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Review
. 2013 Sep;13(9):785-96.
doi: 10.1016/S1473-3099(13)70190-7.

Clinical epidemiology of the global expansion of Klebsiella pneumoniae carbapenemases

L Silvia Munoz-Price  1 , Laurent Poirel, Robert A Bonomo, Mitchell J Schwaber, George L Daikos, Martin Cormican, Giuseppe Cornaglia, Javier Garau, Marek Gniadkowski, Mary K Hayden, Karthikeyan Kumarasamy, David M Livermore, Juan J Maya, Patrice Nordmann, Jean B Patel, David L Paterson, Johann Pitout, Maria Virginia Villegas, Hui Wang, Neil Woodford, John P Quinn
Affiliations
Review

Clinical epidemiology of the global expansion of Klebsiella pneumoniae carbapenemases

L Silvia Munoz-Price et al. Lancet Infect Dis. 2013 Sep.

Abstract

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.

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Conflict of interest statement

Conflicts of interest

LSM-P has received speaking fees from Sage and Steris. LP and PN have received research funds from Merck. MG’s work was partially financed by the grant Narodowy Program Ochrony Antybiotykow (NPOA) from the Polish Ministry of Health, and the grant SPUB MIKROBANK from the Polish Ministry of Science and Higher Education. DML has shareholdings in Dechra, Eco Animal Health, Merck, and Pfizer; has accepted grants, speaking invitations, and conference invitations from Pfizer, Novartis, AstraZeneca, and Astellas; and has advisory or consultancy relationships with Achaogen, AstraZeneca, Basilea, Bayer, Cubist, Curetis, Discuva, GlaxoSmithKline, Kalidex, McKinsey, Meiji, Pfizer, Roche, Tetraphase, Theravance, and Wockhardt. JP has received research funds from Merck and AstraZeneca. MVV has received research grants from Merck Sharp & Dohme, Pfizer SA, Janssen-Cilag SA, Novartis, Merck Colombia, AstraZeneca Colombia SA, bioMerieux Colombia SAS, and Colciencias. JPQ is an employee and potential shareholder in AstraZeneca. All other authors declare that they have no conflicts of interest.

Figures

Figure
Figure. Epidemiological features of producers of Klebsiella pneumoniae carbapenemases by country of origin
Other carbapenemase types include VIM, OXA-48, or NDM. KPC=Klebsiella pneumoniae carbapenemase.
See this image and copyright information in PMC

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References

    1. Yigit H, Queenan AM, Anderson GJ, et al. Novel carbapenem-hydrolyzing beta-lactamase, KPC-1, from a carbapenem-resistant strain of Klebsiella pneumoniae. Antimicrob Agents Chemother. 2001;45:1151–61. - PMC - PubMed
    1. Papp-Wallace KM, Bethel CR, Distler AM, Kasuboski C, Taracila M, Bonomo RA. Inhibitor resistance in the KPC-2 beta-lactamase, a preeminent property of this class A beta-lactamase. Antimicrob Agents Chemother. 2010;54:890–97. - PMC - PubMed
    1. Bradford PA, Bratu S, Urban C, et al. Emergence of carbapenem-resistant Klebsiella species possessing the class A carbapenem-hydrolyzing KPC-2 and inhibitor-resistant TEM-30 beta-lactamases in New York City. Clin Infect Dis. 2004;39:55–60. - PubMed
    1. Chiang T, Mariano N, Urban C, et al. Identification of carbapenem-resistant Klebsiella pneumoniae harboring KPC enzymes in New Jersey. Microb Drug Resist. 2007;13:235–39. - PubMed
    1. Pope J, Adams J, Doi Y, Szabo D, Paterson DL. KPC type beta-lactamase, rural Pennsylvania. Emerg Infect Dis. 2006;12:1613–14. - PMC - PubMed

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