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The most common antimicrobial resistance mechanisms in such microorganisms include the acquisition of mobile genetic elements(MGEs) from other Enterobacterales and the overexpression of efflux pumps, The predominant cause of resistance to B-lactams is the production of B-lactamases, which inactivate the drug by hydrolyzing the B-lactam ring.
The most common antimicrobial resistance mechanisms in such microorganisms include the acquisition of mobile genetic elements(MGEs) from other Enterobacterales and the overexpression of efflux pumps, The predominant cause of resistance to B-lactams is the production of B-lactamases, which inactivate the drug by hydrolyzing the B-lactam ring. Based on the amber scheme, B-lactamases are grouped into four classes: the class B metalloenzymes, also known as Metallo-B-lactamases (MBLs); and the serine-reactive hydrolases (classes A, C, and D)[11]. ECC strains are intrinsically resistant to cephalosporins due to the production of thechromosomalcephalosporinaseblaACT-16whereas the spread of acquired B-lactamases has been often documented, such as the class A extended-spectrum beta-lactamases (ESBLs) of the CTX-M and SHV families as well as carbapenemases, such as the VIM- and NDMtypes (class B), KPC-2 (class A) and OXA-48 (class).
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