3 years ago

Management of KPC-Producing Klebsiella pneumoniae Infections

Klebsiella pneumoniae carbapenemase (KPC)-producing K. pneumoniae (KPC-KP) has become one of the most important contemporary pathogens, especially in endemic areas. Aims our aim was to provide practical suggestion for physicians dealing with the management of KPC-KP infections in critically ill patients, based on expert opinions. Sources PubMed search for relevant publications related to the management of KPC-KP infections. Contents a panel of experts developed a list of 12 questions to be addressed. In view of the current lack of high-level evidence, they were asked to provide answers based on their knowledge and experience in the field. The panel identified several key aspects to be addressed when dealing with KPC-KP in critically-ill patients (preventing colonization in the patient, preventing infection in the colonized patient and colonization of his/her contacts, reducing mortality in the infected patient by rapidly diagnosing the causative agent and promptly adopting the best therapeutic strategy) and provided related suggestions on the basis the available observational literature and the experience of panel members. Implications Diagnostic technologies could speed-up the diagnosis of KPC-KP infections. Combination treatment should be preferred to monotherapy in the case of severe infections. For non-critically-ill patients without severe infections, results from randomized clinical trials are needed for ultimately weighing benefits and costs of using combinations rather than monotherapy. Multifaceted infection-control interventions are needed to decrease the rates of colonization and cross-transmission of KPC-KP.

Publisher URL: www.sciencedirect.com/science

DOI: S1198743X17304998

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