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Lancet Infect Dis. 2009 Apr;9(4):228-36. doi: 10.1016/S1473-3099(09)70054-4.

The real threat of Klebsiella pneumoniae carbapenemase-producing bacteria.

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Service de Bactériologie-Virologie-Hygiène, INSERM U914 "Emerging Resistance to Antibiotics", Hôpital de Bicêtre, Assistance Publique/Hôpitaux de Paris, Faculté de Médecine and Université Paris Sud, K -Bicêtre, France.


From early this decade, Enterobacteriaceae that produce Klebsiella pneumoniae carbapenemases (KPC) were reported in the USA and subsequently worldwide. These KPC-producing bacteria are predominantly involved in nosocomial and systemic infections; although they are mostly Enterobacteriaceae, they can also be, rarely, Pseudomonas aeruginosa isolates. KPC beta lactamases (KPC-1 to KPC-7) confer decreased susceptibility or resistance to virtually all beta lactams. Carbapenems (imipenem, meropenem, and ertapenem) may thus become inefficient for treating enterobacterial infections with KPC-producing bacteria, which are, in addition, resistant to many other non-beta-lactam molecules, leaving few available therapeutic options. Detection of KPC-producing bacteria may be difficult based on routine antibiotic susceptibility testing. It is therefore crucial to implement efficient infection control measures to limit the spread of these pathogens.

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