The Epidemiology and Molecular Aspect of Carbapenemase Producing Enterobactericiae (CPE). A Review

Carbapenems are the last line of defense against Gram-negative and Gram-positive bacteria that cause serious infections. Although they are resistant to most B-lactamases, the presence of carbapenem hydrolyzing enzymes known as carbapenemase has put their use as a last-resort antibiotic in jeopardy. These enzymes are produced most frequently by Enterobacteriaceae. True carbapenemase in Ambler molecular classes A, B, and D are frequently expressed by genes found in mobile genetic elements such plasmids, integrons, and transposons, which frequently contain many resistance determinants, further limiting treatment options. The worldwide development of carbapenem-resistant Gram-negative bacteria has resulted in a large number of nosocomial and community-acquired illnesses, which has become a major public health issue. In vitro evidence of the advantages of combination schemes against polymyxins is still available while polymyxins are still available.