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Updated: Jul 14, 2026

Isolation and Identification of Waterborne Antibiotic-Resistant Bacteria and Molecular Characterization of their Antibiotic Resistance Genes

Isolation and Identification of Waterborne Antibiotic-Resistant Bacteria and Molecular Characterization of their Antibiotic Resistance Genes

Published on: March 3, 2023

Class A carbapenemases.

Jan Walther-Rasmussen¹, Niels Høiby

¹Department of Clinical Microbiology, 9301, Rigshospitalet, National University Hospital, Copenhagen, Denmark. jawalras@mail.tele.dk

The Journal of Antimicrobial Chemotherapy

|June 28, 2007

Summary

Carbapenem resistance in Enterobacteriaceae is rising due to prevalent class A beta-lactamases. These enzymes, like KPC and GES, inactivate carbapenems, limiting treatment options for serious infections.

Area of Science:

Microbiology
Molecular Biology
Biochemistry

Background:

Carbapenems (imipenem, meropenem) are crucial for treating infections caused by extended-spectrum beta-lactamase (ESBL)-producing enterobacteria.
Emergence of carbapenem-inactivating enzymes threatens the efficacy of these last-resort antibiotics.
Carbapenem resistance in Enterobacteriaceae, though rare, is increasing due to prevalent class A beta-lactamases.

Purpose of the Study:

To review the classification and prevalence of class A carbapenemases in Enterobacteriaceae.
To understand the genetic basis and location of carbapenemase genes.
To discuss the enzymatic activity and inhibition of these resistance enzymes.

Main Methods:

Phylogenetic analysis to classify class A carbapenemases.

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Review of genetic mechanisms (plasmid-borne, chromosomal, integrons, transposable elements).

Enzymatic activity profiling and classification using the Bush-Jacoby-Medeiros system.

Main Results:

Class A carbapenemases are phylogenetically grouped into six types (GES, KPC, SME, IMI/NMC-A, SHV-38, SFC-1).
Genes encoding these enzymes are found on plasmids or chromosomes, often associated with mobile genetic elements like integrons and transposons.
These enzymes hydrolyze various beta-lactams, including carbapenems, and are classified into four phenotypic groups (2br, 2be, 2e, 2f).

Conclusions:

Class A carbapenemases are a growing threat to carbapenem efficacy in Enterobacteriaceae.
Understanding their genetic and enzymatic diversity is crucial for surveillance and treatment strategies.
These enzymes remain susceptible to inhibition by clavulanate and tazobactam, similar to other class A beta-lactamases.