Carbapenemasas en especies del género Pseudomonas

Pseudomonas aeruginosa is one of the most relevant nosocomial pathogens, as well as one of the main causes of chronic respiratory infections in patients with underlying diseases such as cystic fibrosis or chronic obstructive pulmonary disease. The high intrinsic antibiotic resistance of this pathogen, together with its extraordinary capacity for acquiring additional resistances through chromosomal mutations, determines a major threat for antimicrobial therapy in hospitals worldwide. Even more concerning is the increasing detection of multiple antimicrobial resistance determinants in this microorganism, frequently located on integrons, acquired by horizontal transfer through plasmids and/or transposons. Among these mechanisms, the carbapenemases are particularly relevant, due to the wide spectrum of antibiotics affected. This work reviews the epidemiology, impact, and detection of the carbapenemases described so far in the Pseudomonas spp., that mainly include class B enzymes (metallo-beta-lactamases [MBL]: IMP, VIM, SPM, GIM, AIM, or DIM), but also, to a lower extent, class A (GES y KPC) and D (OXA) beta-lactamases. The presence of transferable carbapenemases is not only important in P. aeruginosa, but also in other less clinically-relevant species of the genus, since they can act as reservoires and dispersion vectors of these resistance determinants. The growing prevalence of carbapenemase-producing clinical isolates calls for the implementation of multidisciplinary strategies to optimize the detection and minimize the dissemination of these multidrug resistant strains and the involved transferable genetic elements.