Open AccessLaboratory detection and clinical implication of oxacillinase-48 like carbapenemase: The hidden threat
Author(s) -
Yamuna Devi Bakthavatchalam,
Shalini Anandan,
Balaji Veeraraghavan
Publication year - 2016
Publication title -
journal of global infectious diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.437
H-Index - 25
eISSN - 0974-8245
pISSN - 0974-777X
DOI - 10.4103/0974-777x.176149
Subject(s) - klebsiella pneumoniae , cephalosporin , microbiology and biotechnology , escherichia coli , plasmid , broad spectrum , pathogen , outbreak , carbapenem , biology , medicine , gene , virology , antibiotics , chemistry , genetics , combinatorial chemistry
Carbapenemase producing Gram-negative pathogen is of great concern for physician. The challenging aspects are treatment option and infection control. Monitoring of respective carbapenemase resistance mechanism is necessary to prevent the outbreaks. Currently, the rapid emergence of oxacillinase (OXA-48) like is alarming. Increasing frequency of OXA-48 is seen than the classical carbapenemase (KPC, NDM, IMP, and VIM) across the world. The bla OXA-48 gene is commonly identified in Escherichia coli and Klebsiella pneumoniae. The transferrable plasmid of OXA-48 is associated with rapid spread and inter-species dissemination. In general, OXA-48-like enzymes weakly hydrolyzes both carbapenem and broad spectrum cephalosporins. Except OXA-163, which effectively hydrolyze cephalosporin. This poor hydrolytic profile obscures the detection of OXA-48-like. It may go undetected in routine diagnosis and complicates the treatment option. Co-production of OXA-48-like with CTX-M-15 and other carbapenemase (NDM, VIM) leads to the emergence of multidrug resistant strains.