An investigation of klebsiella pneumoniae carbapenemase kpcproducing enterobacteriaceae among patients of acute and longterm acute care hospitals was conducted in 2011. From april 2004 through april 2012, a total of 120 k. Given their multidrug resistance, therapeutic options are limited and, as discussed here. Carbapenemaseproducing enterobacteria cpe infect mainly hospitalized patients but also have been spreading in longterm care facilities. When bacteria such as klebsiella pneumoniae produce an enzyme known as a carbapenemase referred to as kpcproducing organisms, then the class of antibiotics called carbapenems will not work to kill the bacteria and treat the infection. Klebsiella pneumoniae carbapenemase kpc producing bacteria are a group of emerging highly drugresistant gramnegative bacilli causing infections associated with significant morbidity and mortality. It appears as a mucoid lactose fermenter on macconkey agar although found in the normal flora of the mouth, skin, and intestines, it can cause destructive changes to human and animal lungs if aspirated, specifically to the alveoli resulting in bloody, brownish. The klebsiella pneumoniae carbapenemase kpc was detected in a carbapenemresistant respiratory isolate of klebsiella pneumoniae in an irish hospital. Treatment of carbapenemresistant klebsiella pneumoniae. We investigated outcomes, risk factors for mortality and impact of appropriate antimicrobial treatment in patients with bsis caused by molecularly confirmed kpckp. Klebsiella pneumoniae carbapenemase kpcproducing bacteria are a. Carbapenems, such as imipenem and meropenem, are often used to treat infections caused by extendedspectrum betalactamase esblproducing. Arrival of klebsiella pneumoniae producing kpc carbapenemase. Emergence of kpc producing klebsiella pneumoniae in italy.
Introduction to klebsiella pneumoniae carbapenemases. High prevalence of kpc2producing hypervirulent klebsiella pneumoniae causing meningitis in eastern china min xu,1, yiqi fu,2, yunhui fang,3 hao xu,3 haishen kong,3 yanchao liu,1 yu chen,1,3 lanjuan li3 1key laboratory of clinical in vitro diagnostic techniques of zhejiang province, center of clinical laboratory, the first affiliated hospital, college of medicine, zhejiang university. Aims to provide practical suggestion for physicians dealing with the management of kpckp infections in critically ill patients, based on expert opinions. Evaluation of methods to identify the klebsiella pneumoniae. Molecular characterization of kpcproducing klebsiella. In particular, the increasing prevalence of carbapenemresistant klebsiella pneumoniae is a major source of concern. This relatedness was consistent with the history of one uk patient, who had been hospitalized previously in israel. Of 22 isolates, 21 were positive to bla kpc by pcr samples from patients and environment and a clone was identified with a similarity of greater than 75%. Once confined to outbreaks in the northeastern united states us, they have spread throughout the us and most of the world. Klebsiella pneumoniae carbapenemase kpcproducing k.
Prevalence of virulence plasmids in bloodstream isolates of klebsiella pneumoniae and crkp obtained from patients at two hospitals in hong kong published. Klebsiella is a superbug that causes a range of diseases, depending on which part of the body it infects. Klebsiella species are examples of enterobacteriaceae, a. Thus far, studies on klebsiella pneumoniae carbapenemase kpcproducing organisms have only been reported in those with a history of. Detection of the klebsiella pneumoniae carbapenemase kpc in. Klebsiella is a bacteria that can cause different types of infections such as a urinary tract infection or pneumonia, and is considered a not very common pathogen among patients in the community meaning outside the hospital. Many klebsiella infections are acquired in the hospital setting or in longterm care facilities. Emergence of klebsiella pneumoniae carbapenemase kpc. The purpose of this study was detected of the carbapenemase producer k. This is a pdf file of an unedited manuscript that has been accepted for publication. Mapping the evolution of hypervirulent klebsiella pneumoniae. The production of carbapenemases especially klebsiella pneumoniae carbapenemase kpc is the most important mechanism of enzymatic resistance in isolated enterobacteriaceae such as k.
Pdf klebsiella pneumoniae carbapenemase kpc was detected in two isolates of carbapenemresistant k. Some klebsiella bacteria have become highly resistant to antibiotics. Klebsiella pneumoniae definition of klebsiella pneumoniae. Clinical epidemiology of klebsiella pneumoniae carbapenemases. Carbapenemresistant enterobacteriaceae cre, especially klebsiella pneumoniae carbapenemase kpcproducing k. In the united states, klebsiella pneumoniae and klebsiella oxytoca are the two strains responsible for most human. During the outbreak, there were 18 isolates of klebsiella pneumoniae producing kpc 2 in 11 patients. Management of kpcproducing klebsiella pneumoniae infections. Klebsiella pneumoniae in healthcare settings hai cdc. Klebsiella pneumoniae is an important multidrugresistant mdr pathogen affecting humans and a major source for hospital infections associated with high morbidity and mortality due to limited treatment options. Klebsiella pneumoniae is a gramnegative, lactosefermenting, nonmotile, aerobic rodshaped bacterium. To determine the prevalence of brain and spinal cord injury bsci patients among all patients with klebsiella pneumoniae. Detection and treatment options for klebsiella pneumoniae. We investigated outcomes, risk factors for mortality and impact of appropriate antimicrobial treatment in patients with bsis caused by molecularly confirmed kpc kp.
