Antimicrobial Resistance: KEGG Signatures Antimicrobial Resistance: KEGG Signatures| Class | KO | Name | Threat Level | Drug group | |||
| MT | A | 2b | K18698 | beta-lactamase class A TEM | MT | A3 B1 B4 B6 B7 B8 B12 | Extended-spectrum cephalosporin (DG01776, DG01777), Monobactam (DG01454) |
| K18699 | beta-lactamase class A SHV | MT | B1 B4 B5 | ||||
| K18767 | beta-lactamase class A CTX-M | MT | B1 B4 B7 B8 B9 | ||||
| K18797 | beta-lactamase class A PER | MT | B1 B4 B6 B7 B8 | ||||
| K19097 | beta-lactamase class A VEB | MT | B1 B4 B6 | Extended-spectrum cephalosporin (DG01776, DG01777) | |||
| K19317 | beta-lactamase class A BEL | MT | B6 | ||||
| K18796 | beta-lactamase class A LAP | MT | |||||
| 2f | K18768 | beta-lactamase class A KPC | MT | A2 B1 B6 | Carbapenem (DG01458) | ||
| K18970 | beta-lactamase class A GES | MT | B1 B4 B6 | Extended-spectrum cephalosporin (DG01776, DG01777), Carbapenem (DG01458) |
|||
| K19316 | beta-lactamase class A IMI/SME | MT | A2 | Carbapenem (DG01458) | |||
| K22346 | beta-lactamase class A SME | MT | A2 | Carbapenem (DG01458) Second-generation cephalosporin (DG01775) Monobactam (DG01454) |
|||
| 2c | K18795 | beta-lactamase class A CARB-1 | MT | B6 B7 | Carbenicillin (DG00519) | ||
| K19218 | beta-lactamase class A CARB-5 | MT | B1 | Carbenicillin (DG00519) | |||
| K19217 | beta-lactamase class A CARB-17 | MT | |||||
| D | 2d | K18794 | beta-lactamase class D OXA-51 | MT | B1 | Carbapenem (DG01458) | |
| K19318 | beta-lactamase class D OXA-213 | MT | B1 | Carbapenem (DG01458) | |||
| K18971 | beta-lactamase class D OXA-24 | MT | B1 | Carbapenem (DG01458) | |||
| K18793 | beta-lactamase class D OXA-23 | MT | A2 B1 | Carbapenem (DG01458) | |||
| K19319 | beta-lactamase class D OXA-134 | MT | B1 | Carbapenem (DG01458) | |||
| K19320 | beta-lactamase class D OXA-211 | MT | B1 | Carbapenem (DG01458) | |||
| K19321 | beta-lactamase class D OXA-214 | MT | B1 | Extended spectrum penicillin (DG01780) Carbapenem (DG01458) (weak) |
|||
| K19322 | beta-lactamase class D OXA-229 | MT | B1 | Carbapenem (DG01458) | |||
| K18972 | beta-lactamase class D OXA-58 | MT | B1 | Carbapenem (DG01458) | |||
| K21266 | beta-lactamase class D OXA-286 | MT | B1 | ||||
| K18973 | beta-lactamase class D OXA-50 | MT | B6 | Narrow-spectrum penicillin (DG01779) | |||
| K19211 | beta-lactamase class D OXA-62 | MT | Carbapenem (DG01458) | ||||
| K18791 | beta-lactamase class D OXA-2 | MT | B1 B4 B6 B7 B8 | Extended-spectrum cephalosporin (DG01776, DG01777) | |||
| K18792 | beta-lactamase class D OXA-10 | MT | B1 B4 B6 | Extended-spectrum cephalosporin (DG01776, DG01777) | |||
| K18976 | beta-lactamase class D OXA-48 | MT | A2 | Carbapenem (DG01458) | |||
| K19210 | beta-lactamase class D OXA-61 | MT | B2 | Narrow-spectrum penicillin (DG01779) | |||
| K19212 | beta-lactamase class D OXA-63 | MT | Narrow-spectrum penicillin (DG01779) | ||||
| K18790 | beta-lactamase class D OXA-1 | MT | B4 B6 B7 B9 | Extended-spectrum cephalosporin (DG01776, DG01777) Extended spectrum penicillin (DG01780) |
|||
| K19098 | beta-lactamase class D OXA-9 | MT | Narrow-spectrum penicillin (DG01779) | ||||
| K19209 | beta-lactamase class D OXA-42 | MT | Narrow-spectrum penicillin (DG01779) | ||||
| K19213 | beta-lactamase class D OXA-12 | MT | Narrow-spectrum penicillin (DG01779) | ||||
| K21276 | beta-lactamase class D OXA-22 | MT | Narrow-spectrum penicillin (DG01779) | ||||
| K21277 | beta-lactamase class D OXA-60 | MT | Narrow-spectrum penicillin (DG01779) Carbapenem (DG01458) (weak) |
||||
| K22331 | beta-lactamase class D OXA-184 | MT | B2 | ||||
| K22332 | beta-lactamase class D OXA-548 | MT | |||||
| K22333 | beta-lactamase class D OXA-493 | MT | |||||
| K22334 | beta-lactamase class D OXA-464 | MT | |||||
