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      The real threat of Klebsiella pneumoniae carbapenemase-producing bacteria.

      The Lancet Infectious Diseases
      Bacterial Proteins, metabolism, Carbapenems, pharmacology, Drug Resistance, Multiple, Bacterial, Enterobacteriaceae, drug effects, enzymology, Humans, Klebsiella Infections, drug therapy, epidemiology, microbiology, Klebsiella pneumoniae, beta-Lactamases

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          Abstract

          From early this decade, Enterobacteriaceae that produce Klebsiella pneumoniae carbapenemases (KPC) were reported in the USA and subsequently worldwide. These KPC-producing bacteria are predominantly involved in nosocomial and systemic infections; although they are mostly Enterobacteriaceae, they can also be, rarely, Pseudomonas aeruginosa isolates. KPC beta lactamases (KPC-1 to KPC-7) confer decreased susceptibility or resistance to virtually all beta lactams. Carbapenems (imipenem, meropenem, and ertapenem) may thus become inefficient for treating enterobacterial infections with KPC-producing bacteria, which are, in addition, resistant to many other non-beta-lactam molecules, leaving few available therapeutic options. Detection of KPC-producing bacteria may be difficult based on routine antibiotic susceptibility testing. It is therefore crucial to implement efficient infection control measures to limit the spread of these pathogens.

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