an emerging issue in antibiotic resistance in Gram-negative, at least concerning nosocomial pathogens.

It points out the most recent findings on this research subject. If spread also in Enterobacteriaceae, carbapenemase genes may represent a real threat for therapeutic efficacy of all ß-lactams which are still the most prescribed antibiotics.

Carbapenemases belong to structurally unrelated groups of ß-lactamases. They usually hydrolyze most, if not all, ß-lactams. Their genes are associated with a variety of genetic vehicles. They are associated with different antibiotic resistance genes that explain multidrug resistance of the clinical isolates. These ß-lactamases are mostly identified in Pseudomonas aeruginosa, Acinetobacter baumannii, and Enterobacteriaceae.

Many carbapenemase have been discovered after a careful analysis of the antibiotic resistance phenotype of multidrug resistance isolates. Those isolates came from France and mostly from worldwide disseminated laboratories. These fruitful exchanges lead to the discovery of novel mechanisms of resistance to antibiotics and their epidemiology.