Management of KPC-producing Klebsiella pneumoniae infections

Critically Ill Patients Study Group of the European Society of Clinical Microbiology and Infectious Disease (ESCMID), Hellenic Society of Chemotherapy (HSC) and Società Italiana di Terapia Antinfettiva (SITA)

Research output: Contribution to journalReview articlepeer-review

Abstract

Background: Klebsiella pneumoniae carbapenemase (KPC)-producing K. pneumoniae (KPC-KP) has become one of the most important contemporary pathogens, especially in endemic areas. Aims: To provide practical suggestion for physicians dealing with the management of KPC-KP infections in critically ill patients, based on expert opinions. Sources: PubMed search for relevant publications related to the management of KPC-KP infections. Contents: A panel of experts developed a list of 12 questions to be addressed. In view of the current lack of high-level evidence, they were asked to provide answers on the bases of their knowledge and experience in the field. The panel identified several key aspects to be addressed when dealing with KPC-KP in critically ill patients (preventing colonization in the patient, preventing infection in the colonized patient and colonization of his or her contacts, reducing mortality in the infected patient by rapidly diagnosing the causative agent and promptly adopting the best therapeutic strategy) and provided related suggestions that were based on the available observational literature and the experience of panel members. Implications: Diagnostic technologies could speed up the diagnosis of KPC-KP infections. Combination treatment should be preferred to monotherapy in cases of severe infections. For non–critically ill patients without severe infections, results from randomized clinical trials are needed for ultimately weighing benefits and costs of using combinations rather than monotherapy. Multifaceted infection control interventions are needed to decrease the rates of colonization and cross-transmission of KPC-KP.

Original languageEnglish
Pages (from-to)133-144
Number of pages12
JournalClinical Microbiology and Infection
Volume24
Issue number2
DOIs
Publication statusPublished - Feb 1 2018

Keywords

  • Antibiotic treatment
  • ESCMID
  • Klebsiella pneumoniae
  • KPC
  • position paper

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

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