Factors involved in the development of carbapenem resistance

Abstract

Curbing the resistance to carbapenem antibiotics in bacterias of the Enterobacteriaceae family (Klebsiella pneumoniae, Escherichia coli, Serratia spp. and Proteus spp. predominantly), Pseudomonas aeruginosa and Acinetobacter baumanii is among the 10 challenges set by the World Health Organization. Research on resistance mechanisms and the factors involved is essential to stop the development of these species. This study will be based on a quantitative methodology, based on the statistical analysis of data collected from 2010 to 2020 in 30 European countries about the different factors involved: biological and genomic resistance mechanisms, analysis of resistance rates and antibiotics consumption, the influence of population movements, and finally, environmental factors (climate, food industry, animal husbandry, agronomy and fish farming). From a socio-economic point of view, it can be stated that the development of resistance to carbapenems is a globally extended concern. In 2017, the resulting expenditure was estimated at around 94 billion dollars worldwide. Currently, at European level, 33.000 deaths have been recorded. By 2050, an estimated 50 million deaths are expected worldwide. Carbapenems and polymyxins are broad-spectrum beta-lactam antibiotics, used to combat infections caused by resistant bacterias. The overuse of antibiotics and inappropriate treatments are major contributors to increase in resistances, both at hospital level and in industries such as animal husbandry. Population movements have had also a significant influence on the recovery of resistance species. The aim of this research study is not only to detect erroneous commands to curb resistance rates but also to make known new proposals for future investigations.