Global Spread of Carbapenem-Resistant Enterobacteriaceae: A Challenging Threat to the Treatment of Bacterial Diseases in Clinical Practice

The increase in the occurrence of carbapenemase-producing Enterobacteriaceae constitutes a threat not only to treatment of bacterial infection but also to public health problems. Resistance to carbapenems is mostly due to the production of carbapenemases, which are capable of hydrolyzing not only carbapenems but also other groups of antibiotics like penicillins, cephalosporins, quinolones, etc. The most common carbapenemases include veronica integron Metallo-β-lactamases types (VIM), imipenemase (IMP) types, Klebsiella pneumoniae carbapenemase (KPC), oxacillinase-48 (OXA-48), and New Delhi metallo-β-lactamase-1 (NDM-1), encoded by carbapenem resistant determining genes blaVIM, blaIMP, blaKPC, blaOXA-48, and blaNDM, respectively. Carbapenemase activity can be investigated by phenotypic assay however carbapenemase encoding genes can also be part of the routine assay for diagnosis of bacterial infection. In Africa, there is limited data on the prevalence and distribution of carbapenem resistant enterobacteriaceae in clinical studies except in East Africa where a few studies have been done in Kenya and Tanzania.