High prevalence of kpc 2producing hypervirulent klebsiella pneumoniae causing meningitis in eastern china min xu,1, yiqi fu,2, yunhui fang,3 hao xu,3 haishen kong,3 yanchao liu,1 yu chen,1,3 lanjuan li3 1key laboratory of clinical in vitro diagnostic techniques of zhejiang province, center of clinical laboratory, the first affiliated hospital, college of medicine, zhejiang university. Klebsiella pneumoniae carbapenemase kpcproducing bacteria are a group of emerging highly drugresistant gramnegative bacilli causing infections associated with significant morbidity and mortality. Emergence of kpcproducing klebsiella pneumoniae in italy. Klebsiella pneumoniae carbapenemase kpcproducing klebsiella.
It has been a known human pathogen since it was first isolated in the late nineteenth century by edwin klebs. Three cases were confirmed as hospitalacquired infection. Risk factors and clinical impact of klebsiella pneumoniae. All consecutive patients with kpc kp bsis between may 2008 and may 2010. Klebsiella pneumoniae is a member of the family enterobacteriaceae and is one of the most common pathogens causing pneumonia, abscess, bacteremia, and urinary tract infections 1, 2 over several decades, some virulence factors of k. High prevalence of kpc2producing hypervirulent klebsiella. Global dissemination of carbapenemaseproducing klebsiella. To date, blakpc has been found in more than 100 different. Detection of klebsiella pneumoniae carbapenemase kpc. Thus far, studies on klebsiella pneumoniae carbapenemase kpc producing organisms have only been reported in those with a history of foreign travel, and a specific japanese kpc producing isolate has not yet been reported. Klebsiella pneumoniae carbapenemase kpc producing k. Kpc is a causative agent of pneumonia and is one of. When bacteria such as klebsiella pneumoniae produce an enzyme known as a carbapenemase referred to as kpc producing organisms, then the class of antibiotics called carbapenems will not work to kill the bacteria and treat the infection.
Klebsiella pneumoniae are normally harmless bacteria that live in your intestines and feces, but they can be dangerous in other parts of your body. It appears as a mucoid lactose fermenter on macconkey agar. To our knowledge, no study has specifically examined risk factors for kpc producing k. Pdf emergence of kpcproducing klebsiella pneumoniae in. Feb 10, 2014 the production of carbapenemases especially klebsiella pneumoniae carbapenemase kpc is the most important mechanism of enzymatic resistance in isolated enterobacteriaceae such as k. Klebsiella pneumoniae is a gramnegative, nonmotile, encapsulated, lactose fermenting, facultative anaerobic, rodshaped bacterium.
Klebsiella pneumoniae is a significant enterobacteriaceae considered as one of the opportunistic pathogens causing broad spectra of diseases and showing increasingly frequent acquisition of resistance to antibiotics. It is known as a pathogen that attacks hospitalized patients at a higher frequency and needds good antibiotic treatment. Some important virulence factors have been elucidated in klebsiella pneumoniae infections. Other articles where klebsiella pneumoniae is discussed. Epidemic klebsiella pneumoniae st258 is a hybrid strain mbio. Pdf treatment of klebsiella pneumoniae carbapenemase kpc. Treatment of klebsiella pneumoniae carbapenemase kpc. C arbapenemaseproducing klebsiella pneumoniae kpc is a multidrugresistant enteric bacterium that has emerged as a global health threat 1. Klebsiella pneumoniae causes a wide range of infections, including pneumonias, urinary tract infections, bacteremias, and liver abscesses. Klebsiella pneumoniae is a gramnegative, nonmotile, encapsulated, lactosefermenting, facultative anaerobic, rodshaped bacterium. Klebsiella is a type of bacteria commonly found in nature. Although found in the normal flora of the mouth, skin, and intestines, it can cause destructive changes to human and animal lungs if aspirated. Klebsiella pneumoniae, a common gut bacteria, causes problems when it moves outside the gut and causes infection. Pdf emergence of kpcproducing klebsiella pneumoniae in italy.
Klebsiella pneumoniae, also called friedlanders bacillus, was first described in 1882 by german microbiologist and pathologist carl friedlander. Pdf klebsiella pneumoniae carbapenemase kpcproducing. Detection of the klebsiella pneumoniae carbapenemase kpc. Prevalence of blakpc and its occurrence with other beta. Bloodstream infections bsis caused by klebsiella pneumoniae carbapenemases kpc producing k. Multiplex realtime pcr detection of klebsiella pneumoniae. However, starting in the mid1980s, a distinctive syndrome of communityacquired invasive k. Feb 06, 2018 klebsiella is a type of bacteria commonly found in nature. We describe a japanese patient, with no history of travel to foreign countries, admitted due to aspiration pneumonia, and a kpc producing isolate detected in his sputum. The disease is usually seen only in patients with underlying medical. Risk of infection and carriage rates of klebsiella spp. Sts, but this pandemic is driven primarily by the spread of kpc producing k. Klebsiella pneumoniae also known as friedlanders bacillus is a small 0,50,8 x 12 mm gramnegative coccobacilli that causes necrotizing lobar pneumonia. Klebsiella pneumoniae carbapenemases kpc and carbapenemases of the oxacillinase48 oxa48 type have been reported worldwide.
