Emergence of Infections due to a Polymyxin B–Resistant KPC-2-Producing Klebsiella pneumoniae in Critically Ill Patients: What Is the Role of a Previous Colonization?

Increase in Prevalence of KPC-2–Producing Klebsiella pneumoniae Recovered From Respiratory Secretions of Intensive Care Patients—Getting a Free Ride on a Menacing Colistin Resistance

“…baumannii , which contribute ~33.5% and 97.5% of carbapenem resistance, respectively; these isolates were more prevalent from respiratory secretions of ICU patients during the same evaluated period. As previously reported by Lee et al, 9 the emergence of colistin resistance among KPC-2- Kp isolates, which was also found in this study, may be explained by acquisition and development of resistance in the same isolate initially susceptible, or reinfection with a resistant isolate from a heterogeneous bacterial population under antibiotic selective pressure, as previously shown for fosfomycin 10 or polymyxin B when rectal surveillance KPC-2- Kp isolates were evaluated 6 . Although the impact of the presence of KPC on patient outcome has not been evaluated in this study, interest in the early diagnosis and prompt treatment of airway infections is growing, particularly concerning multidrug-resistant pathogens, such as KPC-producers, in the effort to reduce rates of inappropriate empirical therapy 7…”

Know Thy Self, Know Thy Enemy: A Current Survey and a Forecast for KPC-Producing Klebsiella pneumoniae Resistance Among Inpatients in Southern Brazil

“…In addition, despite the current low resistance rates presented to AK and TGC, only in some specific site-related infections has their effectiveness been proven. Thus, as previously shown, the high rate of PMB-resistance seems to be independently associated with its use in clinical practice 2 6 …”

mgrB Mutations Mediating Polymyxin B Resistance in Klebsiella pneumoniae Isolates from Rectal Surveillance Swabs in Brazil

“…However, there have been few reports assessing data on PRKP carriage in patients around the world (2). Some studies have described a remarkable and concerning number of patients who developed infection by PRKP after previous colonization, resulting in elevated mortality rates (3,4). Colonization by KPCproducing K. pneumoniae and polymyxin therapy are considered important risk factors for PRKP infection (5,6).…”