Carbapenem resistance in <i>Enterobacterales</i> from agricultural, environmental and clinical origins: South Africa in a global context

Taish Ramkisson; Diane Rip; Taish Ramkisson; Diane Rip

doi:10.3934/microbiol.2023034

AIMS Microbiology

2023, Volume 9, Issue 4: 668-691. doi: 10.3934/microbiol.2023034

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Review

Carbapenem resistance in Enterobacterales from agricultural, environmental and clinical origins: South Africa in a global context

Taish Ramkisson ,
Diane Rip ^,

Department of Food Science, Stellenbosch University, Stellenbosch, 7600, South Africa

Received: 20 July 2023 Revised: 05 September 2023 Accepted: 15 September 2023 Published: 25 September 2023

Carbapenem agents are regarded as last-resort antibiotics, however, bacterial resistance towards carbapenems has been reported in both clinical and agricultural settings worldwide. Carbapenem resistance, defined as the resistance of a bacteria towards one or more carbapenem drugs, can be mediated in either of, or a combination of, three mechanisms–although, the mechanism mediated through the production of carbapenemases (β-lactamases that are able to enzymatically degrade carbapenems) is of most significance. Of particular concern is the occurrence of carbapenemase producing Enterobacterales (CPE), with literature describing a dramatic increase in resistance globally. In South Africa, increases of carbapenemase activity occurring in Enterobacter species, Klebsiella pneumoniae, Acinetobacter baumannii and Pseudomonas aeruginosa have recently been reported. CPE can also be found in agricultural environments, as global studies have documented numerous instances of CPE presence in various animals such as pigs, cattle, seafood, horses and dogs. However, most reports of CPE occurrence in agricultural settings come from Northern America, Europe and some parts of Asia, where more extensive research has been conducted to understand the CPE phenomenon. In comparison to clinical data, there are limited studies investigating the spread of CPE in agricultural settings in Africa, highlighting the importance of monitoring CPE in livestock environments and the food chain. Further research is necessary to uncover the true extent of CPE dissemination in South Africa. This review will discuss the phenomenon of bacterial antibiotic resistance (ABR), the applications of the carbapenem drug and the occurrence of carbapenem resistance globally.
- carbapenemase-producing Enterobacterales,
- carbapenem resistance,
- β-lactamases,
- Africa,
- agricultural,
- food-animals,
- clinical
Citation: Taish Ramkisson, Diane Rip. Carbapenem resistance in Enterobacterales from agricultural, environmental and clinical origins: South Africa in a global context[J]. AIMS Microbiology, 2023, 9(4): 668-691. doi: 10.3934/microbiol.2023034

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Abstract

Carbapenem agents are regarded as last-resort antibiotics, however, bacterial resistance towards carbapenems has been reported in both clinical and agricultural settings worldwide. Carbapenem resistance, defined as the resistance of a bacteria towards one or more carbapenem drugs, can be mediated in either of, or a combination of, three mechanisms–although, the mechanism mediated through the production of carbapenemases (β-lactamases that are able to enzymatically degrade carbapenems) is of most significance. Of particular concern is the occurrence of carbapenemase producing Enterobacterales (CPE), with literature describing a dramatic increase in resistance globally. In South Africa, increases of carbapenemase activity occurring in Enterobacter species, Klebsiella pneumoniae, Acinetobacter baumannii and Pseudomonas aeruginosa have recently been reported. CPE can also be found in agricultural environments, as global studies have documented numerous instances of CPE presence in various animals such as pigs, cattle, seafood, horses and dogs. However, most reports of CPE occurrence in agricultural settings come from Northern America, Europe and some parts of Asia, where more extensive research has been conducted to understand the CPE phenomenon. In comparison to clinical data, there are limited studies investigating the spread of CPE in agricultural settings in Africa, highlighting the importance of monitoring CPE in livestock environments and the food chain. Further research is necessary to uncover the true extent of CPE dissemination in South Africa. This review will discuss the phenomenon of bacterial antibiotic resistance (ABR), the applications of the carbapenem drug and the occurrence of carbapenem resistance globally.

Conflict of interest

The authors declare no conflict of interest.

Author contributions:

Conceptualization, D.R, Original manuscript preparation, T.R, Review and Editing, D.R and T.R, Project administration, DR.

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