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European health authorities today warned of a hypervirulent carbapenem-resistant strain. Klebsiella pneumoniae It seems to have spread across the continent.
in Rapid risk assessmentthe European Center for Disease Prevention and Control (ECDC) has announced the number of European Union/European Economic Area (EU/EEA) countries reporting hypertoxic cases. Klebsiella pneumoniae (hvKp) sequence type (ST)23 has increased from 4 to 10 since the last assessment in 2021, and the number of isolates submitted for analysis has increased from 12 to 143. Analysis of these isolates shows a predominant lineage, hvKp ST23-. K1 has acquired several carbapenem resistance genes.
ECDC also notes that, despite intensified control efforts, there is also evidence of sustained spread of hvKp ST23-K1 between healthcare facilities within one country (Ireland), which is not confirmed epidemiologically but is a potential possibility. There are also clusters of infections in France, Latvia, and Lithuania that suggest a sexual relationship. Domestic transmission.
Infections that may be untreatable
To date, hvKp strains have been primarily found in Asia and have caused community transmission, primarily among healthy people, which distinguishes them from “classical” virus strains. Klebsiella pneumoniae Strains that usually cause infections in vulnerable, immunocompromised hospitalized patients. Invasive infections caused by hvKp strains, such as pneumonia and liver abscesses, tend to progress rapidly and spread to other sites, and are associated with high morbidity and mortality.
However, in recent years, the hvKp strain has begun to take root in the world. medical field Although the initial strains were sensitive to antibiotics, they have acquired multiple antibiotic resistance genes.
The ECDC report notes that the spectrum of carbapenemase genes detected in hvKp isolates from the EU/EEA is increasing over the years, with some isolates harboring multiple carbapenemase genes. Additionally, hvKp ST23 isolates with resistance to colistin and ceftazidime-avibactam have been reported.
The combination of hypertoxicity and resistance to antibiotics of last resort has led to difficult, life-threatening, and potentially untreatable infections.
“Increasing cases of carbapenem-resistant highly toxic substances Klebsiella pneumoniae (hvKp) reported to ECDC by EU/EEA countries is a cause for concern because the severity of hvKp infections, combined with resistance to last-line antibiotics, makes the infection difficult to treat. ” said Dominique Monnet, PharmD, ECDC. Head of Antimicrobial Resistance and Healthcare-Associated Infections said: press release.
High risk of further spread of nosocomial infections
ECDC also stated that the population at risk of hvKp infection is likely to be larger than the well-known “classical” high-risk groups. Klebsiella pneumoniae Hospitals in the EU/EEA are thought to be more likely to experience further outbreaks. In fact, the pathogen is likely already circulating in countries where surveillance systems are not well established, the report said.
To prevent further spread of hvKp strains in healthcare settings, ECDC is strengthening infection prevention and control measures, increasing clinical and public health awareness, increasing testing capacity, and establishing national standard testing for all hvKp isolates. Request for submission to the institution.
“Prospective data collection on hvKp isolates, including epidemiological and clinical data on cases, carriage, and associated risk factors, will improve understanding of national prevalence and transmission routes and determine the need for further surveillance. “, the authorities said.
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