New research from NYC Health + Hospitals shows concerning changes in the prevalence and epidemiology of carbapenem-resistant Klebsiella pneumoniae infections.
Researchers identified 509 patients treated for the infections at the New York City-based health system between Jan. 1, 2016, and June 30, 2022, using data from the CDC's National Healthcare Safety Network. Researchers also reviewed patients' medical records to determine where they were admitted from. The study was published Sept. 20 in Emerging Infectious Diseases.
Three takeaways:
1. Carbapenem-resistant K. pneumoniae infections steadily fell between 2016 and 2020 before increasing in late 2021 and early 2022 amid the pandemic, researchers said.
2. Fifty-one percent of all infections were considered community-onset, which researchers called a surprising and "disconcerting" trend.
"[Thirty-one percent] of patients with community-onset isolates lived at home, were not on hemodialysis and had not been recently hospitalized," researchers said. "Previous studies have indicated cases of community-onset [carbapenem-resistant Enterobacterales] are rather unusual, accounting for [about 10 percent] of cases."
3. Researchers also found the mechanism behind antibiotic resistance in these bacteria is changing, making some cases harder to treat.
"The number of community-onset cases, the increasing overall numbers, and the emergence of NDM-possessing carbapenem-resistant K. pneumoniae identified in this study are concerning," the authors wrote. "Aggressive and universal surveillance and isolation measures involving both acute-care and long-term care facilities … will likely be needed to control further spread of these pathogens."