KPC

In this story about the use of rapid genomic sequencing to monitor a hospital outbreak of multi-drug resistant Klebsiella pneumoniae (more details here), this end bit is interesting (italics mine): "In the E. coli outbreak, we had enough E. coli reference strains and knew enough about E. coli biology to quickly identify a set of genes for specific diagnostics before we had the whole genome sequence," says Dag Harmsen, a microbiologist at the University of Münster who was involved in sequencing efforts during both outbreaks. "But we don't have as much experience with Klebsiella, so this time…
If you haven't heard, there's a new antibiotic resistance gene, NDM-1, which stands for New Delhi metallo-beta-lactamase-1. This gene has been found in Gram-negative Enterobacteriaceae (E. coli and Klebsiella), and confers resistance to every penicillin derivative. Like the KPC genes, this gene is found on miniature chromosomes that also carry other resistance genes, making this organism resistant to just about everything we can throw at it. By way of Maryn McKenna, we find this nice ATCC chart which shows just how bad one of these bacteria can be: All those "R"s mean that drug doesn't…
I'm conflicted about Nicholas Kristof's recent op-ed about antibiotic resistant organisms. On the one hand, Kristof is one of the only national columnists to raise this issue at all. On the other hand, I found his most recent column somewhat confusing--and I'm an expert in this area (I also think he's jumping to unfounded conclusions, but more about that later in the post). I think this is largely an effect similar to playing "telephone": information is being transferred multiple times from the primary source and finally conveyed by someone with no biological training. So what I'm going…
(from here) By way of Maryn McKenna, we find that the Obama Administration has decided to massively cut the funding for the CDC's antimicrobial resistance and vaccination efforts. I thought this was the kind of anti-science bullshit that the Bush Administration did. From the IDSA (pdf): Under CDC's proposed budget, the agency's already severely strapped Antimicrobial Resistance budget would be cut dramatically by $8.6 million--roughly 50 percent. This vital program is necessary to help combat the rising crisis of drug resistance, a critical medical problem that the agency deems "one of the…
Yesterday, four people emailed me, asking about Brian Palmer's Slate article about antibiotic resistance. Since I'll probably get more such emails (and thank you for sending them), I'll offer my thoughts below: 1) Palmer's basic point about antibiotic development not being the answer is right. All a new drug does is kick the can down the road, since resistance will evolve to the new drug. Having said that, we currently do need new drugs, so we shouldn't stop developing them. 2) Palmer is not correct about plasmid curing as being a solution to antibiotic resistance. If we come up with a…
I've been looking at the House and Senate Bills, and, on antibiotic resistance, they're not bad. Both bills would evaluate hospitals on hospital-acquired infection rates (although there's no mention of nursing homes, which are a significant focus of infection). This is good. The House bill focuses primarily on reporting of hospital-acquired infections. It's actually very specific, and there's an entire section dedicated to it (starting at p. 913). Hospitals would be penalized if they fail to report. Infections (and pertinent information, which includes resistance) would be publicly…
In the midst of the concern about TEH SWINEY FLOO!, very few people (other than the Mad Biologist), have been discussing the double whammy of influenza followed by bacterial infections. A couple of years ago, I first started describing reports of KPCs: No, KPC isn't a new fast food restaurant. It's short for Klebsiella pneumoniae carbapenemase. The bad news: it's very hard to treat. The good news: it's very rare...for now. Actually, the correct term is KPC-possessing K. pneumoniae [these genes are now showing up in other bacteria], but we'll just use the slang 'KPC'--it's what all the cool…
A couple of weeks ago, after I posted about a very serious emerging bacterial threat, KPC, I received an email from a reader with an elderly relative in the hospital with a very serious case of pneumonia caused by KPC. What he* told me is shocking. The relative, who has had repeated hospital stays and a previous MRSA infection, was in the hospital for a week before any laboratory cultures were performed. That's right, a patient with practically every major risk factor for a multidrug resistant infection wasn't tested for a week. So this patient wasn't isolated, exposing other ICU patients…
No, KPC isn't a new fast food restaurant. It's short for Klebsiella pneumoniae carbapenemase. The bad news: it's very hard to treat. The good news: it's very rare...for now. Actually, the correct term is KPC-possessing K. pneumoniae*, but we'll just use the slang 'KPC'--it's what all the cool microbiologists use (I'll refer to the carbapenemase gene as the 'KPC gene'). KPC causes pneumonia, urinary tract infections, and sepsis; the mortality rate from these infections is extremely high. The KPC gene confers resistance to all cephalosporins and Ã-lactam antibiotics: basically,…