**The Emerging Problems of Carbapenem-Resistant Gram-Negative Bacillary Pneumonia Gram-Negative Bacillary Pneumonia**

**The Emerging Problems of Carbapenem-Resistant** 

DOI: 10.5772/intechopen.69630

Mihaela Ileana Ionescu Mihaela Ileana Ionescu Additional information is available at the end of the chapter

Additional information is available at the end of the chapter

http://dx.doi.org/10.5772/intechopen.69630

#### **Abstract**

Carbapenem-resistant Gram-negative organisms are increasingly isolated from lower respiratory tract infections. Limited treatment options are the main problems for physicians and clinical microbiologists who have to face such clinical cases. Bacteriological diagnosis, starting with accurate Gram smear performed from properly collected specimens and ending with antibiotic susceptibility testing, is essential. Morphological characters of bacterial cells provide important clues about the nature of infection, prior to bacterial isolation and identification. Attempts to find complementary options for the respiratory contamination and treatment of carbapenem-resistant Gram-negative bacillary pneumonia led us to test the susceptibility of 21 essential oils. Among them, *Thymus vulgaris*, *Eugenia caryophyllata*, *Origanum vulgare*, *Melaleuca alternifolia* and *Aniba rosaeodora* essential oils proved to be efficient against *Acinetobacter baumannii* carbapenem-resistant strain and *Escherichia coli* ATCC 25922. In an attempt to evaluate the magnitude of environmental spreading of the carbapenemase genes, 40 carbapenemase sequences of different organisms were compared. Carbapenemases show striking similarities inside each beta-lactamase class (A, D, and B), no matter their origin environmental organisms or clinical isolates. Class B carbapenemases are most widely distributed, metallo-beta-lactamases being present in bacteria as well in Archaea.

**Keywords:** carbapenemase producer, nosocomial pneumonia, essential oils, environmental pollution
