Affiliation:
1. International Health Management Associates, Inc., Schaumburg, Illinois, USA
2. AstraZeneca Pharmaceuticals LP, Waltham, Massachusetts, USA
Abstract
ABSTRACT
The
Klebsiella pneumoniae
carbapenemase (KPC), first described in the United States in 1996, is now a widespread global problem in several Gram-negative species. A worldwide surveillance study collected Gram-negative pathogens from 202 global sites in 40 countries during 2012 to 2014 and determined susceptibility to β-lactams and other class agents by broth microdilution testing. Molecular mechanisms of β-lactam resistance among carbapenem-nonsusceptible
Enterobacteriaceae
and
Pseudomonas aeruginosa
were determined using PCR and sequencing. Genes encoding KPC enzymes were found in 586 isolates from 22 countries (76 medical centers), including countries in the Asia-Pacific region (32 isolates), Europe (264 isolates), Latin America (210 isolates), and the Middle East (19 isolates, Israel only) and the United States (61 isolates). The majority of isolates were
K. pneumoniae
(83.4%); however, KPC was detected in 13 additional species. KPC-2 (69.6%) was more common than KPC-3 (29.5%), with regional variation observed. A novel KPC variant, KPC-18 (KPC-3[V8I]), was identified during the study. Few antimicrobial agents tested remained effective
in vitro
against KPC-producing isolates, with ceftazidime-avibactam (MIC
90
, 4 μg/ml), aztreonam-avibactam (MIC
90
, 0.5 μg/ml), and tigecycline (MIC
90
, 2 μg/ml) retaining the greatest activity against
Enterobacteriaceae
cocarrying KPC and other β-lactamases, whereas colistin (MIC
90
, 2 μg/ml) demonstrated the greatest
in vitro
activity against KPC-positive
P. aeruginosa
. This analysis of surveillance data demonstrated that KPC is widely disseminated. KPC was found in multiple species of
Enterobacteriaceae
and
P. aeruginosa
and has now become a global problem.
Publisher
American Society for Microbiology
Subject
Infectious Diseases,Pharmacology (medical),Pharmacology
Cited by
75 articles.
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