Rise and fall of KPC-producing<i>Klebsiella pneumoniae</i>in New York City

Abdallah, Marie; Olafisoye, Olawole; Cortes, Christopher; Urban, Carl; Landman, David; Ghitan, Monica; Collins, BeverlyAnn; Bratu, Simona; Quale, John

doi:10.1093/jac/dkw242

Cited by 29 publications

(25 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We found that 9.7% of K. pneumoniae bloodstream isolates were carbapenem-resistant overall, including 11.9% of isolates in NYC centers. Our findings are consistent with those of Abdallah and colleagues, who found that 13% of K. pneumoniae isolates from multiple NYC medical centers during a similar time period possessed bla KPC (17). In contrast, recent national surveillance studies reported carbapenem resistance in only 3 to 6% of K. pneumoniae (18)(19)(20).…”

Section: Discussionsupporting

confidence: 92%

Multicenter Clinical and Molecular Epidemiological Analysis of Bacteremia Due to Carbapenem-Resistant Enterobacteriaceae (CRE) in the CRE Epicenter of the United States

Satlin

Chen

Patel

et al. 2017

Antimicrob Agents Chemother

201

158

View full text Add to dashboard Cite

Although the New York/New Jersey (NY/NJ) area is an epicenter for carbapenem-resistant Enterobacteriaceae (CRE), there are few multicenter studies of CRE from this region. We characterized patients with CRE bacteremia in 2013 at eight NY/NJ medical centers and determined the prevalence of carbapenem resistance among Enterobacteriaceae bloodstream isolates and CRE resistance mechanisms, genetic backgrounds, capsular types (cps), and antimicrobial susceptibilities. Of 121 patients with CRE bacteremia, 50% had cancer or had undergone transplantation. The prevalences of carbapenem resistance among Klebsiella pneumoniae, Enterobacter spp., and Escherichia coli bacteremias were 9.7%, 2.2%, and 0.1%, respectively. Ninety percent of CRE were K. pneumoniae and 92% produced K. pneumoniae carbapenemase (KPC-3, 48%; KPC-2, 44%). Two CRE produced NDM-1 and OXA-48 carbapenemases. Sequence type 258 (ST258) predominated among KPC-producing K. pneumoniae (KPC-Kp). The wzi154 allele, corresponding to cps-2, was present in 93% of KPC-3-Kp, whereas KPC-2-Kp had greater cps diversity. Ninety-nine percent of CRE were ceftazidime-avibactam (CAZ-AVI)-susceptible, although 42% of KPC-3-Kp had an CAZ-AVI MIC of Ն4/4 g/ml. There was a median of 47 h from bacteremia onset until active antimicrobial therapy, 38% of patients had septic shock, and 49% died within 30 days. KPC-3-Kp bacteremia (adjusted odds ratio [aOR], 2.58; P ϭ 0.045), cancer (aOR, 3.61, P ϭ 0.01), and bacteremia onset in the intensive care unit (aOR, 3.79; P ϭ 0.03) were independently associated with mortality. Active empirical ther-

show abstract

Section: Discussionsupporting

confidence: 92%

Multicenter Clinical and Molecular Epidemiological Analysis of Bacteremia Due to Carbapenem-Resistant Enterobacteriaceae (CRE) in the CRE Epicenter of the United States

Satlin

Chen

Patel

et al. 2017

Antimicrob Agents Chemother

201

158

View full text Add to dashboard Cite

show abstract

“…This effect has similarities with other enteropathogenetic syndromes such as Clostridium difficile colitis and candidaemia, at least by the means of exogenous colonization [103,104]. In a multicentre US study, KPC-KP clearance was attributed to a reduction in the use of urinary catheters, a factor that should be considered in the implementation of a bundle procedure [105].…”

Section: Can Kpc-kp Infections Be Prevented? How?mentioning

confidence: 94%

Management of KPC-producing Klebsiella pneumoniae infections

Bassetti

Giacobbe

Giamarellou

et al. 2018

Clinical Microbiology and Infection

156

103

View full text Add to dashboard Cite

“…14 In a New York-based multicenter survey, the prevalence of bla KPC within K. pneumoniae isolates peaked at 36% in 2006. 23 Of great interest, a notable decline has since been recorded to 25% in 2009 and 13% in 2013-2014. 23 Spread to the Great Lakes region of the United States has been described.…”

Section: Where Are Cpe Found?mentioning

confidence: 99%

“…23 Of great interest, a notable decline has since been recorded to 25% in 2009 and 13% in 2013-2014. 23 Spread to the Great Lakes region of the United States has been described. The Consortium on resistance against carbapenems in Klebsiella and other Enterobacteriaceae (CRACKLE) is a prospective, multicenter, observational study of hospitals in Ohio, Pennsylvania and Michigan.…”

Section: Where Are Cpe Found?mentioning

confidence: 99%

The global epidemiology of carbapenemase-producing Enterobacteriaceae

2016

View full text Add to dashboard Cite

Carbapenemase-producing Enterobacteriaceae (CPE) are an important and increasing threat to global health. Both clonal spread and plasmid-mediated transmission contribute to the ongoing rise in incidence of these bacteria. Among the 4 classes of β-lactamases defined by the Ambler classification system, the carbapenemases that confer carbapenem resistance in Enterobacteriaceae belong to 3 of them: Class A (K. pneumoniae carbapenemases, KPC), Class B (metallo-β-lactamases, MBL including New Delhi metallo-β-lactamases, NDM) and Class D (OXA-48-like carbapenemases). KPC-producing CPE are the most commonly occurring CPE in the United States. MBL-producing CPE have been most commonly associated with the Indian Subcontinent as well as with specific countries in Europe, including Romania, Denmark, Spain, and Hungary. The epicenter of OXA-48-like-producing is in Turkey and surrounding countries. Detailed knowledge of the epidemiology and molecular characteristics of CPE is essential to stem the spread of these pathogens.

show abstract

Rise and fall of KPC-producingKlebsiella pneumoniaein New York City

Abstract: Over the past decade there has been a steady decline in KPC-producing K. pneumoniae in most New York City hospitals. The reason for the decline is probably multifactorial, involving a reduction in device (catheter) utilization and possibly an improvement in infection control practices.

Cited by 29 publications

References 14 publications

Multicenter Clinical and Molecular Epidemiological Analysis of Bacteremia Due to Carbapenem-Resistant Enterobacteriaceae (CRE) in the CRE Epicenter of the United States

Multicenter Clinical and Molecular Epidemiological Analysis of Bacteremia Due to Carbapenem-Resistant Enterobacteriaceae (CRE) in the CRE Epicenter of the United States

Management of KPC-producing Klebsiella pneumoniae infections

The global epidemiology of carbapenemase-producing Enterobacteriaceae

Contact Info

Product

Resources

About