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Review
. 2024 Mar 27:12:1376513.
doi: 10.3389/fpubh.2024.1376513. eCollection 2024.

Carbapenem-resistant Gram-negative bacteria (CR-GNB) in ICUs: resistance genes, therapeutics, and prevention - a comprehensive review

Qi Li  1   2 , Xiaoshi Zhou  1   2 , Rou Yang  1   2 , Xiaoyan Shen  2   3 , Guolin Li  1   4 , Changji Zhang  1   4 , Pengfei Li  2 , Shiran Li  1   2 , Jingxian Xie  1 , Yong Yang  1   2
Affiliations
Review

Carbapenem-resistant Gram-negative bacteria (CR-GNB) in ICUs: resistance genes, therapeutics, and prevention - a comprehensive review

Qi Li et al. Front Public Health. .

Abstract

Intensive care units (ICUs) are specialized environments dedicated to the management of critically ill patients, who are particularly susceptible to drug-resistant bacteria. Among these, carbapenem-resistant Gram-negative bacteria (CR-GNB) pose a significant threat endangering the lives of ICU patients. Carbapenemase production is a key resistance mechanism in CR-GNB, with the transfer of resistance genes contributing to the extensive emergence of antimicrobial resistance (AMR). CR-GNB infections are widespread in ICUs, highlighting an urgent need for prevention and control measures to reduce mortality rates associated with CR-GNB transmission or infection. This review provides an overview of key aspects surrounding CR-GNB within ICUs. We examine the mechanisms of bacterial drug resistance, the resistance genes that frequently occur with CR-GNB infections in ICU, and the therapeutic options against carbapenemase genotypes. Additionally, we highlight crucial preventive measures to impede the transmission and spread of CR-GNB within ICUs, along with reviewing the advances made in the field of clinical predictive modeling research, which hold excellent potential for practical application.

Keywords: CR-GNB; ICU; genes; infection control strategies; mechanism; predictive model.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Resistance mechanisms in Gram-negative bacteria and Gram positive bacteria.
Figure 2
Figure 2
β-lactamases in MDR-GNB according to Ambler’s classification.
See this image and copyright information in PMC

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The author(s) declare that financial support was received for the research, authorship, and/or publication of this article. This research was supported by the Committee of Cadre Health, Sichuan Province, China (No.2023–220).

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