Chapter 11 : Mobilization of Carbapenemase-Mediated Resistance in

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After decades of worry, extreme drug resistance has become an unfortunate reality in many hospitals around the world. Rather than arriving in the form of vancomycin-resistant or pan-drug-resistant tuberculosis, extreme drug resistance has emerged in enteric Gram-negative bacilli. Essentially unheard of prior to 2003, in 2011 11% of isolates from intensive care units in the United States were resistant to carbapenems, with an attributable mortality rate of 40% from associated invasive infections ( ). From a recent World Health Organization report, carbapenem resistance in had been seen in almost all countries that had data, and some countries reported carbapenem resistance rates of more than 50% ( ). The Centers for Disease Control and Prevention (CDC) listed carbapenem-resistant as one of the three most urgent groups of drug-resistant microbes threatening human health in the United States ( ).

Citation: Mathers A. 2016. Mobilization of Carbapenemase-Mediated Resistance in , p 201-212. In Scheld W, Hughes J, Whitley R (ed), Emerging infections 10. ASM Press, Washington, DC. doi: 10.1128/microbiolspec.EI10-0010-2015
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Figure 1

Global epidemiology of three major carbapenemase enzymes in . Distribution of KPC; distribution of OXA-48; distribution of NDM. Legend colors (darkest to lightest): endemic, multiple outbreaks, sporadic, unknown.

Citation: Mathers A. 2016. Mobilization of Carbapenemase-Mediated Resistance in , p 201-212. In Scheld W, Hughes J, Whitley R (ed), Emerging infections 10. ASM Press, Washington, DC. doi: 10.1128/microbiolspec.EI10-0010-2015
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Figure 2

Schematic of mechanisms of mobility of carbapenemase genes in .

Citation: Mathers A. 2016. Mobilization of Carbapenemase-Mediated Resistance in , p 201-212. In Scheld W, Hughes J, Whitley R (ed), Emerging infections 10. ASM Press, Washington, DC. doi: 10.1128/microbiolspec.EI10-0010-2015
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Ambler class β-lactamases with efficient carbapenem hydrolysis found in

Citation: Mathers A. 2016. Mobilization of Carbapenemase-Mediated Resistance in , p 201-212. In Scheld W, Hughes J, Whitley R (ed), Emerging infections 10. ASM Press, Washington, DC. doi: 10.1128/microbiolspec.EI10-0010-2015

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