Marta Hugas, EFSAs chief scientist said: The detection of resistance to carbapenems
in poultry and to linezolid in methicillin-resistant Staphylococcus aureus in pigs is alarming because these antibiotics are used in humans to treat serious infections.
were considered the only [beta]-lactam agents active against such extended - spectrum B - lactamase-producing strains1, but irrational use of Carbapenems
has also resulted in the development of resistance to this class of antibiotics as well.
In univariable analysis, we have found the association of CRKP infection with Charlson comorbidity index, renal dysfunction, cardiovascular disease, ICU stay at the time of the positive culture, previous antibiotic use, use of [sz]-lactams and [sz]-lactamase inhibitor combinations, use of cephalosporins, carbapenems
, fluoroquinolones, and antifungal agents, receipt of mechanical ventilation, indwelling of urethral catheter and gastric tube, hemodialysis, blood products' use, and Charlson comorbidity index [Table 1].
Until recently, the carbapenems
were considered as the last resort against the infections by Acinetobacter and were regarded as the most powerful antibiotics due to potent antibacterial activity and low toxicity.
Penicillin derivatives (Piperacillin/Tazobactam) and carbapenem
(Imipenem and Meropenem) are the most sensitive antibiotics covering all the organisms isolated in our study.
coli isolates were extremely sensitive to carbapenems
and 4th generation cephalosporins.
are widely used against gram negative and gram positive microbes; sensitivity to Meropenem was 91.
Since some MBL-producing Gram negative bacteria show low-level resistance or even sensitivity to carbapenems
, the CLSI breakpoints of carbapenems
among them have changed since June 2010.
6) In particular, resistance to carbapenems
suggests the possibility of carbapenemase production or another acquired resistance mechanism.
aeruginosa isolates that were tested for resistance for all five antibiotic classes: cephalosporins, beta-lactam and beta-lactamase inhibitors, carbapenems
3] The mechanism of resistance to carbapenems
among Enterobacteriaceae is complex and mediated by several different mechanisms, such as the over-production of ampC enzymes, extended-spectrum betalactamases (ESBLs), carbapenemases that inactivate the [beta]-lactam antibiotics, including the carbapenems
, efflux pumps and deletion of porins.
Enzymes that catalyze the cleavage of p-lactam rings in penicillins, cephalosporins, monobactams, and carbapenems
were first described by Abraham and Chain in 1940.