Commentary

Emerging superbugs: The threat of Carbapenem Resistant Enterobacteriaceae

  • Received: 03 June 2020 Accepted: 29 June 2020 Published: 01 July 2020
  • Carbapenem-resistant Enterobacteriaceae (CRE) are gram-negative bacteria that are resistant to carbapenems, a group of antibiotics considered as the last-resource for the treatment of infections caused by multidrug-resistant bacteria. CRE constitutes a major threat to health care systems because infections caused by these pathogens are difficult to treat and are commonly associated with high mortality due to the limited availability of effective antibiotics. While infection prevention and timely detection are of vital importance to control CRE infections, developing new and effective anti-CRE therapies is also crucial. Accumulating evidence indicates that gut microbiota alteration (dysbiosis) is associated with an increased intestinal colonization with CRE and consequently with higher risk of developing CRE infections. Importantly, therapeutic interventions aimed to modify the gut microbiota composition via fecal microbiota transplantation (FMT) have been explored in various clinical settings with some of them showing promising results, although larger clinical trials are needed to confirm the efficacy of this strategy. Here, we highlight the challenges associated with the emergence of CRE infections.

    Citation: Le Thanh Dong, Helen V. Espinoza, J. Luis Espinoza. Emerging superbugs: The threat of Carbapenem Resistant Enterobacteriaceae[J]. AIMS Microbiology, 2020, 6(3): 176-182. doi: 10.3934/microbiol.2020012

    Related Papers:

  • Carbapenem-resistant Enterobacteriaceae (CRE) are gram-negative bacteria that are resistant to carbapenems, a group of antibiotics considered as the last-resource for the treatment of infections caused by multidrug-resistant bacteria. CRE constitutes a major threat to health care systems because infections caused by these pathogens are difficult to treat and are commonly associated with high mortality due to the limited availability of effective antibiotics. While infection prevention and timely detection are of vital importance to control CRE infections, developing new and effective anti-CRE therapies is also crucial. Accumulating evidence indicates that gut microbiota alteration (dysbiosis) is associated with an increased intestinal colonization with CRE and consequently with higher risk of developing CRE infections. Importantly, therapeutic interventions aimed to modify the gut microbiota composition via fecal microbiota transplantation (FMT) have been explored in various clinical settings with some of them showing promising results, although larger clinical trials are needed to confirm the efficacy of this strategy. Here, we highlight the challenges associated with the emergence of CRE infections.


    加载中


    Funding



    This research received no external funds.

    Conflicts of Interest



    The authors declare no conflict of interest.

    Author contribution



    LTD: acquisition of data, drafting the article; (HVE) acquisition of data and drafting the article; (JLE) the conception and design of the study, drafting and final approval of the version to be submitted.

