The emergence of multidrug-resistant bacteria poses a significant threat to global public health. A recent study published in The Lancet Microbe highlighted a case of Klebsiella pneumoniae, a bacterium isolated from an 86-year-old woman with a urinary infection in Brazil’s Northeast region. This particular strain of Klebsiella pneumoniae was found to be resistant to all available antibiotics, leading to the patient’s death just 24 hours after being hospitalized.
Researchers sequenced the bacterium’s genome and discovered that it shared similarities with strains previously detected in the United States. This suggests that the multidrug-resistant strain has the potential to spread globally. Nilton Lincopan, a professor at the University of São Paulo’s Biomedical Sciences Institute, expressed concern over the bacterium’s adaptability and ability to acquire resistance mechanisms that render existing drugs ineffective.
Lincopan oversees the One Health Brazilian Resistance (OneBR) database, which contains data on critical priority pathogens identified by the World Health Organization. These pathogens have limited treatment options and require containment measures to prevent further dissemination. The OneBR database currently houses 700 genomes of human and animal pathogens, aiding in the surveillance and control of multidrug-resistant bacteria.
Healthcare facilities are urged to report the detection of multidrug-resistant strains to local authorities and take necessary precautions to prevent transmission. Patients infected with such bacteria must be isolated, and healthcare workers must implement strict infection control measures to protect other patients.
Klebsiella pneumoniae, known as an opportunistic pathogen, can cause severe infections in individuals with weakened immune systems. In hospital settings, patients in intensive care units or undergoing treatment for other conditions are at a higher risk of acquiring secondary infections. Preventing the spread of multidrug-resistant bacteria is crucial to safeguarding public health and preserving the efficacy of existing antibiotics. The COVID-19 pandemic has not only brought about challenges in terms of the virus itself, but it has also led to an increase in multidrug-resistant bacteria, posing a serious threat to public health. One such bacterium that has been on the rise is Klebsiella pneumoniae, known for its ability to develop resistance to multiple antibiotics.
Researchers have observed a rapid increase in pan-beta-lactam-resistant K. pneumoniae strains co-producing carbapenemases across Latin America and the Caribbean during the pandemic. Carbapenemases are enzymes that render most antimicrobial compounds ineffective, while beta-lactams are the most commonly used class of antibiotics. This alarming trend prompted the Pan American Health Organization (PAHO) and the World Health Organization (WHO) to issue an epidemiological alert.
A recent global genomic analysis conducted by a team led by Fábio Sellera from the Metropolitan University of Santos (UNIMES) in Brazil revealed a significant growth in multidrug-resistant bacteria, particularly K. pneumoniae strains. This underscores a new resistance trend that poses a grave threat to public health.
In response to the emergence of these drug-resistant strains, the United States Food and Drug Administration (FDA) approved an antibiotic called ceftazidime/avibactam in 2015. This combination of a third-generation cephalosporin with a beta-lactamase inhibitor has shown efficacy in treating K. pneumoniae strains producing carbapenemases. This antibiotic was also approved by ANVISA in Brazil in 2018 due to the high prevalence of KPC infections in the country.
However, the increased hospitalization of COVID-19 patients with secondary infections caused by these drug-resistant bacteria has led to a surge in the use of ceftazidime/avibactam, potentially fueling the emergence of strains resistant to this antibiotic. As a result, KPC-producing strains have evolved rapidly, becoming resistant to the latest therapeutic options available.
To combat the spread of drug-resistant bacteria, researchers emphasize the importance of continuous monitoring of pathogenic strains in hospitals and the rational prescribing of antibiotics. Patients are also advised to adhere to the full course of treatment prescribed by healthcare providers, even if they start feeling better before completing the regimen. This practice can help prevent the emergence of more drug-resistant strains and preserve the effectiveness of available antibiotics.
The findings of this study were published with Felipe Vásquez Ponce, a Ph.D. candidate at ICB-USP, as the first author. As the global healthcare community grapples with the challenges posed by the COVID-19 pandemic, it is crucial to address the growing threat of multidrug-resistant bacteria and take proactive measures to safeguard public health.
