MS2

[MS2-01] Heterogeneity among antimicrobial resistance

〇Yukihiro Akeda¹ (1. Dept Bacteriol I, Natl Inst Infect Dis)

Keywords:薬剤耐性、腸内細菌目細菌、heterogeneity

In recent years, antimicrobial resistance (AMR) has become a major global public health concern. Countries around the world have tried to understand the current situation and are introducing various action plans to prevent spreading AMR bacteria, including new antimicrobials development and antimicrobial stewardship. There are various bacterial species as AMR bacteria concerned, and carbapenem-resistant Enterobacterales (CRE) are ranked among the top critical multi-drug resistant pathogens of high clinical and public health concern. CRE is resistant to most antibiotics, including carbapenems, which are regarded as "drugs of last resort'', and it is reported that about half of cases of bloodstream infection with CRE lead to death. Carbapenem resistance of CRE is mainly due to ß-lactamase (carbapenemases). Carbapenem resistance and multi-drug resistance are spreading widely across bacterial species due to the spread of plasmids encoding drug resistance genes including carbapenemase genes. Unlike classical types of drug-resistant bacteria such as MRSA, it is difficult to detect because it does not depend on a specific bacterial species. In addition, CRE belong to the order Enterobacterales, and it has been reported that it spreads as commensal in the gastrointestinal tract of healthy individuals. Therefore, genomic epidemiological analysis is effective to understand the prevalence/spreading of CRE clones, and it revealed the new types of carbapenem-resistant clones that cannot be detected by usual microbiological diagnosis. In this symposium, I would like to present new mechanisms of carbapenem resistance and the heterogeneity of bacterial populations which should be monitored in the future as a countermeasure against drug-resistant bacteria.
Conflict of Interest: Nothing to be declared.