One or more virulence factors may contribute to pathogenicity in humans. Predictors of mortality in patients with bloodstream. Full text outbreak of klebsiella pneumoniae carbapenemase. In humans, the bacteria are often present in parts of the digestive tract where they do not generally cause problems. Klebsiella pneumoniae is one of such clinically significant organisms that have acquired much public health concern. The optimal treatment of infections caused by kpc bacteria is not well. The spread of enterobacteriaceae, primarily klebsiella pneumoniae, producing kpc, vim, imp, and ndm carbapenemases, is causing an unprecedented public health crisis. Treatment of klebsiella pneumoniae carbapenemase kpc infections. Bacteria producing klebsiella pneumoniae carbapenemases kpcs are rapidly. These infections are often complicated by devastating.
Molecular epidemiological characteristics of klebsiella. Klebsiella pneumoniae infections occur in humans of all ages, however the highest risk groups appear to be infants, the elderly and the immunocompromised. Bloodstream infections bsis caused by klebsiella pneumoniae carbapenemases kpcproducing k. Klebsiella infection genetic and rare diseases information.
This procedure provides instructions for taqmanbased realtime pcr detection of. In humans it is an unusual part of pharyngeal and oral microflora, but is. Automated and nonautomated methods for carbapenem susceptibility were evaluated for. Klebsiella pneumoniae is a gramnegative, nonmotile, lactose fermenting, rodshape organism. Emergence of carbapenemresistant hypervirulent klebsiella. Klebsiella pneumoniae is a bacterium that normally lives inside human intestines, where. Carbapenemaseproducing klebsiella pneumoniae, a key. Jun 29, 2019 the most common carbapenemases that are overproduced by these strains include klebsiella pneumoniae carbapenemase kpc and metalloenzymes. Therefore, the aim of our study was to provide updated epidemiologic data on contemporary carbapenemaseproducing k.
Klebsiella pneumoniae has traditionally been considered an opportunistic pathogen and is a common cause of nosocomial infections. In this study, 15 bla kpcpositive klebsiella pneumoniaethat showed dis crepant results for imipenem and meropenem from 4 new. Klebsiella pneumoniae is a member of the klebsiella genus of enterobacteriaceae and belongs to the normal flora of the human mouth and intestine. Kpc is an enzyme that degrades penicillin, cephalosporin, and broadspectrum. Carbapenem resistance in klebsiella pneumoniaenot detected by. Klebsiella pneumoniae an overview sciencedirect topics. Klebsiella pneumoniae carbapenemase kpcproducing bacteria are amongst the most important causative agents of nosocomial infections worldwide. In the united states, klebsiella pneumoniae and klebsiella oxytoca are the two strains responsible for most human illnesses. The most common carbapenemases that are overproduced by these strains include klebsiella pneumoniae carbapenemase kpc and metalloenzymes. The investigation found extensive spread of kpcproducing enterobacteriaceae throughout 4 adjacent counties in indiana and illinois over a 1yr period. We investigated the relationship between virulence factors and multilocus sequence types sts and assessed the risk factors for bacteremia in patients with pneumonia due to k. Klebsiella pneumoniae is a common enterobacterium that causes a disease spectrum that includes severe pneumonia lobular or lobar, enteritis, urinary tract infection, and miscellaneous septic lesions, including sinusitis, meningitis, and otitis. To our knowledge, no study has specifically examined risk factors for kpcproducing k.
Pdf treatment of klebsiella pneumoniae carbapenemase. Klebsiella pneumoniae carbapenemase kpcproducing enterobacteriaceae have been reported in many countries, and outbreaks due to kpcproducing organisms have been reported worldwide 1,2,3. This organism is also surrounded by a capsule, which increases its virulence by acting as a physical barrier to evade the hosts immune response. We summarize the wide resistome of this pathogen, which encompasses plentiful chromosomal and plasmidencoded antibiotic resistance. Aims to provide practical suggestion for physicians dealing with the management of kpc kp infections in critically ill patients, based on expert opinions. The klebsiella pneumoniae carbapenemase kpc enzyme, encoded by alleles of the bla kpc gene, represents one of the five major carbapenemase families. Genomic epidemiology of global klebsiella pneumoniae. The enzyme may confer lowlevel carbapenem resistance, and the failure of susceptibility methods to identify this resistance has been reported. Epidemiology of carbapenemase producing klebsiella.
47 993 204 1311 652 499 962 524 1466 421 772 1138 1330 1084 790 1342 984 1387 790 1067 9 71 1255 1323 805 819 1178 796 600 1320 101 850