Resistance of Klebsiella pneumoniae and Escherichia coli to β-lactam antibiotics: prevalence and mechanisms of rapid spread
DOI:
https://doi.org/10.5281/zenodo.20005157Keywords:
Key words: Escherichia coli, Klebsiella pneumoniae, antibiotic resistance, β-lactamase, horizontal gene transfer.Abstract
The growth of antibiotic resistance (ABR) in common bacterial pathogens is a global threat to public health and healthcare systems worldwide. The problem has been widely recognized as highly significant, prompting rigorous surveillance and comprehensive studies of the molecular mechanisms underlying ABR development and spread. This publication aimed to review current data concerning beta-lactam antibiotic (BLA) resistance in major nosocomial pathogens, Escherichia coli and Klebsiella pneumoniae. Materials and methods. Review of relevant articles retrieved by a search of the PubMed, Cochrane Library databases, and WHO published data. Results and discussion. In 2017, the WHO, for the first time, published a list of 12 families of antibiotic-resistant pathogens (Bacterial Priority Pathogens List (BPPL)) posing the greatest threat to human health. Escherichia coli and Klebsiella pneumoniae were classified in the critical priority category. The updated 2024 version of BPPL comprises three additional families and continues to categorize carbapenem-resistant Enterobacterales as a critical priority. Infections caused by Gram-negative enteric bacilli have been treated with BLA for a long time. This prompted the evolution of various bacterial resistance mechanisms, particularly numerous types of β-lactamases (β-lactam-degrading enzymes), including extended-spectrum β-lactamases (ESBLs). This trend is also observed in Ukraine: in 2014-2020, the average rate of BLA resistance among Enterobacterales strains isolated from surgical site infections was 60,0-65,0%, reaching 85,0-100,0% in the ICU. Unfortunately, the current national research infrastructure fails to generate sufficient genomic data, hindering reliable assessment of the local spread of ESBL. The review highlights the diversity and quick molecular evolution of multiple BLA-resistance mechanisms in Escherichia coli and Klebsiella spp., as well as the role of horizontal gene transfer in their spreading. Monitoring this process in hospital settings is crucial for developing a reasonable strategy to overcome ABR and requires implementing genomic surveillance of antimicrobial resistance.
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