Metallo-beta-lactamases: mechanisms, treatment challenges, and future prospects

Document Type

Article

Publication Date

4-1-2024

Publication Title

Expert review of anti-infective therapy

Abstract

INTRODUCTION: Metallo-beta-lactamases (MBLs) are responsible for resistance to almost all beta-lactam antibiotics. Found predominantly in Gram-negative bacteria, they severely limit treatment options. Understanding the epidemiology, risk factors, treatment, and prevention of infections caused by MBL-producing organisms is essential to reduce their burden.

AREAS COVERED: The origins and structure of MBLs are discussed. We describe the mechanisms of action that differentiate MBLs from other beta-lactamases. We discuss the global epidemiology of MBL-producing organisms and their impact on patients' outcomes. By exposing the mechanisms of transmission of MBLs among bacterial populations, we emphasize the importance of infection prevention and control.

EXPERT OPINION: MBLs are spreading globally and challenging the majority of available antibacterial agents. Genotypic tests play an important role in the identification of MBL production. Phenotypic tests are less specific but may be used in low-resource settings, where MBLs are more predominant. Infection prevention and control are critical to reduce the spread of organisms producing MBL in healthcare systems. New combinations such as avibactam-aztreonam and new agents such as cefiderocol have shown promising results for the treatment of infections caused by MBL-producing organisms. New antibiotic and non-antibiotic agents are being developed and may improve the management of infections caused by MBL-producing organisms.

Medical Subject Headings

Humans; beta-Lactamases; Anti-Bacterial Agents; Aztreonam; Gram-Negative Bacteria; Bacteria; Microbial Sensitivity Tests; beta-Lactamase Inhibitors

PubMed ID

38275276

ePublication

ePub ahead of print

Volume

22

Issue

4

First Page

189

Last Page

201

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