ABSTRACT
This chapter analyzes the epidemiology of Carbapenem-Resistant Enterobacteriaceae (CRE) as well as current and future treatment options against the increasingly resistant bacteria. Furthermore, it provides an extensive review of the different mechanisms by which Entero- bacteriaceae develop resistance against carbapenems. Besides carbapenemase production, Enterobacteriaceae have alternative mechanisms by which they can present carbapenem resistance. These are unspecific mechanisms which can result in multi-drug resistance, such as the production of other f3-lactamases, porin loss and efflux pump overexpression. Lastly, eravacycline (Tetraphase) is a synthetic fluorocycline with broad-spectrum antimicrobial activity against Gram-positive, Gram-negative and anaerobic bacteria, regardless of resistance to other antibiotic classes. This antibiotic has several potential advantages over tigecycline, which include a more potent in vitro antibacterial activity, excellent oral bioavailability, lower potential for drug interactions and superior activity in biofilm. Regarding cefiderocol, it is the first siderophore-conjugated cephalosporin antibiotic to advance into late-stage development.
