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Copyright ©The Author(s) 2020.
World J Hepatol. Dec 27, 2020; 12(12): 1136-1147
Published online Dec 27, 2020. doi: 10.4254/wjh.v12.i12.1136
Table 1 Synthesis of a selection of the studies published on spontaneous bacterial peritonitis due to carbapenem-resistant Enterobacteriaceae producing pathogens
Ref.
Total number SBP/CRE SBP
CRE
CRE N-SBP/Total SBP
Not-N-SBP/Total SBP
Piano et al[14], 20121/1K. pneumoniae1/10/1
Li et al[27], 201531/6K. pneumoniae, E. coli2/4, 2/22/4, 0/2
Alexopoulou et al[28], 2016130/6K. pneumoniae, E. coli5/5, 1/10/5, 0/1
Lutz et al[29], 201692/3E. faecium3/30/3
Tudorascu et al[30], 201664/3K. pneumoniae, E. coli, Enterobacter1/1, 1/1, 1/10/1, 0/1, 0/1
Salerno et al[31], 201656/8K. pneumoniae, E. coli5/7, 0/17/2, 1/1
Béjar-Serrano et al[32], 201922/1E. cloacae1/10/1
Table 2 Class A carbapenemase asset found in each pathogen
Pathogens
Class A carbapenemase

KPC-1
KPC-2
KPC-3
GES-4
GES-5
GES-6
SME-1
SME-2
SME-3
NMC-A
K. pneumoniae++++++
S. marcescens+++
E. coli+
E. cloacae++
Table 3 Class B carbapenemase asset found in each pathogen
Pathogens
Class B carbapenemase

IMP-1
IMP-1-like
IMP-4
IMP-8
VIM-1
VIM-1-like
VIM-2
VIM-2-like
VIM-4
VIM-5
K. pneumoniae+++++++
S. marcescens++++
E. coli+++
E. cloacae++++++++
C. freundii+++
Table 4 Class D carbapenemase asset found in each pathogen
Pathogens
Class D carbapenemase
OXA-48OXA-163OXA-181OXA-244
K. pneumoniae+++
S. marcescens+
E. coli+++
E. cloacae+
Table 5 Advantages and disadvantages of the antimicrobials used to treat spontaneous bacterial peritonitis due to gram-negative bacteria producing carbapenem-resistant Enterobacteriaceae
Antimicrobial agent
Advantages
Disadvantages
Ref.
Aminoglycosides (i.e. Plazomicin)Good activity against GNB producing ESβL, KPC, AmpC but not MβL enzymesHeterogeneous susceptibility high dose (toxicity)[49]
Polimixins (i.e. Colistin)Low resistance emergenceLow efficacy for Klebsiella spp. producing KPC enzymes[56]
FosfomicynModerate activity against MDR–CRERapid emergence of antibiotic resistance[59]
Glycylcycline (i.e. Tigecycline)Good activity against MDR–CREHigh dose (toxicity)[62]
Fluorocycline (i.e. Eravacycline)Broad spectrum activity (even if MDR and XDR pathogens). Active against the most common tetracycline-resistance mechanisms. High oral bioavailability. Safety and tolerabilityNot active on Pseudomonas spp. and Burkholderia spp.[63- 65]
β-lactams/β-lactamase inhibitors (i.e. ceftazidime/avibactam)Good activity against GNB producing ESβL, KPC, AmpC, OXA-48 and MβL. Safety and tolerabilityFrequent emergence of antibiotic resistance[67]
Carbapenem/β-lactamase inhibitors (i.e. meropenem/vaborbactam or Imipenem/cilastatin/relebactam)Good activity against GNB producing ESβL, KPC and AmpC. Outcome improvementNot active on GNB producing OXA-48 and MβL[79]
Monobactam/β-lactamase inhibitor (i.e. aztreonam/avibactam)Good activity against GNB producing ESβL, KPC, AmpC and OXA-48Recently approved[50- 52]
Siderophore cephalosporin (i.e. Cefidecol)Broad spectrum of activity against GNB, including MDR Enterobacteriaceae, Pseudomonas aeruginosa and A. baumanniiRecently approved[50]