Carbapenem Resistance Mechanisms, Carbapenemase Genes Dissemination, and Laboratory Detection Methods: A Review

In recent years, carbapenem-resistant Enterobacteriaceae (CRE) has expanded quickly throughout the world, posing a serious threat to public health. They are also very difficult to treat and are associated with a high fatality rate. The class of antimicrobials known as carbapenems is regarded as the most trustworthy and last line of defense. It is possible to distinguish between CRE resistance mechanisms that produce carbapenemase enzymes and those that do not. The three classes of beta-lactamases, class A, class B, and class D, which have the highest clinical significance among nosocomial pathogens, class D, contain a variety of carbapenemase types. Carbapenem resistance genes have been disseminated by the vertically intrinsic inheritance method and the horizontally acquired inheritance method. The primary factor contributing to the rise in CRE prevalence is the plasmid-mediated horizontal transfer of carbapenemase genes. For the clinical prevention and treatment of these infections, CRE, particularly carbapenemase-producing Enterobacteriaceae (CPE), must be accurately and promptly detected. For application in clinical microbiology laboratories, numerous CRE phenotypes and genotypes fast detection techniques have been created. In this article, we summarized the various mechanisms of carbapenem resistance and the classification of carbapenemases enzymes, and we compared the advantages and limitations of the carbapenem resistance detection methods.