Carbapenemase-Producing Enterobacteriaceae
Top Cited Papers
Open Access
- 2 February 2015
- journal article
- review article
- Published by Georg Thieme Verlag KG in Seminars in Respiratory and Critical Care Medicine
- Vol. 36 (01), 074-084
- https://doi.org/10.1055/s-0035-1544208
Abstract
Carbapenemase-producing Enterobacteriaceae (CPE) were almost nonexistent up to the 1990s, but are today encountered routinely in hospitals and other healthcare facilities in many countries including the United States. KPC-producing Klebsiella pneumoniae was the first to emerge and spread globally and is endemic in the United States, Israel, Greece, and Italy. Recently, NDM-producing Enterobacteriaceae and OXA-48-producing K. pneumoniae appear to be disseminating from South Asia and Northern Africa, respectively. They are almost always resistant to all β-lactams including carbapenems and many other classes. Mortality from invasive CPE infections reaches up to 40%. To obtain the maximal benefit from the limited options available, dosing of antimicrobial agents should be optimized based on pharmacokinetic data, especially for colistin and carbapenems. In addition, multiple observational studies have associated combination antimicrobial therapy with lower mortality compared with monotherapy for these infections. The outcomes appear to be especially favorable when patients are treated with a carbapenem and a second agent such as colistin, tigecycline, and gentamicin, but the best approach is yet to be defined.Keywords
This publication has 100 references indexed in Scilit:
- Infections caused by carbapenem-resistant Klebsiella pneumoniae among patients in intensive care units in Greece: a multi-centre study on clinical outcome and therapeutic optionsClinical Microbiology & Infection, 2014
- High rate of colistin resistance among patients with carbapenem-resistant Klebsiella pneumoniae infection accounts for an excess of mortalityClinical Microbiology & Infection, 2013
- Predictors of Mortality in Bloodstream Infections Caused by Klebsiella pneumoniae Carbapenemase-Producing K. pneumoniae: Importance of Combination TherapyClinical Infectious Diseases, 2012
- NDM-1-Producing Klebsiella pneumoniae Resistant to Colistin in a French Community Patient without History of Foreign TravelAntimicrobial Agents and Chemotherapy, 2012
- Predictors of mortality in patients with bloodstream infections caused by KPC-producing Klebsiella pneumoniae and impact of appropriate antimicrobial treatmentClinical Microbiology & Infection, 2011
- Multiresistant Gram-negative bacteria: the role of high-risk clones in the dissemination of antibiotic resistanceFEMS Microbiology Reviews, 2011
- Colistin-Resistant, Klebsiella pneumoniae Carbapenemase (KPC)-Producing Klebsiella pneumoniae Belonging to the International Epidemic Clone ST258Clinical Infectious Diseases, 2011
- Dissemination of NDM-1 positive bacteria in the New Delhi environment and its implications for human health: an environmental point prevalence studyThe Lancet Infectious Diseases, 2011
- Molecular Epidemiology of KPC-Producing Klebsiella pneumoniae Isolates in the United States: Clonal Expansion of Multilocus Sequence Type 258Antimicrobial Agents and Chemotherapy, 2009
- Outbreak of infections due to KPC-2-producing Klebsiella pneumoniae in a hospital in Crete (Greece)Journal of Infection, 2009