Infection with Klebsiella pneumoniae is a serious danger to older hospitalized patients, with an estimated mortality rate as high as 40 percent. It has generally been treated with broad-spectrum cephalosporin antibiotics. Another class of antibiotics, carbapenems, is used as an antibiotic of last resort for the most persistent infections.
But now carbapenem-resistant Klebsiella strains, or CRKP, are appearing across the nation, even outside of health care facilities.
A study in the March issue of Infection Control and Hospital Epidemiology reports that the proportion of Klebsiella cases resistant to cephalosporins increased to 11.6 percent in 2010 from 5.3 percent in 1999. The proportion resistant to carbapenems increased to 4.5 percent in 2010 from less than 0.1 percent in 2002.
The senior author, Ramanan Laxminarayan, a researcher at the Center for Disease Dynamics, Economics and Policy in Washington, D.C., compared the problem to that of methicillin-resistant Staphylococcus aureus.
“There’s a similarity to MRSA, which prior to the early 2000s was not seen in the community, and it was very surprising when it showed up,” he said. “But there had already been new drug developments for MRSA. The problem with CRKP is that we don’t have any new drugs. This could wind up being worse than MRSA.”