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Research has shown that carbapenem-resistant strains of Klebsiella pneumoniae are spreading in hospitals
Ingrid Torjesen
Tuesday, July 30, 2019
Strains of antibiotic resistance Klebsiella pneumoniae, an opportunistic pathogen that can cause respiratory and blood infections in humans, spreads to hospitals in Europe, has published research * in Microbiology of nature found.
Some strains of K. pneumoniae are resistant to carbapenem antibiotics that represent the last line of defense in the treatment of infections and are therefore considered extremely medicated resistant.
Researchers at the Genomic Agent Monitoring Center, based at the Wellcome Sanger Institute of the University of Friborg, and their partners, badyzed the genomes of nearly 2,000 K. pneumoniae samples taken from patients in 244 hospitals in 32 countries.
They have identified a small number of genes that, when expressed, can cause antibiotic resistance to carbapenems. These genes produce enzymes called carbapenemases, which "chew" the antibiotics, rendering them unusable.
The recent emergence of a small number of "high-risk" clones carrying one or more carbapenemase genes, which have spread rapidly, is a subject of public health concern. It is thought that intensive use of antibiotics in hospitals promotes the spread of these highly resistant bacteria, which outperform other strains easier to deal with antibiotics.
Dr. Sophia David of the Genomic Monitoring Center said: "The One Health Approach" to antibiotic resistance focuses on the spread of pathogens by humans, animals and the environment, including hospitals. But in the case of carbapenem resistant Klebsiella pneumoniaeOur results imply that hospitals are the main facilitator of transmission – more than half of the samples carrying a carbapenemase gene were closely related to the others collected in the same hospital, suggesting that the bacterium spreads from person to person primarily. in the hospital. "
Antibiotic-resistant bacteria samples were also much more likely to be closely related to samples from a different hospital in the same country rather than between multiple countries – suggesting that national health plays an important role in the spread of these antibiotic-resistant bacteria. .
Despite the obvious threat of carbapenem resistance K. pneumoniae For patients, more effective infection control in hospitals, including consideration of how patients move from one hospital to another and hygiene interventions, will have an impact.
Professor Hajo Grundmann, co-lead author and director of the Institute for Infection Control and Hospital Hygiene of the Medical Center of the University of Freiburg, said: "We are optimistic With good hospital hygiene, which includes the early identification and isolation of patient bacteria, we can not only delay the spread of these pathogens, but also successfully control them. infection control and ongoing genomic surveillance of antibiotic-resistant bacteria to ensure that new resistant strains are quickly detected and the spread of antibiotic resistance is prevented. "
It is estimated that 341 deaths in Europe were caused by carbapenem-resistant people K. pneumoniae in 2007; in 2015, the number of deaths had increased six-fold to 2,094. The high number of deaths is due to the fact that once carbapenems are no longer effective against antibiotic-resistant bacteria, there is little left of options. Infants, the elderly and the immunocompromised are particularly at risk.
* David S, Reuter S, Harris SR, et al. The epidemic of Klebsiella pneumoniae resistant to carbapenem in Europe is due to nosocomial spread. Nature Microbiology, July 29, 2019. DOI: 10.1038 / s41564-019-0492-8
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