Researchers at an Indian hospital have identified strains of hypervirulent, carbapenem-resistant Klebsiella pneumoniae associated with extremely high mortality rates, according to a new study in the Journal of the Association of Physicians of India.
The findings represent the first report of a hypervirulent form of the drug-resistant pathogen in India, the authors of the study say. Strains of K pneumoniae that combine carbapenem resistance and hypervirulence, which to date have been reported only in China, can cause severe infections that spread quickly throughout the body.
Infectious disease experts have called the combination a “worst-case” scenario that poses a significant threat to public health.
High mortality tied to high resistance, hypervirulence
In the study, researchers at Christian Medical College in Tamil Nadu state tested isolates of carbapenem-resistant K pneumoniae obtained from 86 patients hospitalized with bacteremia in 2015 and 2016. They conducted antibiotic susceptibility testing to assess resistance to meropenem, performed string tests to evaluate virulence, and looked for carbapenem-resistance and virulence genes using polymerase chain reaction (PCR) analysis. They used multilocus sequence typing (MLST) to determine the sequence type (ST) of 10 of the isolates.
The results were then analyzed for association between 30-day mortality, meropenem minimum inhibitory concentration (MIC), string-test positivity, and carbapenem-resistance genes.
Source and further reading: CIDRAP