Clinical and Public Health Microbiology

Drug-Resistant and Hypervirulent Strain of Klebsiella Pneumonia Emerges in China

Doctors in Hangzhou in southeastern China have been struggling with a new type of Klebsiella pneumoniae since 2016, and want to warm clinicians around the world to look out for it and for other multiple-threat strains of bacteria that may be emerging.

The bacterium is a fusion of extremely drug-resistant and extremely virulent strains of Klebsiella that Chinese scientists had feared might combine someday.  The new organism can resist every antibiotic available in China and progresses very fast, starting in the lungs and spreading to other organs, like the liver.  The virulent strain is currently widespread in Chinese hospitals.

At the moment, the bacterium is called carbapenem-resistant [CRE], hypervirulent K. pneumoniae.

The first outbreak killed five people in an intensive care unit in Hangzhou.  “This fatal outbreak happened in a brand-new hospital with very good hygiene,” said microbiologist Sheng Chen, of the Hong Kong Polytechnic University, who co-led the study.  “Drug-resistant strains shouldn’t have appeared so quickly.”  All the Hangzhou victims were 53 or older, on ventilators after major surgery, and died from severe lung failure, multiorgan failure, or septic shock.  Because the new bacterium cannot be cured in China, the only strategy healthcare professionals have is to identify outbreaks quickly and isolate the victims until they either die or recover.

“The study describes an alarming evolutionary event,” said epidemiologists Liang Chen and Barry Kreisworth of Rutgers University who commented on the article in the journal.

“Failure to control its early spread right now will make a global epidemic hard to avoid,” the researchers concluded.

For more information, go to the August 29 issue of The Lancet Infectious Diseases