Hypervirulent, antibiotic resistant Klebsiella found in China
A fatal outbreak of hypervirulent Carbapenem-resistant Klebsiella pneumoniae has been reported in August’s edition of The Lancet Infectious Disease. This convergence of antibiotic resistance, hypervirulence and high transmission rate within a single strain led to 100% mortality rate in infected patients.
Five patients undergoing surgery for multiple trauma wounds were placed on mechanical ventilation and admitted to the intensive care unit of Zhejiang University Hospital, Hangzou, China. All five patients acquired severe pneumonia, Carbapenem-resistant Klebsiella pneumonia infections and did not respond to antibiotic treatment. All died due to severe lung infection, multi-organ failure or septic shock.
Analysis of the Klebsiella strains involved identified that they all had virtually identical antibacterial susceptibility profiles and resistance genes that originated from a single clone. Investigators found that the hypervirulence of the strains stemmed from a 170kbp virulence plasmid. This is a worrying evolutionary event – the combination of classic Carbapenem-resistance with hypervirulence creating what the authors of the study describe as “real superbugs”.
These strains were also found in specimens collected from other areas within China. Carbapenem-resistant hypervirulent strains pose a huge threat to human health and show the capacity of microorganisms to constantly evolve. The key to combating these developing strains is vigilance, early detection, containment and the use of infection control measures to prevent transmission and spread.