Insights into Non-Enzymatic Carbapenem Resistance: Role of Porin Alterations among <i>Klebsiella pneumoniae</i>
<p id="p1">Carbapenem resistance in <em><italic xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">Klebsiella pneumoniae</italic></em> is a growing public health concern, with loss or deficiency of outer mem...
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| Autores principales: | , , |
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| Formato: | Capítulo de libro |
| Lenguaje: | inglés |
| Publicado: |
IntechOpen
2025
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| Materias: | |
| Acceso en línea: | https://www.intechopen.com/chapters/89397 |
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| Sumario: | <p id="p1">Carbapenem resistance in <em><italic xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">Klebsiella pneumoniae</italic></em> is a growing public health concern, with loss or deficiency of outer membrane porins (OMPs) and β-lactamases production, including extended-spectrum-β-lactamase (ESBL) and cephalosporinases, playing a significant role. <em><italic xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">K. pneumoniae</italic></em> is often found in urinary tract infections, pneumonia, and severe bacteremia, playing a significant role in hospital-acquired infections worldwide. The emergence of ESBL-producing <em><italic xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">K. pneumoniae</italic></em> is closely related to the overuse of expanded-spectrum cephalosporins, a critical factor in its rise. Carbapenems were once the last resort against multidrug-resistant strains producing ESBLs. However, their overuse and misuse have led to resistance mechanisms emerging. This has resulted in carbapenem-resistant Enterobacteriaceae becoming a major public health concern, with limited treatment options, fast transmission, and high mortality rates. Resistance to carbapenems may result from the production of carbapenemases or ESBL and/or AmpC β-lactamases in association with alteration in the outer membrane porins. <em><italic xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">K. pneumoniae</italic></em>, which normally lacks a chromosomally encoded class C β-lactamase, can easily acquire a plasmid encoding AmpC or another broad-spectrum-β-lactamase. These enzymes can confer high-level carbapenem resistance in porin-deficient strains. In addition, ESBL-producing <em><italic xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">K. pneumoniae</italic></em> with deficiency in OmpK35 and OmpK36 may contribute to the antibiotic resistance. These enzymes can confer high-level carbapenem resistance in porin-deficient strains.</p> |
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| ISBN: | 978-1-83634-842-9 |
| DOI: | 10.5772/intechopen.114946 |