Klebsiella pneumoniae Overview

Rising resistance to last-resort drugs is cause for concern

Klebsiella pneumoniae is a member of the Enterobacteriaceae family, which along with E. coli accounts for the vast majority of hospital and community-acquired urinary tract infections (UTIs). It is also a frequent cause of nosocomial (health care–associated) bloodstream infections and community-acquired pneumonia among alcoholics.

Klebsiella pneumoniae is a member of the Enterobacteriaceae family, which along with E. coli accounts for the vast majority of hospital and community-acquired urinary tract infections (UTIs). It is also a frequent cause of nosocomial (health care–associated) bloodstream infections and community-acquired pneumonia among alcoholics.

The observed rise of carbapenem-resistant K. pneumoniae (CRKP) is disconcerting for several reasons. First, K. pneumoniae carbapenemase (KPC) infection is associated with a fatal outcome in 47%–57% of cases. Second, treatment is limited to either collistin (an old antibiotic rarely used because of its kidney toxicity) or tigecycline (which fails to clear bloodstream infections) – a limitation that highlights the urgent need to develop drugs active against Gram-negative bacteria. Third, the ability of carbapenemase-encoding genes to spread through plasmid transfer enables the spread of resistance to related species like E. coli, a transfer that may occur even in the same patient. Finally, the presence of KPC is difficult to detect in routine laboratory testing. The epidemiology of carbapenem-resistant bacteria may therefore follow the endemic spread of MRSA beyond hospitals and into the community.

VISUALIZATION
GUIDE

>> WORLD

Hovering over the histogram bars displays the 2009 resistance rate and sample size for each country; Click the CHAPTER 2 button to view the same data as a chloropleth map.

>> REGIONAL TRENDS

Click the play button to animate time series and view the progression of resistance in the nine U.S. census divisions. To focus on particular regions, hover over the trend lines or select from the map; Hold the CTRL button on you keyboard to make multiple selections.

USED
DEFINITIONS

Depending on the type of data, values in the atlas are measured in three widely accepted units: percent of bacterial isolates resistant to a given antibiotic class (% resistant), number of bacterial isolates tested (sample size) and number of filled outpatient prescriptions per 1,000 inhabitants (Rxs/1,000 pop).

DATA
SOURCES

Outpatient antibiotic use data were obtained from the IMS Health’s XponentTM database – an information service that covers more than 70% (estimated) of all prescriptions dispensed in retail, mail and long-term care pharmacies in the United States. 

The data for the US comes from The Surveillance Network, a vast collection of individual susceptbility results from hospitals around the country. The data is managed and distributed by Eurofins-Mednet.

European data is sourced from EARS-Net, a publicly available surveillance system maintained by the European Centers for Disease Control and covering up to 30 countries.

Canadian data hails from the CANWARDS 2009 study coordinated by the Canadian Antimicrobial Resistance Alliance and is also accessible to the publc via the CARA website