Clinical epidemiology of the global expansion of Klebsiella pneumoniae carbapenemases

L Silvia Munoz-Price, Laurent Poirel, Robert A Bonomo, Mitchell J Schwaber, George L Daikos, Martin Cormican, Giuseppe Cornaglia, Javier Garau, Marek Gniadkowski, Mary K Hayden, Karthikeyan Kumarasamy, David M Livermore, Juan J Maya, Patrice Nordmann, Jean B Patel, David L Paterson, Johann Pitout, Maria Virginia Villegas, Hui Wang, Neil WoodfordJohn P Quinn

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Klebsiella pneumoniae carbapenemases (KPCs) were originally identified in the USA in 1996. Since then, these versatile β-lactamases have spread internationally among Gram-negative bacteria, especially K pneumoniae, although their precise epidemiology is diverse across countries and regions. The mortality described among patients infected with organisms positive for KPC is high, perhaps as a result of the limited antibiotic options remaining (often colistin, tigecycline, or aminoglycosides). Triple drug combinations using colistin, tigecycline, and imipenem have recently been associated with improved survival among patients with bacteraemia. In this Review, we summarise the epidemiology of KPCs across continents, and discuss issues around detection, present antibiotic options and those in development, treatment outcome and mortality, and infection control. In view of the limitations of present treatments and the paucity of new drugs in the pipeline, infection control must be our primary defence for now.
Original languageEnglish
Pages (from-to)785-96
Number of pages12
JournalThe Lancet Infectious Diseases
Issue number9
Publication statusPublished - Sep 2013


  • Aminoglycosides
  • Anti-Bacterial Agents
  • Bacteremia
  • Bacterial Proteins
  • Colistin
  • Communicable Disease Control
  • Geography
  • Humans
  • Klebsiella Infections
  • Klebsiella pneumoniae
  • Minocycline
  • Treatment Outcome
  • beta-Lactamases

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