Carbapenemase-producing Enterobacteriaceae and non-Enterobacteriaceae from animals and the environment: an emerging public health risk of our own making?

Acquired carbapenemases pose one of the most pressing public health threats relating to antibiotic resistance. In most countries, the number of carbapenemase-producing bacteria from human clinical specimens is rising, and the epidemiological status of these multiresistant bacteria is progressively w...

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Bibliographic Details
Published in:Journal of antimicrobial chemotherapy 2014-02, Vol.69 (2), p.287-291
Main Authors: Woodford, Neil, Wareham, David W, Guerra, Beatriz, Teale, Christopher
Format: Article
Language:English
Subjects:
Animals
Antibiotics
Bacterial Proteins - analysis
Bacterial Proteins - biosynthesis
beta-Lactamases - analysis
beta-Lactamases - biosynthesis
Carbapenems - pharmacology
Carbapenems - therapeutic use
Drug resistance
Drug Resistance, Multiple, Bacterial - drug effects
Drug Resistance, Multiple, Bacterial - physiology
Enterobacteriaceae
Enterobacteriaceae - enzymology
Enterobacteriaceae - isolation & purification
Enterobacteriaceae Infections - diagnosis
Enterobacteriaceae Infections - drug therapy
Enterobacteriaceae Infections - epidemiology
Environment
Gram-negative bacteria
Humans
International organizations
Public health
Public Health - trends
Salmonella
Salmonella enterica
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Summary:Acquired carbapenemases pose one of the most pressing public health threats relating to antibiotic resistance. In most countries, the number of carbapenemase-producing bacteria from human clinical specimens is rising, and the epidemiological status of these multiresistant bacteria is progressively worsening. Furthermore, there is a growing number of reports of carbapenemases found either in bacteria isolated from non-human sources or in Salmonella enterica subsp. enterica, a zoonotic species. However, carbapenemases are not yet systematically sought in bacteria from non-human sources, reports of them are largely observational, and there is limited investigation of carbapenemase-positive bacteria in animals and possible links with people who may have acted as potential sources. Active surveillance and monitoring for carbapenem-resistant bacteria in the food chain and other non-human sources is urgently needed, with an enhanced and rigorous follow-up of all positive results. The carbapenems are currently our last good defence against multiresistant Gram-negative bacteria. Our ability to limit the rise and spread of carbapenemase producers, which occur only at basal levels in many countries at present, should serve as a key performance indicator for the success or failure of the efforts that have been called for by international organizations and governments to reduce the impact of antibiotic resistance.
ISSN:0305-7453
1460-2091
DOI:10.1093/jac/dkt392