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The hypervirulent Klebsiella pneumoniae (hvKp), which can cause serious and life-threatening infections, has been detected across Africa, Europe, the East Mediterranean, Western Pacific, America and South-East Asia.
The “classic” Klebsiella pneumoniae (Kp) causes major problems in hospitals due to its antibiotic resistance, where it can contaminate medical equipment and spread quickly. The bacteria spreads through person-to-person contact, contaminated water, soil or equipment and wounds caused by injury or surgery.
It is known to cause pneumonia, UTIs, bloodstream infections and meningitis – inflammation of the brain and spinal cord – particularly among vulnerable patients.
This new “hypervirulent” version is even more dangerous, causing “severe invasive infections”, even in healthy individuals, that “develop quickly and spread to various body sites”, according to the Center for Infectious Disease Research and Policy (CIDRAP).
“Infections caused by hvKp strains have been associated with high morbidity and mortality”, the CIDRAP added.
People are recommended to wash their hands often, for example, before preparing or eating food and changing wound dressings as well as after using the toilet, coughing and sneezing and touching hospital surfaces such as bed rails, door handles and remote controls.
The WHO report looked at data from 43 global countries and territories, including the US, the UK, Australia, India and Japan. Several countries, including the UK, Thailand, India and Iran said they had found a particularly concerning strain, known as sequence type (ST)23.
This strain carries carbapenemase genes, which are resistant to carbapenem antibiotics and all available beta-lactam antibiotics – including penicillins.
This combination of hypervirulence and antibiotic resistance genes is “worrisome”, according to CIDRAP.
“In general, carbapenem-resistant gram-negative bacteria are a major concern as the ability to treat them is severely constrained,” said Dr Amesh Adalja, from the John Hopkins University Center for Health Security.
“When you couple carbapenem-resistance with the hypervirulence exhibited by certain strains of Kp, it is a recipe for increased morbidity and mortality from this bacterium.”
(ST)23 strains have the ability to “out-compete” other gut bacteria, which can lead to colonisation and spread and generate outbreaks, the WHO has warned. “It is expected that there will be an increased risk of spread of these strains at both the community and hospital levels”.
Officials added that while the global risk is deemed moderate, the prevalence of kvKp “may be underestimated” due to surveillance limitations and the fact that infections “may go unnoticed”.
“With the concurrence of hypervirulence and antibiotic resistance, it is expected that there will be an increased risk of spread of these strains at both the community and hospital levels,” the WHO added.
It continued that prevention and control pose “significant challenges” as so far it has not been possible to establish the extent of its spread in the countries and information on the subject is limited.
“As with other resistance mechanisms, the risk of spread could increase due to high movements of people (within and between countries and regions).”
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