Abstract

Carbapenemase-mediated resistance, driven by enzymes that inactivate lastresort carbapenem antibiotics, has emerged as a critical global health threat. To delineate its true scope, we conducted an exhaustive review of the past five years’ literature, focusing on the five principal carbapenemases (KPC, NDM, VIM, IMP, and OXA-48-like) in human clinical isolates. All relevant studies were synthesized into a unified database, which served as the basis for generating individual world maps for each enzyme and a composite map illustrating their co-occurrence. These visual tools illuminate the uneven yet interconnected nature of carbapenemase dissemination, underscoring the value of spatially resolved data in combating antimicrobial resistance. Our findings reveal distinct regional patterns: KPC dominates much of the Americas and Western Europe; NDM is most burdensome in the Indian subcontinent and North Africa; VIM remains concentrated in Southern Europe; IMP is endemic in Japan and parts of China; and OXA-48-like enzymes prevail around the Mediterranean and in the Middle East. These disparities reflect local genetic transfer dynamics, via plasmids, integrons, and other mobile elements, as well as variations in antibiotic use practices and surveillance capacity. Accurate, up-to-date distribution maps are therefore indispensable for tailoring surveillance strategies, optimizing antimicrobial stewardship, and directing research funding, all of which are vital for slowing the spread of these formidable resistance determinants. © (2025), (Universidad Bernardo O'Higgins). All rights reserved.