The Carbapenems Issue

  • David Sotello
  • Wadih Chakkour
  • Kristen Fuhrmann
Keywords: Resistance, Antibiotics, Carbapenem, Carbapenemase, β-lactamase


The development of antibiotics remains one of the great advances in medicine. Antibiotics have saved countless lives. Unfortunately, the widespread use of antimicrobials has led to the development of antimicrobial resistance. Antibiotic resistance is an important concern for public health; it is associated with poor outcomes. Carbapenems, members of the β-lactam class of antibiotics, have the broadest spectrum of antimicrobial activity. Carbapenem resistance is one of the toughest challenges in infectious diseases; it is associated with high mortality and is seen more often now due to the proliferation of multi-drug resistant bacteria. Multiple genes that cause carbapenem resistance have been identified. Resistance transmission is usually nosocomial, but community-acquired infections with resistance have been reported. Early recognition of high risk patients for multi-drug resistant infections is fundamental for adequate management. The rational use of antibiotics is required to prevent the spread of antimicrobial resistance; this requires multidisciplinary efforts among clinicians, Infection Control departments, and Antimicrobial Stewardship programs.


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Martens E, Demain AL. The antibiotic resistance crisis, with

a focus on the United States. J Antibiot (Tokyo). 2017;70:


Marston HD, Dixon DM, Knisely JM, et al. Antimicrobial

resistance. JAMA. 2016;316:1193–1204.

Doi Y, Chambers HF. Other β-Lactam Antibiotics. In: Mandell,

Douglas, and Bennett’s Principles and Practice of Infectious

Diseases, Updated edition. 8th Edition, Pennsylvania:

Saunders, 2015. Chapter 22:293–297.

Nau R, Sörgel F, Eiffert H. Penetration of drugs through the

blood-cerebrospinal fluid/blood-brain barrier for treatment

of central nervous system infections. Clin Microbiol Rev


Friedman ND, Carmeli Y, Walton AL, et al. Carbapenemresistant

Enterobacteriaceae: a strategic roadmap for infection

control. Infect Control Hosp Epidemiol 2017;38:


Lolans K, Queenan AM, Bush K, et al. First nosocomial

outbreak of Pseudomonas aeruginosa producing an integron-borne

metallo-beta-lactamase (VIM-2) in the United

States. Antimicrob Agents Chemother 2005;49:3538–40.

Kelly AM, Mathema B, Larson EL. Carbapenem-resistant

Enterobacteriaceae in the community: a scoping review.

See comment in PubMed Commons belowInt J Antimicrob

Agents 2017;50:127–134.

Magiorakos AP, Burns K, Rodríguez Baño J, et al. Infection

prevention and control measures and tools for the

prevention of entry of carbapenem-resistant Enterobacteriaceae

into healthcare settings: guidance from

the European Centre for Disease Prevention and Control.

Antimicrob Resist Infect Control 2017; 6: 113.

Codjoe FS, Donkor ES. Carbapenem resistance: a review.

Med Sci (Basel) 2017;21:6(1).

Doi Y, Paterson DL. Carbapenemase-producing Enterobacteriaceae.

Semin Respir Crit Care Med 2015;36:74–84.

How to Cite
Sotello, D., Chakkour, W., & Fuhrmann, K. (2018). The Carbapenems Issue. The Southwest Respiratory and Critical Care Chronicles, 6(25), 5-7.