A WOMAN who was admitted to hospital with a UTI died after contracting a dangerous new strain of superbug.
A strain of the bacterium Klebsiella pneumoniae – a type of bacteria that can cause serious infections, including pneumonia, bloodstream infections, and wound infection – was found in an 86-year-old woman who was admitted to hospital in Brazil.
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The woman, who was admitted to hospital with a urinary tract infection (UTI), was taken to a hospital in Brazil’s Northeast region in 2022.
The particular strain of Klebsiella pneumoniae she had proved resistant to all available antibiotics, and after 24 hours of being hospitalised, she died.
A group of researchers have since looked at the bacterium’s genome and compared it with a database of 48 similar sequences.
Alarmingly, the results showed the strain in question had previously been detected in the United States (US), and was already circulating in Brazil – with the potentially to spread around the world.
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An article on the study was published in The Lancet Microbe.
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Hypervirulent Klebsiella pneumoniae (hvKp)
Hypervirulent Klebsiella pneumoniae (hvKp) is the new strain of superbug that can cause life-threatening infections in healthy people.
Cases have been reported in 16 countries including Australia, India, Japan, Switzerland, Thailand, the USA, and the UK.
The new strain is considered more virulent than the classical K. pneumoniae (cKp) strain, which typically affects people in hospitals.
The cKp strain is known to cause pneumonia, UTIs, bloodstream infections and meningitis, particularly among vulnerable patients.
But the new strain, a “hypervirulent” version, is considered even more dangerous, making even healthy people seriously ill.
What the study found
The bacterium found in the woman was found to be so versatile it adapted to changes in treatment, “easily acquiring resistance mechanisms not targeted by existing drugs either single or in combination”, said Nilton Lincopan, last author of the article and a professor at the University of São Paulo’s Biomedical Sciences Institute (ICB-USP) in Brazil.
Prof Lincopan also runs One Health Brazilian Resistance, a database with epidemiological, phenotypical and genomic data on bacteria classified as “critical priority pathogens” by the World Health Organisation (WHO).
Health services are required to notify the local epidemiological surveillance authority when multidrug-resistant strains like this are detected.
It was advised patients with the superbug must be isolated, and all health workers involved must take precautions to prevent transmission of the pathogen to other patients.
Prof Lincopan added: “As an opportunistic pathogen, the bacterium may not cause disease in patients with normal immunity, but in people with low immunity, it can cause severe infections. In the hospital environment, patients in intensive care units [ICUs] or being treated for other diseases can acquire a secondary infection such as pneumonia.
“With no treatment available and with a depressed immune system, they often die.”
Countries that have reported hvKp
A WHO report looked at data from 43 countries and territories globally. A total of 16 reported cases of hvKp. This included:
The WHO has classified the risk of hvKp as moderate, but noted that there may be a gap in data on the true number of infections and hospitalisations.
It has also urged countries to strengthen laboratory capacities to detect hvKp, promote clinical and public health awareness, and to continue to closely monitor reported cases and events.
The researchers working on The Lancet Microbe study also stressed the importance of rationing prescribing of antibiotics.
Their message for patients is when antibiotics are prescribed they must adhere to the full course of treatment even if they feel well after two or three days.
This will also avoid the emergence of more drug-resistant strains.
What is Klebsiella pneumoniae?
Klebsiella pneumoniae is a type of bacteria that can cause healthcare-associated infections.
It’s mainly transmitted through direct or indirect contact with contaminated persons or objects, such as human faeces, water and medical devices, and is a common cause of antibiotic-resistant infections.
It can accumulate and transfer drug-resistance genes, and can develop into extremely drug resistant (XDR) strains.
Klebsiella pneumoniae can cause infections in the urinary tract, respiratory tract, lungs, wounds, and bloodstream.
It tends to be more common among vulnerable patients in hospital, but new strains have been seen to cause severe infections in healthy individuals.
The World Health Organisation (WHO) said: “Klebsiella pneumoniae strains that can cause severe infections in healthy individuals and have been identified with increasing frequency in recent years are considered hypervirulent compared to classical strains because of their ability to infect both healthy and immunocompromised individuals and because of their increased tendency to produce invasive infections.”
To prevent infection, health officials recommend people wash their hands:
- Before preparing or eating food
- Before touching their eyes, nose or mouth
- Before and after changing wound dressings or bandages
- After using the toilet
- After blowing their nose, coughing or sneezing
- After touching hospital surfaces, such as bed rails, bedside tables, door handles, remote controls, or phones
Source: WHO and CDC
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