Carbapenem Resistance Gene (KPC/NDM/OXA 48/OXA 23/VIM/IMP)

Carbapenems are a class of beta-lactam antibiotics characterized by their broad-spectrum activity against both aerobic and anaerobic gram-positive and gram-negative bacteria [1]. Due to their stability against β-lactamases and low toxicity, they can treat severe and complicated infections. Carbapenems exhibit high stability against plasmid-mediated extended-spectrum β-lactamases(ESBLs), as well as chromosome- and plasmid-mediated cephalosporinases(Amp C enzymes) [2].

The main resistance mechanisms to carbapenem antibiotics include carbapenems production, loss or mutation of outer membrane proteins, overexpression of efflux pumps, and variation of penicillin-binding proteins, among which carbapenemase production is the most important mechanism [3]. Carbapenemases could be classified into A, B, and D according to the Ambler classification with Klebsiella pneumoniae carbapenemase (KPC) as Class A

includes) which is the major resistance mechanism of almost all β-lactam antibiotics in Enterobacterales, especially in Klebsiella pneumoniae in recent years, including KPC-2 in China [4], New Delhi metallo-β-lactamases as Class B enzymes including blaNDM (blaNDM-1 to blaNDM-29), blaIMP (blaIMP-1 to blaIMP-85), and blaVIM (blaVIM-1 to blaVIM-69) [5], and oxacillinases(OXA) as Class D including OXA-23, OXA-24, OXA-40, OXA-48, OXA-58, OXA-51, etc. [6].