Clinical epidemiology of the global expansion of Klebsiella pneumoniae carbapenemases

Munoz-Price, L Silvia, Poirel, Laurent, Bonomo, Robert A, Schwaber, Mitchell J, Daikos, George L, Cormican, Martin, Cornaglia, Giuseppe, Garau, Javier, Gniadkowski, Marek, Hayden, Mary K, Kumarasamy, Karthikeyan, Livermore, David M, Maya, Juan J, Nordmann, Patrice, Patel, Jean B, Paterson, David L, Pitout, Johann, Villegas, Maria Virginia, Wang, Hui, Woodford, Neil and Quinn, John P (2013) Clinical epidemiology of the global expansion of Klebsiella pneumoniae carbapenemases. The Lancet Infectious Diseases, 13 (9). pp. 785-96. ISSN 1473-3099

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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.

Item Type: Article
Additional Information: Copyright © 2013 Elsevier Ltd. All rights reserved.
Uncontrolled Keywords: aminoglycosides,anti-bacterial agents,bacteremia,bacterial proteins,colistin,communicable disease control,geography,humans,klebsiella infections,klebsiella pneumoniae,minocycline,treatment outcome,beta-lactamases
Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School
Depositing User: Pure Connector
Date Deposited: 20 Jan 2014 16:54
Last Modified: 21 Apr 2020 22:37
URI: https://ueaeprints.uea.ac.uk/id/eprint/46654
DOI: 10.1016/S1473-3099(13)70190-7

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