What do We Know so Far about Ges Carbapenemases, and What Threat do They Pose?

Abstract

Carbapenemases, classified as bacterial enzymes, have the ability to hydrolyze carbapenems – important broad-spectrum antibiotics. This work attempts to summarize the information on the diversity of Guiana Extended-Spectrum (GES) subgroup of carbapenemases, and highlights the serious threat posed by infections caused by bacteria capable of producing these enzymes. The structure, functional characteristics, classification of different types of GES carbapenemases and diagnostic methods are discussed in detail. There are 59 GES-type carbapenemases, which have different amino acid sequences of the protein chains as well as activity against various antibiotics. Currently, bacterial strains with antibiotic resistance of the GES type are treated with: cefiderocil belonging to the cephalosporins, eravacycline belonging to the tetracyclines, lefamulin belonging to the pleuromutulins, colistin, fosfomycin, nitrofurantoin, tobramycin, amikacin, imipenem with relebactam, meropenem with waborbactam, ceftazidime with avibactam and plazomycin. In addition, the following drugs are under study: durlobactam with sulbactam, taniborbactam and cefepime with enmetazobactam This paper aims to summarize the current knowledge on GES-type carbapenemases, their diagnosis and treatment.

Keywords

• antimicrobial resistance
• carbapenemases
• guiana extended-spectrum
• carbapenemases
• carbapenemase-producing strains