An Overview on Phenotypic and Genotypic Characterisation of Carbapenem-Resistant .

Amal A Sabour, Naveed Ahmed, Mai Abdel Haleem A Abusalah, Shawqi A Almushrif, Kovy Arteaga Livias, Haifa A Almuhtaresh, Fatimah S Al Yami, Elmoeiz Ali Elnagi Mohammed, Duaa M Alabdullah, Mashael Alhajri, Sara Alwarthan, Maha A Alshiekheid, Ali A Rabaan, Khalid Eljaaly, Jumana M Al-Jishi, Huseyin Tombuloglu, Wasl Al-Adsani, Hawra Albayat, Abbas Al Mutair, Saad Alhumaid, Faryal Khamis, Mohammed Garout, Amal H Alfaraj

Journal: Medicina (Kaunas, Lithuania) 2022;58(11):1675

PMID: 36422214

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Abstract

Improper use of antimicrobials has resulted in the emergence of antimicrobial resistance (AMR), including multi-drug resistance (MDR) among bacteria. Recently, a sudden increase in Carbapenem-resistant (CRE) has been observed. This presents a substantial challenge in the treatment of CRE-infected individuals. Bacterial plasmids include the genes for carbapenem resistance, which can also spread to other bacteria to make them resistant. The incidence of CRE is rising significantly despite the efforts of health authorities, clinicians, and scientists. Many genotypic and phenotypic techniques are available to identify CRE. However, effective identification requires the integration of two or more methods. Whole genome sequencing (WGS), an advanced molecular approach, helps identify new strains of CRE and screening of the patient population; however, WGS is challenging to apply in clinical settings due to the complexity and high expense involved with this technique. The current review highlights the molecular mechanism of development of Carbapenem resistance, the epidemiology of CRE infections, spread of CRE, treatment options, and the phenotypic/genotypic characterisation of CRE. The potential of microorganisms to acquire resistance against Carbapenems remains high, which can lead to even more susceptible drugs such as colistin and polymyxins. Hence, the current study recommends running the antibiotic stewardship programs at an institutional level to control the use of antibiotics and to reduce the spread of CRE worldwide.

Address: Molecular Diagnostic Laboratory, Johns Hopkins Aramco Healthcare, Dhahran 31311, Saudi Arabia.; College of Medicine, Alfaisal University, Riyadh 11533, Saudi Arabia.; Department of Public Health and Nutrition, The University of Haripur, Haripur 22610, Pakistan.; Department of Pharmacy Practice, Faculty of Pharmacy, King Abdulaziz University, Jeddah 21589, Saudi Arabia.; Pharmacy Practice and Science Department, College of Pharmacy, University of Arizona, Tucson, AZ 85716, USA.; Administration of Pharmaceutical Care, Al-Ahsa Health Cluster, Ministry of Health, Al-Ahsa 31982, Saudi Arabia.; Infectious Disease Department, King Saud Medical City, Riyadh 7790, Saudi Arabia.; Department of Medicine, Infectious Diseases Hospital, Kuwait City 63537, Kuwait.; Department of Infectious Diseases, Hampton Veterans Administration Medical Center, Hampton, VA 23667, USA.; Department of Botany and Microbiology, College of Science, King Saud University, Riyadh 11451, Saudi Arabia.; Internal Medicine Department, Qatif Central Hospital, Qatif 635342, Saudi Arabia.; Infection Diseases Unit, Department of Internal Medicine, Royal Hospital, Muscat 1331, Oman.; Department of Internal Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Ammam 34212, Saudi Arabia.; Pediatric Department, Abqaiq General Hospital, First Eastern Health Cluster, Abqaiq 33261, Saudi Arabia.; Department of Genetics Research, Institute for Research and Medical Consultations (IRMC), Imam Abdulrahman Bin Faisal University, Dammam 34221, Saudi Arabia.; Department of Community Medicine and Health Care for Pilgrims, Faculty of Medicine, Umm Al-Qura University, Makkah 21955, Saudi Arabia.; Molecular Diagnostic Laboratory, Dammam Regional Laboratory and Blood Bank, Dammam 31411, Saudi Arabia.; Department of Clinical Laboratory Sciences, Prince Sultan Military College of Health Sciences, Dhahran 34313, Saudi Arabia.; Department of Medical Laboratory, King Fahad Military Medical Complex, Dhahran 34313, Saudi Arabia.; Department of Clinical Laboratories Services, Dammam Medical Complex, Dammam Health Network, Dammam 5343, Saudi Arabia.; Facultad de Ciencias de la Salud, Universidad Científica del Sur, Lima 15001, Peru.; Facultad de Medicina, Universidad Nacional Hermilio Valdizán, Huánuco 10000, Peru.; Research Center, Almoosa Specialist Hospital, Al-Ahsa 36342, Saudi Arabia.; College of Nursing, Princess Norah Bint Abdulrahman University, Riyadh 11564, Saudi Arabia.; School of Nursing, Wollongong University, Wollongong, NSW 2522, Australia.; Nursing Department, Prince Sultan Military College of Health Sciences, Dhahran 33048, Saudi Arabia.; Department of Microbiology and Hematology Laboratory, Dammam Comprehensive Screening Centre, Dammam 31433, Saudi Arabia.; Faculty of Medical Allied Science, Zarqa University, Zarqa 13110, Jordan.; Department of Medical Microbiology and Parasitology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia.

DOI: 10.3390/medicina58111675

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MeSH Terms: Humans, Carbapenems, Genotype, Colistin, Anti-Bacterial Agents, Antimicrobial Stewardship