Klebsiella pneumoniae carbapenemase-producing: Epidemiology, detection, new in vitro testing and infection control

Abstract

The World Health Organization (WHO) has identified antimicrobial resistance as one of the three most important issues in the world for human health. The natural evolution of antibiotic resistance is coerced by misuse of antibiotics, thus causing excessive evolutionary pressure on microorganisms. The microorganisms multi-drug resistant (MDR) represents a 'global emergency, especially in nosocomial infections, in particular, the intensive care units are the most susceptible to this type of problem .The production of beta-lactamases is the main mechanism of resistance in gram-negative bacteria against beta-lactam antibiotics; some of these are encoded by chromosomal genes, other genes from plasmid or integrated into transposable elements, and can be constitutive or inducible. In 1985, after the introduction of imipenem, carbapenem, new class of beta-lactam antibiotics called "life-saving" drugs were considered to be universally active against Enterobacteriaceae. These antibiotics were able to combine exceptional intrinsic antibacterial activity with high stability against beta-lactamases, including ESBLs; thus became the treatment of choice for infections caused by ESBL-producing strains. Klebsiella pneumoniae carbapenemase (KPC) is a serine carbapenemase gene encoded by the plasmid blaKPC (Transposon Tn4401, Tn3-type), belonging to the class A of Amber. The first K. pneumoniae KPC producer, was identified in North Carolina, USA, in 1996 this was resistant to all beta-lactams, including carbapenems.