| K22335 | beta-lactamase class D OXA-114 | MT | Extended spectrum penicillin (DG01780) Third-generation cephalosporin (DG01776) |
||||
| K22351 | beta-lactamase class D OXA-209 | MT | Extended-spectrum penicillin (DG01780) | ||||
| K22352 | beta-lactamase class D OXA-29 | MT | Extended-spectrum penicillin (DG01780) | ||||
| C | 1 | K19095 | beta-lactamase class C CMY-1 | MT | B4 | Extended-spectrum cephalosporin (DG01776, DG01777) | |
| K19096 | beta-lactamase class C CMY-2 | MT | B4 B7 | Second-generation cephalosporin (DG01775) Third-generation cephalosporin (DG01776) |
|||
| K19100 | beta-lactamase class C DHA | MT | |||||
| K19101 | beta-lactamase class C FOX | MT | |||||
| K19214 | beta-lactamase class C ACC | MT | |||||
| K19215 | beta-lactamase class C ACT/MIR | MT | Extended-spectrum penicillin (DG01780) Second-generation cephalosporin (DG01775) |
||||
| K20319 | beta-lactamase class C ADC | MT | |||||
| K20320 | beta-lactamase class C PDC | MT | |||||
| B | 3 | K18782 | metallo-beta-lactamase class B IMP | MT | A2 B1 B4 B6 B9 | Extended-spectrum cephalosporin (DG01776, DG01777), Carbapenem (DG01458) |
|
| K18781 | metallo-beta-lactamase class B VIM | MT | B4 B6 | Extended-spectrum cephalosporin (DG01776, DG01777), Carbapenem (DG01458) |
|||
| K18780 | metallo-beta-lactamase class B NDM | MT | A2 B1 | Carbapenem (DG01458) | |||
| K19099 | metallo-beta-lactamase class B GIM | MT | A2 B6 | Carbapenem (DG01458) | |||
| K19216 | metallo-beta-lactamase class B IND | MT | Carbapenem (DG01458) | ||||
| KO | Name | Threat Level | Drug group | ||
| MT | K17840 | aminoglycoside 2'-N-acetyltransferase I | MT | B6 B12 | Aminoglycoside (DG01447) |
| K03395 | aminoglycoside 3-N-acetyltransferase I | MT | B1 B6 B7 | ||
| K19275 | aminoglycoside 3-N-acetyltransferase II | MT | B1 B7 | ||
| K19276 | aminoglycoside 3-N-acetyltransferase IV | MT | B6 | ||
| K19277 | aminoglycoside 3-N-acetyltransferase VI | MT | B7 | ||
| K19278 | aminoglycoside 6'-N-acetyltransferase Ib | MT | B1 B6 | ||
| K19301 | aminoglycoside 6'-N-acetyltransferase II | MT | B1 B6 | ||
| K18815 | aminoglycoside 6'-N-acetyltransferase I | MT | B1 B6 B7 | ||
| K18816 | aminoglycoside 6'-N-acetyltransferase I | MT | B1 B6 B7 B11 | ||
| K17881 | aminoglycoside 2''-adenylyltransferase | MT | B1 | ||
| K19544 | aminoglycoside 4'-adenylyltransferase | MT | B6 | ||
| K19272 | aminoglycoside 3'-phosphotransferase I | MT | B1 B7 | ||
| K19300 | aminoglycoside 3'-phosphotransferase II | MT | B6 | ||
| K19299 | aminoglycoside 3'-phosphotransferase III | MT | B11 | ||
| K19274 | aminoglycoside 3'-phosphotransferase VI | MT | B1 | ||
| K19315 | aminoglycoside 3'-phosphotransferase XV | MT | B6 | ||
| K10673 | streptomycin 3"-kinase | MT | B1 B6 B7 | ||
| K04343 | streptomycin 6-kinase | MT | B1 B6 B7 | ||
| K18845 | 16S rRNA (guanine(1405)-N(7))-methyltransferase | MT | B1 B6 | ||
| MT | K18220 | ribosomal protection tetracycline resistance protein | MT | A1 | Tetracycline (DG00005) |
| MT | K00561 | 23S rRNA (adenine-N6)-dimethyltransferase | MT | B11 | Macrolide antibiotic (DG01551) |
| K18231 | macrolide transport system ATP-binding/permease protein | MT | B1 B11 | ||
| K06979 | macrolide phosphotransferase | MT | B1 | ||
| K08217 | MFS transporter, DHA3 family, macrolide efflux protein | MT | B7 B11 | ||
| MT | K18552 | MFS transporter, DHA1 family, florfenicol/chloramphenicol resistance protein |
MT | B6 B7 | Phenicol (DG01576) |
| K19271 | chloramphenicol O-acetyltransferase type A | MT | A3 B1 B6 B7 B11 | ||
| K00638 | chloramphenicol O-acetyltransferase type B | MT | B1 B6 B7 | ||
| K18554 | chloramphenicol 3-O phosphotransferase | MT | B12 | ||
| MT | K18589 | dihydrofolate reductase DfrA | MT | B1 B6 B7 | Trimethoprim (DG01581) |