    [1] Thabit AK, Crandon JL, Nicolau DP (2015) Antimicrobial resistance: impact on clinical and economic outcomes and the need for new antimicrobials. Expert Opin Pharmacother 16: 159-177. doi: 10.1517/14656566.2015.993381
    [2] Kelly AM, Mathema B, Larson EL (2017) Carbapenem-resistant enterobacteriaceae in the community: a scoping review. Int J Antimicrob Agents 50: 127-134. doi: 10.1016/j.ijantimicag.2017.03.012
    [3] van Duin D, Doi Y (2017) The global epidemiology of carbapenemase-producing enterobacteriaceae. Virulence 8: 460-469. doi: 10.1080/21505594.2016.1222343
    [4] Suay-García B, Pérez-Gracia MT (2019) Present and future of carbapenem-resistant enterobacteriaceae (CRE) infections. Antibiotics (Base 8.
    [5] Friedman ND, Carmeli Y, Walton AL, et al. (2017) Carbapenem-resistant enterobacteriaceae: A strategic roadmap for infection control. Infect Control Hosp Epidemiol 38: 580-594. doi: 10.1017/ice.2017.42
    [6] Nordmann P, Poirel L (2019) Epidemiology and diagnostics of carbapenem resistance in gram-negative bacteria. Clin Infect Dis 69: S521-S528. doi: 10.1093/cid/ciz824
    [7] Livorsi DJ, Chorazy ML, Schweizer ML, et al. (2018) A systematic review of the epidemiology of carbapenem-resistant enterobacteriaceae in the United States. Antimicrob Resist Infect Control 7: 55. doi: 10.1186/s13756-018-0346-9
    [8] Dantes R, Mu Y, Belflower R, et al. (2013) National burden of invasive methicillin-resistant Staphylococcus aureus infections, United States, 2011. JAMA Intern Med 173: 1970-1978.
    [9] Young-Xu Y, Kuntz JL, Gerding DN, et al. (2015) Clostridium difficile infection among veterans health administration patients. Infect Control Hosp Epidemiol 36: 1038-1045. doi: 10.1017/ice.2015.138
    [10] Sievert DM, Ricks P, Edwards JR, et al. (2013) Antimicrobial-resistant pathogens associated with healthcare-associated infections: summary of data reported to the National Healthcare Safety Network at the Centers for Disease Control and Prevention, 2009–2010. Infect Control Hosp Epidemiol 34: 1-14. doi: 10.1086/668770
    [11] Guh AY, Bulens SN, Mu Y, et al. (2015) Epidemiology of carbapenem-resistant enterobacteriaceae in 7 US communities, 2012–2013. JAMA 314: 1479-1487. doi: 10.1001/jama.2015.12480
    [12] Bassetti M, Peghin M, Pecori D (2016) The management of multidrug-resistant enterobacteriaceae. Curr Opin Infect Dis 29: 583-594. doi: 10.1097/QCO.0000000000000314
    [13] Shimasaki T, Seekatz A, Bassis C, et al. (2019) Increased relative abundance of Klebsiella pneumoniae carbapenemase-producing Klebsiella pneumoniae within the gut microbiota is associated with risk of bloodstream infection in long-term acute care hospital patients. Clin Infect Dis 68: 2053-2059. doi: 10.1093/cid/ciy796
    [14] Christophy R, Osman M, Mallat H, et al. (2017) Prevalence, antibiotic susceptibility and characterization of antibiotic resistant genes among carbapenem-resistant gram-negative bacilli and yeast in intestinal flora of cancer patients in North Lebanon. J Infect Public Health 10: 716-720. doi: 10.1016/j.jiph.2016.10.009
    [15] Tran DM, Larsson M, Olson L, et al. (2019) High prevalence of colonisation with carbapenem-resistant enterobacteriaceae among patients admitted to Vietnamese hospitals: Risk factors and burden of disease. J Infect 79: 115-122. doi: 10.1016/j.jinf.2019.05.013
    [16] Espinoza JL (2018) Machine learning for tackling microbiota data and infection complications in immunocompromised patients with cancer. J Intern Med 284: 189-192. doi: 10.1111/joim.12746
    [17] Cammarota G, Ianiro G, Tilg H, et al. (2017) European consensus conference on faecal microbiota transplantation in clinical practice. Gut 66: 569-580. doi: 10.1136/gutjnl-2016-313017
    [18] Korach-Rechtman H, Hreish M, Fried C, et al. (2020) Intestinal dysbiosis in carriers of carbapenem-resistant enterobacteriaceae. mSphere 5. doi: 10.1128/mSphere.00173-20
    [19] Davido B, Batista R, Michelon H, et al. (2017) Is faecal microbiota transplantation an option to eradicate highly drug-resistant enteric bacteria carriage? J Hosp Infect 95: 433-437. doi: 10.1016/j.jhin.2017.02.001
    [20] Dinh A, Fessi H, Duran C, et al. (2018) Clearance of carbapenem-resistant enterobacteriaceae vs vancomycin-resistant enterococci carriage after faecal microbiota transplant: a prospective comparative study. J Hosp Infect 99: 481-486. doi: 10.1016/j.jhin.2018.02.018
    [21] Huttner BD, de Lastours V, Wassenberg M, et al. (2019) A 5-day course of oral antibiotics followed by faecal transplantation to eradicate carriage of multidrug-resistant enterobacteriaceae: a randomized clinical trial. Clin Microbiol Infect 25: 830-838. doi: 10.1016/j.cmi.2018.12.009
    [22] Bilinski J, Grzesiowski P, Sorensen N, et al. (2017) Fecal microbiota transplantation in patients with blood disorders inhibits gut colonization with antibiotic-resistant bacteria: Results of a prospective, single-center study. Clin Infect Dis 65: 364-370. doi: 10.1093/cid/cix252
    [23] Parpia AS, Ndeffo-Mbah ML, Wenzel NS, et al. (2016) Effects of response to 2014–2015 Ebola outbreak on deaths from Malaria, HIV/AIDS, and Tuberculosis, West Africa. Emerg Infect Dis 22: 433-441. doi: 10.3201/eid2203.150977
  • Reader Comments
  • © 2020 the Author(s), licensee AIMS Press. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0)
通讯作者: 陈斌, bchen63@163.com
  • 1. 

    沈阳化工大学材料科学与工程学院 沈阳 110142

  1. 本站搜索
  2. 百度学术搜索
  3. 万方数据库搜索
  4. CNKI搜索

Metrics

Article views(7005) PDF downloads(566) Cited by(19)

Article outline

Figures and Tables

Figures(1)

Other Articles By Authors

/

DownLoad:  Full-Size Img  PowerPoint
Return
Return

Catalog