Clinical epidemiology of the global expansion of Klebsiella pneumoniae carbapenemases. Lancet Infect Dis 2013 Sep;13(9):785-96
Date
08/24/2013Pubmed ID
23969216Pubmed Central ID
PMC4673667DOI
10.1016/S1473-3099(13)70190-7Scopus ID
2-s2.0-84882712084 (requires institutional sign-in at Scopus site) 1382 CitationsAbstract
Klebsiella pneumoniae carbapenemases (KPCs) were originally identified in the USA in 1996. Since then, these versatile β-lactamases have spread internationally among Gram-negative bacteria, especially K pneumoniae, although their precise epidemiology is diverse across countries and regions. The mortality described among patients infected with organisms positive for KPC is high, perhaps as a result of the limited antibiotic options remaining (often colistin, tigecycline, or aminoglycosides). Triple drug combinations using colistin, tigecycline, and imipenem have recently been associated with improved survival among patients with bacteraemia. In this Review, we summarise the epidemiology of KPCs across continents, and discuss issues around detection, present antibiotic options and those in development, treatment outcome and mortality, and infection control. In view of the limitations of present treatments and the paucity of new drugs in the pipeline, infection control must be our primary defence for now.
Author List
Munoz-Price LS, Poirel L, Bonomo RA, Schwaber MJ, Daikos GL, Cormican M, Cornaglia G, Garau J, Gniadkowski M, Hayden MK, Kumarasamy K, Livermore DM, Maya JJ, Nordmann P, Patel JB, Paterson DL, Pitout J, Villegas MV, Wang H, Woodford N, Quinn JPMESH terms used to index this publication - Major topics in bold
AminoglycosidesAnti-Bacterial Agents
Bacteremia
Bacterial Proteins
Colistin
Communicable Disease Control
Geography
Humans
Klebsiella Infections
Klebsiella pneumoniae
Minocycline
Treatment Outcome
beta-Lactamases