| K19643 | dihydrofolate reductase DfrA | MT | B1 | ||
| K18590 | dihydrofolate reductase DfrA | MT | B7 | ||
| K19644 | dihydrofolate reductase DfrA | MT | B7 | ||
| K19645 | dihydrofolate reductase DfrB | MT | B6 B7 | ||
| Module | Name | Threat Level | ||
| MT | M00625 | Methicillin resistance | MT | B10 |
| M00627 | beta-Lactam resistance, Bla system | MT | B10 | |
| M00745 | Imipenem resistance, repression of porin OprD | MT | B6 | |
| M00651 | Vancomycin resistance, D-Ala-D-Lac type | MT | B5 | |
| M00652 | Vancomycin resistance, D-Ala-D-Ser type | MT | B5 | |
| M00704 | Tetracycline resistance, efflux pump Tet38 | MT | B10 | |
| M00725 | CAMP resistance, dltABCD operon | MT | B10 | |
| M00726 | CAMP resistance, lysyl-phosphatidylglycerol (L-PG) synthase MprF | MT | B10 | |
| M00730 | CAMP resistance, VraFG transporter | MT | B10 | |
| M00744 | CAMP resistance, protease PgtE | MT | B7 B8 | |
| M00718 | Multidrug resistance, efflux pump MexAB-OprM | MT | B6 | |
| M00639 | Multidrug resistance, efflux pump MexCD-OprJ | MT | B6 | |
| M00641 | Multidrug resistance, efflux pump MexEF-OprN | MT | B6 | |
| M00642 | Multidrug resistance, efflux pump MexJK-OprM | MT | B1 B6 | |
| M00643 | Multidrug resistance, efflux pump MexXY-OprM | MT | B6 | |
| M00769 | Multidrug resistance, efflux pump MexPQ-OpmE | MT | B6 | |
| M00649 | Multidrug resistance, efflux pump AdeABC | MT | B1 | |
| M00696 | Multidrug resistance, efflux pump AcrEF-TolC | MT | A2 B4 B7 B8 | |
| M00697 | Multidrug resistance, efflux pump MdtEF-TolC | MT | B9 | |
| M00698 | Multidrug resistance, efflux pump BpeEF-OprC | MT | B1 | |
| M00700 | Multidrug resistance, efflux pump AbcA | MT | B10 | |
| M00702 | Multidrug resistance, efflux pump NorB | MT | B10 C1 | |
| M00714 | Multidrug resistance, efflux pump QacA | MT | B10 C1 | |
| M00705 | Multidrug resistance, efflux pump MepA | MT | B10 C1 | |
| M00746 | Multidrug resistance, repression of porin OmpF | MT | B7 B8 B9 | |
| Threat level by CDC A. Urgent threats A1. Clostridium difficile B. Serious threatsA2. Carbapenem-resistant Enterobacteriaceae (CRE) A3. Drug-resistant Neisseria gonorrhoeae B1. Multidrug-resistant Acinetobacter C. Concerning threatsB2. Drug-resistant Campylobacter B3. Fluconazole-resistant Candida (a fungus) B4. Extended spectrum beta-lactamase producing Enterobacteriaceae (ESBLs) B5. Vancomycin-resistant Enterococcus (VRE) B6. Multidrug-resistant Pseudomonas aeruginosa B7. Drug-resistant non-typhoidal Salmonella B8. Drug-resistant Salmonella enterica serovar Typhi B9. Drug-resistant Shigella B10. Methicillin-resistant Staphylococcus aureus (MRSA) B11. Drug-resistant Streptococcus pneumoniae B12. Drug-resistant tuberculosis C1. Vancomycin-resistant Staphylococcus aureus (VRSA) C2. Erythromycin-resistant group A Streptococcus C3. Clindamycin-resistant group B Streptococcus According to: Antibiotic Resistance Threats in the United States, 2013 |
| Priority pathogens list by WHO Priority 1: Critical 1. Acinetobacter baumannii, carbapenem-resistant Priority 2: High2. Pseudomonas aeruginosa, carbapenem-resistant 3. Enterobacteriaceae, carbapenem-resistant, ESBL-producing 1. Enterococcus faecium, vancomycin-resistant Priority 3: Medium2. Staphylococcus aureus, methicillin-resistant, vancomycin-intermediate and resistant 3. Helicobacter pylori, clarithromycin-resistant 4. Campylobacter spp., fluoroquinolone-resistant 5. Salmonellae, fluoroquinolone-resistant 6. Neisseria gonorrhoeae, cephalosporin-resistant, fluoroquinolone-resistant 1. Streptococcus pneumoniae, penicillin-non-susceptible 2. Haemophilus influenzae, ampicillin-resistant 3. Shigella spp., fluoroquinolone-resistant According to: WHO priority pathogens list for R&D of new antibiotics, 2017 |