Klebsiella pneumoniae superbug: what it is, what are the risks and the treatment

Bacteria resistant to antimicrobial drugs, such as antibiotics, are popularly known as superbugs. The increase in the number of these microorganisms puts the health of humans and animals at risk, according to the World Health Organization (WHO).

Antimicrobial resistance occurs when bacteria, viruses, fungi and parasites no longer respond to available drugs. As a result of drug resistance, antibiotics and other antimicrobial agents become ineffective and common infections become difficult or impossible to treat, increasing the risk of disease spread, severe cases and deaths.

Five babies died at the Santa Casa State Hospital, in Cuiabá, Mato Grosso, due to infection by a multiresistant bacteria called Klebsiella pneumoniae.

What is the bacteria Klebsiella pneumoniae

A Klebsiella pneumonia is part of a group of bacteria called enterobacteria, which includes the better known Escherichia coli (E coli). Klebsiella bacteria are normally found in the human intestine, where they do not cause disease, and can also be present in human feces.

In healthcare facilities, Klebsiella infections often occur among patients who are being treated for other conditions. The risk is increased among those hospitalized who need devices such as ventilators or catheters in their veins and who require long-term antibiotic treatment. The microorganism can cause different types of healthcare-associated infections, including pneumonia, bloodstream infections, and meningitis.

Increasingly, Klebsiella bacteria develop high antimicrobial resistance. More recently, they have become able to resist a class of antibiotics known as carbapenems.

When bacteria like Klebsiella pneumoniae produce an enzyme known as carbapenemase (known as KPC-producing organisms), the class of antibiotics called carbapenems do not work to kill the bacteria and treat the infection, putting the lives of patients at risk.

Klebsiella species are examples of enterobacteria, a normal part of human gut bacteria, that can become resistant to carbapenems. According to the Centers for Disease Control and Prevention (CDC), in the United States, carbapenem antibiotics are usually the last line of defense against infections with gram-negative bacteria, such as K. pneumoniaeresistant to other antibiotics.

How Klebsiella bacteria spread

The infection by Klebsiella pneumoniae happens from exposure to the bacteria, which can happen through the respiratory tract or the bloodstream.

In healthcare settings, it can be spread through person-to-person contact, such as from patient to patient through the contaminated hands of healthcare workers or other individuals. Less commonly, there is contamination by the environment. Unlike viruses, bacteria do not spread through the air.

In general, hospitalized patients can be exposed to Klebsiella when they are using respirators, intravenous catheters or through contact with wounds.

To prevent the spread of Klebsiella infections between patients, healthcare workers should follow specific infection control precautions, which include strict adherence to hand hygiene and the use of aprons and gloves when entering rooms where patients with illnesses are. related to Klebsiella. Healthcare facilities must also follow strict cleaning procedures to prevent the spread of the bacteria.

Other measures include washing patients’ hands before eating, before touching their eyes, nose or mouth, and when changing dressings or bandages. Hand washing with soap and water and the use of alcohol gel is also recommended after using the bathroom, blowing your nose, coughing or sneezing and after touching hospital surfaces such as bed rails, bedside tables, doorknobs, controls remote or telephone.

Klebsiella infections that are not drug resistant can be treated with antibiotics. Infections caused by KPC-producing bacteria can be difficult to treat because fewer antibiotics are effective against them.

In these cases, a microbiology lab should run tests to determine which antibiotics will treat the infection, according to the CDC.

Increased bacterial resistance

Bacterial resistance is directly associated with the excessive and incorrect use of antimicrobials available for the treatment of infections in humans and animals, warns the WHO.

It is the bacteria that become resistant and not human beings, as explained by researcher Ana Paula Assef, from the Hospital Infection Research Laboratory at the Oswaldo Cruz Institute (IOC/Fiocruz).

“With the inappropriate use of antibiotics, a ‘selection’ process can occur: while the ‘sensitive’ bacteria are eliminated from the treatment, the ‘resistant’ ones remain and multiply”, says Ana Paula.

As antibiotics become ineffective, the number of infections that become more difficult to treat also tends to increase. “With the exhaustion of therapeutic actions, infections that today are known to have a simple treatment, may, in the future, cause greater damage to the body, as we will have less resources to fight them”, says the researcher from Fiocruz.

Developing a new antibiotic can take 10 to 15 years and cost more than $1 billion, according to the WHO. As much as new drugs are formulated, bacteria continue to create resistance mechanisms, which makes the development of antibiotics seen as an unprofitable market.