Researchers have found support for the strong association between carbapenem-resistant Klebsiella pneumoniae (CRKP) colonization and bloodstream infection (BSI). A recently published study that examined the risk factors for CRKP rectal colonization and subsequent BSI in critically ill patients indicates that hospitalized patients become infected with their colonizing strains.
CRKP strains isolated from both the blood cultures and corresponding rectal specimens of patients were screened by polymerase chain reaction for the presence of antibiotic resistance-associated genes. The blaKPC-2 gene was detected in all tested strains, and over 21% of colonized patients developed a BSI. The duration of intensive care unit (ICU) stay, patient/nurse ratio, and prior use of antimicrobials were associated with CRKP rectal colonization. Limiting antianaerobic antimicrobial administration, reducing the duration of ICU stay, and maintaining a low patient/nurse ratio are possible strategies suggested to restrict rectal CRKP colonization in ICUs. The Centers for Disease Control and Prevention (CDC) has recommended active surveillance testing to identify colonization, limit the spread, and prevent infections.
This is a very aggressive approach but containment of new resistance germs is really important. Otherwise we could see these new nightmare bacteria become very common and essentially untreatable."
Principal Deputy Director of CDC
Kontopoulou K, Iosifidis E, Antoniadou E, et al. The clinical significance of carbapenem-resistant Klebsiella pneumoniae rectal colonization in critically ill patients: from colonization to bloodstream infection. J Med Microbiol. 2019. doi: 10.1099/jmm.0.000921. [Epub ahead of print]